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Sample records for america classifying caesarean

  1. WHO Global Survey on Maternal and Perinatal Health in Latin America: classifying caesarean sections

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    Faúndes Anibal

    2009-10-01

    Full Text Available Abstract Background Caesarean section rates continue to increase worldwide with uncertain medical consequences. Auditing and analysing caesarean section rates and other perinatal outcomes in a reliable and continuous manner is critical for understanding reasons caesarean section changes over time. Methods We analyzed data on 97,095 women delivering in 120 facilities in 8 countries, collected as part of the 2004-2005 Global Survey on Maternal and Perinatal Health in Latin America. The objective of this analysis was to test if the "10-group" or "Robson" classification could help identify which groups of women are contributing most to the high caesarean section rates in Latin America, and if it could provide information useful for health care providers in monitoring and planning effective actions to reduce these rates. Results The overall rate of caesarean section was 35.4%. Women with single cephalic pregnancy at term without previous caesarean section who entered into labour spontaneously (groups 1 and 3 represented 60% of the total obstetric population. Although women with a term singleton cephalic pregnancy with a previous caesarean section (group 5 represented only 11.4% of the obstetric population, this group was the largest contributor to the overall caesarean section rate (26.7% of all the caesarean sections. The second and third largest contributors to the overall caesarean section rate were nulliparous women with single cephalic pregnancy at term either in spontaneous labour (group 1 or induced or delivered by caesarean section before labour (group 2, which were responsible for 18.3% and 15.3% of all caesarean deliveries, respectively. Conclusion The 10-group classification could be easily applied to a multicountry dataset without problems of inconsistencies or misclassification. Specific groups of women were clearly identified as the main contributors to the overall caesarean section rate. This classification could help health care

  2. Understanding the factors associated with differences in caesarean section rates at hospital level: the case of Latin America.

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    Taljaard, Monica; Donner, Allan; Villar, José; Wojdyla, Daniel; Faundes, Anibal; Zavaleta, Nelly; Acosta, Arnaldo

    2009-11-01

    As in many other regions of the world, caesarean section (CS) rates in Latin America are increasing. Studies elsewhere have shown that providing feedback to caregivers regarding their own performance relative to their peers can significantly reduce the rates. Our objectives are to calculate risk-adjusted CS rates for hospitals in Latin America and to identify factors associated with differences among risk-adjusted rates. We included 120 randomly selected institutions in eight countries of Latin America, representing 97 095 pregnancies. We used random-effects models to calculate a risk-adjusted rate for each hospital and to identify hospitals significantly higher or lower than a benchmark rate. We conducted a regression analysis to identify characteristics of hospitals associated with differences among risk-adjusted rates. The overall CS rate was 35%, ranging from 0% to 85%. Risk-adjusted CS rates ranged from 11% to 78%. Three-quarters of hospitals had risk-adjusted rates significantly above the previously identified benchmark of 20%. Characteristics of institutions explained 48% of the variability among risk-adjusted rates, including being a private as opposed to a public institution, having some economic incentive for CS as opposed to no incentive, and having > or = 50 maternity beds. Strategies to halt further increases in CS rates and reduce rates to levels that reflect the best quality of care, are urgently needed worldwide. The involvement of local quality control departments is an essential component in achieving success. Our results can be used to identify institutions that can be targets for further interventions to reduce CS rates.

  3. Court-ordered caesareans.

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    Prochaska, Elizabeth; Lomri, Sara

    2014-11-01

    Court-ordered caesarean sections are in the news after a number of recent legal decisions authorising surgery for women who lack mental capacity to consent. The decisions have not always been based on good evidence and they raise serious concerns about the protection of the rights of mentally ill women. The authors explain the legal process and question the wisdom of recent judgements.

