Delayed Childbirth Associated With Increased Cesarean Section Need And Impaired Uterine Tissue Contraction

Impaired contraction of womb could be a contributor to association between older maternal age and increased rate of cesarean sections, according to a study released on June 30, 2008 in open access journal PLoS Medicine . A cesarean section, sometimes also called a c-section, is a method of childbirth in which newborn is surgically removed from uterus. C-sections are associated with higher mortality and morbidity rates than vaginal deliveries, and are thus often reserved for cases in which vaginal birth could put mother's or baby's life at risk. The rate of cesarean section performance has increased considerably in last 20 to 30 years in developed world, which could have implications for not just mother and baby but also healthcare providers and policy makers. According to World Health Organization ( WHO ) , acceptable cesarean rates are between 10-15% in any given developed countries. In light of this, they report following rates: 20% in United Kingdom in 2004, 22. 5% in Canada in 2001 and 2002, 30. 2% in the United States in 2005. Earlier studies indicate that increased maternal age generally increases rate of cesarean performance, and this trend has been shown in many different countries. However, the reason for this association is unclear, and it's unknown to what extent this association is true. These questions were tacked in a two part study run by Professor Gordon Smith and colleagues at Cambridge University in United Kingdom. In first part of the study, a large set of data taken in Scotland, known as the�Scottish Morbidity Record ( SMR2 ) was used to examine association between maternal age and outcome of labor. The records, taken between 1980 and 2005, comprised half of a million records. Specifically, they examined what proportion of increase in c-section rates could be directly associated with a change in maternal age distribution. It was found that risk of a cesarean section increased linearly as age of expectant first time mother increased. Over time, additional trends were observed in proportion of women in age group: number of women between 30 and 34 years increased three-fold, between 35 and 39 years increased seven-fold, and over 40 doubled. IT was estimated that approximately 38% of these additional cesarean surgeries could have been vaginal births if age distribution had remained constant after 1980. The team concluded from this that a sizable portion of the cesarean section rate increase could be due to delaying first childbirth in a woman's life. In second part of the study, samples of muscle from wall of the uterus itself, known as myometrium, that were taken during routine surgery to examine the correlation between muscle contractility and maternal age. The team hypothesized that it was this loss of ability of muscle to contract, a biological effect of aging, was a cause of increased need for cesarean sections. The biopsies were taken from 62 women, with a variety of number of previous births, who were undergoing routine elective cesarean delivery. They found that impaired uterine function was indeed associated with age as based on the type of contraction and ability of muscle tissue to contract. In conjunction, article states, these studies indicate that the trend of advanced maternal age isn't just associated with increased cesarean sections, but that this substantial increase in cesareans could potentially be caused by a decreased ability of uterus to function. Further work is necessary to determine if this causal relationship is indeed true, but if explained, could help health care professionals and policy makers make decisions that could reduce population cesarean rates with minimal negative effects on maternal and infant outcomes. About PLoS Medicine PLoS Medicine is an open access, freely available international medical journal. It publishes original research that enhances our understanding of human health and disease, together with commentary and analysis of important global health issues. For more information, visit http: //www. plosmedicine. org. About Public Library of Science The Public Library of Science ( PLoS ) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit http: //www. plos. org. The effect of delaying childbirth on primary cesarean section rates. Smith GCS, Cordeaux Y, White IR, Pasupathy D, Missfelder-Lobos H, et al. PLoS Med 5 ( 7 ) : e144. doi: 10. 1371/journal. pmed. 0050144. Click Here For Full Length Article Written by Anna Sophia McKenney Copyright: Medical News Today Not to be reproduced without permission of Medical News Today

Plastic surgery clinic at the heart Europe

What you have to know before use Zolpidem.

Zolpidem: uses

Zolpidem is used to treat sleep problems ( insomnia ) . It may help we fall asleep faster, stay asleep longer, and reduce the number of times we awaken during night. Zolpidem belongs to a class of drugs called sedative/hypnotics. It acts on your brain to produce a calming effect.

Zolpidem: how to use

Read the Patient Information Leaflet provided by your pharmacist before we start using Zolpidem and each time we get a refill. If we have any questions regarding information, consult your doctor or pharmacist.

Take Zolpidem by mouth, usually once nightly immediately before bedtime on an empty stomach, or as directed by your doctor. Do not take it with food because effect of medication will be delayed.

Swallow Zolpidem whole. Do not crush, chew, or break Zolpidem. Doing so can destroy long action of drug and may increase side effects.

Dosage is based on your medical condition, age, and response to therapy.

Although unlikely, Zolpidem can infrequently cause temporary memory loss. To avoid this effect, do not take a dose of Zolpidem unless you have time for a full night's sleep that lasts at least 7-8 hours. For example, don't take Zolpidem during an overnight plane flight of less than 8 hours.

Zolpidem may cause dependence, especially if it has been used regularly for an extended period of time, or if it has been used in high doses. In such cases, if we suddenly stop Zolpidem, withdrawal reactions may occur while use Zolpidem. Such reactions can include nausea, vomiting, flushing, stomach cramps, nervousness, or shakiness. Report any such reactions to your doctor immediately. When stopping extended, regular treatment with Zolpidem, gradually reducing the dosage as directed will help prevent withdrawal reactions. Consult your doctor or pharmacist for more details.

