Shoji Tomoda

Clinical Evaluation of the Q-Tip Test in Normal Pregnant Women

The crisis frequency of stress incontinence (SI) is known to be high among pregnant women. This preliminary study was performed to determine whether the diagnostic standard of the Q-tip test used in the diagnosis of SI in nonpregnant women is applicable to pregnant women. The Q-tip tests were performed regularly during pregnancy and after parturition on primipara (n = 71) and multipara (n = 55) who were not in SI crisis at any time during the pregnancy. The values measured in multipara were significantly higher than in primipara (p = 0.0001), and the tendency to be higher was more prominent at 2–5 months and 10 months of pregnancy. These findings show that different normal values of the Q-tip test are necessary for primipara and multipara.

Sevoflurane anesthesia for elective cesarean section

Sevoflurane anesthesia was given to sixteen women who had been scheduled for elective cesarean section. The maternal systolic blood pressure significantly decreased during the anesthesia induction. Both the anesthesia induction and emergence were smooth and rapid. These findings were supported partially by the pharmacokinetic analysis of sevoflurane concentration in the maternal artery and expired gas mixture. Spontaneous uterine contractions were good in 12 patients, fair in two and poor in two. The measured blood loss was 752±257 ml including amniotic fluid. No blood transfusion was given to any patient. The median value of the Apgar score at one minute was seven (range three to nine). No neonate was intubated for resuscitation. No abnormal maternal laboratory data were found, including liver and kidney function tests and blood cell counts one week after the operation. No adverse effect of sevoflurane on the neonate was found one week after the delivery and three months after the discharge.