  4. Caesarean section: an historical riddle.

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    Majumdar, S K

    2001-01-01

    Etymologically, the word 'Caesar' originates from the Latin word 'Caedaere' meaning - 'to cut'. So cutting remains the core point, but little is known about the real origin of the history of Caesarean Section. There is evidence that, the ancient Hindus excelled in surgery and many operations were performed, including caesarean section. This operation was mentioned several times in the Mishnah of Rabbi Judah, the first large commentary on the Hebrew Bible. There are also several mythological anecdotes in Hindu, Buddhist and Greek mythologies. The myth of caesarean section did not even escape the keen eyes of William Skakespeare. The landmarks, treatises and the advancement in this operative procedure are presented in this article.

  5. Neonatology and the caesarean section.

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    Zanini, R; Minghetti, D

    2012-10-01

    The origins of the use of the Caesarean section date far back in human history. Traces of this procedure can be found in Greek mythology and in the history of Ancient Rome. Many documents about the history of religion make reference to a delivery from the abdomen.

  6. User fee exemptions and equity in access to caesarean sections: an analysis of patient survey data in Mali

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    El-Khoury Marianne

    2012-08-01

    Full Text Available Abstract Introduction Little rigorous evidence exists on how health service utilization varies across socioeconomic groups after a user fee exemption policy has been implemented, and the evidence that does exist is mixed. In this paper, we estimate the distribution of caesarean section deliveries across socioeconomic groups following Mali’s implementation of a fee exemption policy for caesareans in 2005. Methods We conducted a patient survey in 2010 to collect socioeconomic data from 2,477 women who had caesareans in a representative sample of 25 facilities across all regions of Mali. We used these data along with data from the most recent Demographic and Health Survey to construct a wealth index and classify women into population-based wealth groupings. We compared the wealth distribution of women delivering via caesarean section to that of a nationally representative sample of women giving birth. Results We found that wealthier women make up a disproportionate share of those having free caesareans, five years after implementation of the fee exemption policy. Women in the richest two quintiles accounted for 58 percent of all caesareans, while women in the poorest two quintiles accounted for 27 percent of all caesareans. Fewer women in the poorest two-fifths of the population are receiving caesareans than what we would expect given their share in the population of women giving birth. Conclusions While fee exemptions remove important financial barriers to accessing priority maternal health services, they are insufficient to ensure equal access among wealth groups.

  7. Induced vaginal birth after previous caesarean section

    OpenAIRE

    Akylbek Tussupkaliyev; Andrey Gayday; Bibigul Karimsakova; Saule Bermagambetova; Lunara Uteniyazova; Guldana Iztleuova; Gulkhanym Kusherbayeva; Meruyert Konakbayeva; Assylzada Merekeyeva; Zamira Imangaliyeva

    2016-01-01

    Introduction The rate of operative birth by Caesarean section is constantly rising. In Kazakhstan, it reaches 27 per cent. Research data confirm that the percentage of successful vaginal births after previous Caesarean section is 50–70 per cent. How safe the induction of vaginal birth after Caesarean (VBAC) remains unclear. Methodology The studied techniques of labour induction were amniotomy of the foetal bladder with the vulsellum ramus, intravaginal administra...

  8. A STUDY OF VAGINAL BIRTH AFTER CAESAREAN

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    Ratana

    2015-06-01

    Full Text Available OBJECTIVE : To evaluate the efficacy and safety of attempted VBAC with a view to decrease the incidence of caesarean section . METHOD S : A prospective study is carried out on women with one previous LSCS for a non - recurrent cause attending ANC & labour room of RIMS for 2 years from 1 st Aug 2007 to 31 st July 2009. RESULTS : 100 eligible PCS women agreed to undergo trial of labour. Of these 50 delivered vaginally and the remaining 50 had to undergo emergency repeat caesarean section due to fetal distress, scar tenderness o r non - progress of labour resulting in a VBAC rate of 50%. CONCLUSION : A trial of labour in cases of previous caesarean section is the way to reduce the overall caesarean section rate. Physicians need to discuss the risks and benefits of VBAC following tria l of labour or elective repeat caesarean section with patients and patients’ choices must be considered.