Though it's very unlikely to occur, Zolpidem can also result in abnormal drug-seeking behavior ( addiction/habit-forming ) . Do not increase your dose, take it more frequently or use it for a longer period of time than prescribed. Properly stop medication when so directed. This will lessen chances of becoming addicted.

When used for an extended period, Zolpidem may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.

You may have trouble sleeping first few nights after you stop taking Zolpidem. This is called rebound insomnia and it's normal. It'll usually go away after 1-2 nights. If this effect continues, contact your doctor.

Inform your doctor if your condition persists or worsens after 7-10 days.

Zolpidem: side effects

Dizziness, lightheadedness, headache, upset stomach, diarrhea, and dry mouth may occur while use Zolpidem. To minimize the risk of falls, remember to get up slowly when rising from a seated or lying position. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Zolpidem may make you sleepy during day. Tell your doctor if you have daytime drowsiness. Your dose may need to be adjusted.

Remember that your doctor has prescribed Zolpidem because he or she has judged that the benefit to you is greater than risk of side effects. Many people using Zolpidem don't have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur:

Tell your doctor immediately if any of these rare but very serious side effects occur:

Rarely, after taking Zolpidem, people have gotten out of bed and driven vehicles while not fully awake ( " sleep-driving " ) . People have also sleepwalked, prepared/eaten food, made phone calls, or had sex while not fully awake. Often, these people don't remember these events. If we discover that we have experienced any of these events, tell your doctor immediately.

A very serious allergic reaction to Zolpidem is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

This isn't a complete list of possible side effects. If we notice other effects not listed above, contact your doctor or pharmacist.

Zolpidem: precautions

Before taking Zolpidem, tell your doctor or pharmacist if you're allergic to it; or if we have any other allergies.

Before using Zolpidem, tell your doctor or pharmacist your medical history, especially of:

Zolpidem may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Avoid alcoholic beverages because they may increase risk of Zolpidem's side effects.

Caution is advised when using Zolpidem in children because they may be more likely to experience hallucinations, especially if they have attention deficit disorder ( ADD ) or attention deficit hyperactivity disorder ( ADHD ) .

The elderly may be more sensitive to the effects of this drug, especially dizziness and excessive drowsiness.

Zolpidem should be used only when clearly needed during pregnancy. Infants born to mothers who have taken sedative/hypnotic drugs near time of delivery may have undesirable effects such as withdrawal symptoms. Discuss risks and benefits with your doctor.

A small amount of Zolpidem passes into breast milk. Consult your doctor before breast-feeding.

Zolpidem: interactions

Your healthcare professionals ( e. g. , doctor or pharmacist ) may already be aware of any possible drug interactions and may be monitoring we for it. Don't start, stop or change the dosage of any medicine before checking with them first.

Zolpidem shouldn't be used with the following medication because a very serious interaction may occur while use Zolpidem:

If we are currently using any of these medications listed above, tell your doctor or pharmacist before starting Zolpidem.

Before using Zolpidem, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines ( e. g. , diphenhydramine ) , anti-seizure drugs ( e. g. , carbamazepine ) , medicine for anxiety ( e. g. , alprazolam, diazepam ) , muscle relaxants, narcotic pain relievers ( e. g. , codeine ) , psychiatric medicines ( e. g. , chlorpromazine, risperidone, amitriptyline, trazodone ) .

Check the labels on all your medicines ( e. g. , cough-and-cold products ) because they may contain ingredients that cause drowsiness. Ask your pharmacist about safe use of those products.

This document does not contain all possible interactions. Therefore, before using Zolpidem, tell your doctor or pharmacist of all products we use. Keep a list of all your medications with you, and share list with your doctor and pharmacist.

Zolpidem: overdose

If overdose of Zolpidem is suspected, contact your local poison control center or emergency room immediately. US residents can call US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include slowed breathing or a deep sleep from which we can't be awakened.

Zolpidem: notes

Don't share Zolpidem with others. It is against the law.

Usually, insomnia is temporary and requires sleep medication only for a short time. If we require treatment for more than 2 weeks, laboratory and/or medical tests should be performed to find cause of your sleep problem.

As we get older, your sleep pattern may naturally change and your sleep may be interrupted several times during night. Consult your doctor or pharmacist for ways to improve your sleep without medication, such as avoiding caffeine and alcohol close to bedtime, avoiding daytime naps, and going to bed at same time each night.

Zolpidem: missed dose

If we miss a dose Zolpidem, take it as soon as we remember if it's still near bedtime and we have trouble falling asleep. If it's already next day, resume your usual dosing schedule that night at bedtime. Do not double dose to catch up.

Zolpidem: storage

Store Zolpidem at room temperature between 59-77 degrees F ( 15-25 degrees C ) . Brief storage up to 86 degrees F ( 30 degrees C ) is permitted. Don't store in the bathroom. Keep all medicines away from children and pets.

Properly discard Zolpidem when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Zolpidem with US shipping

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