  9. Women's perceptions of caesarean birth: a Roy international study.

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    Fawcett, Jacqueline; Aber, Cynthia; Haussler, Susan; Weiss, Marianne; Myers, Sheila Taylor; Hall, Jaye L; Waters, V Lynn; King, Charlette; Tarkka, Marja-Terttu; Rantanen, Anja; Astedt-Kurki, Paivi; Newton, Jennifer; Silva, Virginia

    2011-10-01

    The purpose of this Roy adaptation model-based multi-site international mixed method study was to examine the relations of type of caesarean birth (unplanned/planned), number of caesarean births (primary/repeat), and preparation for caesarean birth to women's perceptions of and responses to caesarean birth. The sample included 488 women from the United States (n = 253), Finland (n = 213), and Australia (n = 22). Path analysis revealed direct effects for type of and preparation for caesarean birth on responses to caesarean birth, and an indirect effect for preparation on responses to caesarean birth through perception of birth the experience.

  10. An audit of caesarean sections for very low birth weight babies.

    LENUS (Irish Health Repository)

    Khalifeh, A

    2012-02-01

    This study reviewed caesarean sections for very low birth weight babies in a tertiary referral maternity hospital. Maternal and neonatal complications were recorded and classified according to uterine incision type. We reviewed medical records of 89 women over a period of 2 years. The indication for the caesarean section influenced the type of uterine incision made (p = 0.004). Women who had antepartum haemorrhage were more likely to need a vertical incision. There was also a higher incidence of vertical incisions for gestations <28 weeks (p = 0.029). Surprisingly, when the computerised discharge summaries were reviewed retrospectively, all the vertical uterine incisions were recorded as lower segment caesarean sections. This would have a clinical impact on those women in future pregnancies, especially in a highly mobile population.

  11. The effect of distant reiki on pain in women after elective Caesarean section: A double-blinded randomised controlled trial

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    S. van der Vaart (Sondra); H. Berger (Howard); C. Tam (Carolyn); Y.I. Goh (Ingrid); V.M.G.J. Gijsen (Violette); S.N. de Wildt (Saskia); A. Taddio (Anna); G. Koren (Gideon)

    2011-01-01

    textabstractIntroduction: Approximately 25% of all babies in North America are delivered via Caesarean section (C-section). Though a common surgical procedure, C-section recovery can be painful. Opioids, specifically codeine, are commonly used to ease pain; however, its active metabolite, morphine,

  12. Prolonged labour as indication for emergency caesarean section

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    Maaløe, Nanna; Sorensen, B L; Onesmo, R

    2012-01-01

    To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour.......To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour....

  13. Classifying Microorganisms

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    Sommerlund, Julie

    2006-01-01

    This paper describes the coexistence of two systems for classifying organisms and species: a dominant genetic system and an older naturalist system. The former classifies species and traces their evolution on the basis of genetic characteristics, while the latter employs physiological characteris......This paper describes the coexistence of two systems for classifying organisms and species: a dominant genetic system and an older naturalist system. The former classifies species and traces their evolution on the basis of genetic characteristics, while the latter employs physiological...... and integration possible, the field of molecular biology seems to be overwhelmingly homogeneous, and in need of heterogeneity and conflict to add drive and momentum to the work being carried out. The paper is based on observations of daily life in a molecular microbiology laboratory at the Technical University...

  14. Methods of achieving and maintaining an appropriate caesarean section rate.

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    Robson, Michael

    2013-04-01

    Caesarean section rates continue to increase worldwide. The appropriate caesarean section rate remains a topic of debate among women and professionals. Evidence-based medicine has not provided an answer and depends on interpretation of the literature. Overall caesarean section rates are unhelpful, and caesarean section rates should not be judged in isolation from other outcomes and epidemiological characteristics. Better understanding of caesarean section rates, their consequences and their benefits will improve care, and enable learning between delivery units nationally and internationally. To achieve and maintain an appropriate caesarean section rate requires a Multidisciplinary Quality Assurance Programme in each delivery unit, recognising caesarean section rates as one of many factors that determine quality. Women will always choose the type of delivery that seems safest to them and their babies. Professionals need to monitor the quality of their practice continuously in a standardised way to ensure that women can make the right choice.

  15. A Second Trimester Caesarean Scar Pregnancy

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    Pooja Sikka

    2014-01-01

    Full Text Available Caesarean scar pregnancy, where conceptus is implanted on previous scar, is a rare entity. We present one such case of scar pregnancy presenting to us in the second trimester and was managed with methotrexate and uterine artery embolization, followed by hysterotomy. Uterus could be conserved and hysterectomy could be avoided.

  16. Intervention for Postpartum Infections following Caesarean Section

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    Hyldig, Nana; Bille, Camilla; Kruse, Marie;

    Purpose: To examine the effect on wound healing, using Negative Pressure Wound Therapy (NPWT) compared with standard wound dressings in women, who experience spontaneous dehiscence or reoperation due to infection or hematoma after caesarean section. In addition, an analysis of the health economic...

  17. The professional responsibility model of obstetric ethics and caesarean delivery.

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    Chervenak, Frank A; McCullough, Laurence B

    2013-04-01

    In this chapter, we provide an account of the professional responsibility model of obstetric ethics, and identify its implications for two major topics: patient-choice caesarean delivery and trial of labour after caesarean delivery. The professional responsibility model of obstetric ethics is based on the ethical concept of medicine as a profession and the ethical principles of beneficence and respect for autonomy. The obstetrician has beneficence-based and autonomy-based obligations to the pregnant woman and beneficence-based obligations to the fetus when it is a patient. Because the viable fetus is a patient, the ethics of caesarean delivery requires balancing of obligations to the pregnant and fetal patient. The implication of the professional responsibility model for patient-choice caesarean delivery is that the obstetrician should respond to such requests with a recommendation against non-indicated caesarean delivery and for vaginal delivery. These recommendations should be explained and discussed in the informed consent process. It is ethically permissible to implement an informed, reflective decision for non-indicated caesarean delivery. The implication for trial of labour after caesarean delivery is that, in settings properly equipped and staffed, the obstetrician should offer both trial of labour after caesarean delivery and planned caesarean delivery to women who have had one previous low transverse incision. The obstetrician should recommend against trial of labour after caesarean delivery for women with a previous classical incision.

  18. Changing trends in incidence and indications of caesarean section.

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    Khan, A; Ghani, T; Rahim, A; Rahman, M M

    2014-01-01

    Caesarean section is most frequently performed major operation in obstetrics. The rate of caesarean section has been increasing both in developed and developing countries in the past decade. This study was done to find out the change of sociodemographic condition of respondents, identify the different types & rate of caesarean section indications, the outcome of different indications, estimate the rate of caesarean section proportion of the elective & emergency indications and evaluate the complications of caesarean sections. This is a cross-sectional study of randomly selected 130 cases of lower caesarean section done at Sir Salimullah Medical College & Mitford Hospital, Dhaka from March 2006 to August 2006. In this study 80(61.5%) cases underwent emergency caesarean section and in 50(38.5%) cases elective caesarean section had done. Among indications of caesarean section repeat section scores the top of the list. No maternal mortality case recorded in this study. This study shows high incidence of caesarean section which does not reflect the picture of total population of Bangladesh.

  19. Caesarean section in Ancient Greek mythology.

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    Lurie, Samuel

    2015-01-01

    The narrative of caesarean birth appears on several occasions in Greek mythology: in the birth of Dionysus is the God of the grape harvest and winemaking and wine; in the birth of Asclepius the God of medicine and healing; and in the birth of Adonis the God of beauty and desire. It is possible, however not obligatory, that it was not solely a fantasy but also reflected a contemporary medical practice.

  20. Induced vaginal birth after previous caesarean section

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    Akylbek Tussupkaliyev

    2016-11-01

    Full Text Available Introduction The rate of operative birth by Caesarean section is constantly rising. In Kazakhstan, it reaches 27 per cent. Research data confirm that the percentage of successful vaginal births after previous Caesarean section is 50–70 per cent. How safe the induction of vaginal birth after Caesarean (VBAC remains unclear. Methodology The studied techniques of labour induction were amniotomy of the foetal bladder with the vulsellum ramus, intravaginal administration of E1 prostaglandin (Misoprostol, and intravenous infusion of Oxytocin-Richter. The assessment of rediness of parturient canals was conducted by Bishop’s score; the labour course was assessed by a partogram. The effectiveness of labour induction techniques was assessed by the number of administered doses, the time of onset of regular labour, the course of labour and the postpartum period and the presence of complications, and the course of the early neonatal period, which implied the assessment of the child’s condition, described in the newborn development record. The foetus was assessed by medical ultrasound and antenatal and intranatal cardiotocography (CTG. Obtained results were analysed with SAS statistical processing software. Results The overall percentage of successful births with intravaginal administration of Misoprostol was 93 per cent (83 of cases. This percentage was higher than in the amniotomy group (relative risk (RR 11.7 and was similar to the oxytocin group (RR 0.83. Amniotomy was effective in 54 per cent (39 of cases, when it induced regular labour. Intravenous oxytocin infusion was effective in 94 per cent (89 of cases. This percentage was higher than that with amniotomy (RR 12.5. Conclusions The success of vaginal delivery after previous Caesarean section can be achieved in almost 70 per cent of cases. At that, labour induction does not decrease this indicator and remains within population boundaries.

  1. Rising caesarean section rates in public hospitals in Malaysia 2006.

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    Ravindran, J

    2008-12-01

    The caesarean section rate in Malaysian public hospitals has increased to 15.7% from 10.5% in the year 2000. There are inter-state variations in the rate ranging from a high of 25.4% in Melaka to 10.9% in Sabah. The West Coast states generally had a higher caesarean section rate than the East Coast states as well as East Malaysia. It would be prudent for Malaysia to implement stringent caesarean audits to ensure that rising caesarean section rates are kept in check.

  2. OUTCOME OF PREGNANCY IN WOMEN WITH PREVIOUS CAESAREAN SECTION

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    Bellad Girija

    2016-06-01

    Full Text Available BACKGROUND Carefully selected cases of Vaginal Birth after Caesarean Section (VBAC is safe and successful. Even though options of elective caesarean section or a trial of labour are given to women with prior caesarean section, the risk is always present. In successful VBACs, morbidity is less compared to repeat caesarean section. That is why this study is conducted to determine the outcome of pregnancy in women with previous CS. OBJECTIVES 1. To evaluate the clinical course of labour in cases with previous caesarean section. 2. To study the perinatal outcome in cases with previous caesarean section either by vaginal delivery or repeat Caesarean section. 3. To study maternal morbidity in these cases. METHOD A retrospective analysis of medical records of 250 women with a previous caesarean section, who delivered in BIMS Hospital between May 2015 and July 2015 was carried out. Women with recurrent indications for caesarean section and those having nonrecurrent indications with any complicating factors in present pregnancy and women with previous two caesarean sections were not given trial for vaginal delivery. Those women with previous section for the non-recurrent indications were given trial for vaginal delivery. STATISTICAL ANALYSIS Was done by Chi-square test. RESULT In 250 cases, 132 cases were given trial for vaginal delivery. In these, vaginal delivery was 61.3% and repeat section was 38%. There is an association between maternal morbidity and type of delivery. Birth weight was associated with the type of delivery. There is no association between neonatal outcome and type of delivery. CONCLUSION In carefully selected patients, appropriate timing and close supervision, trial of vaginal delivery in previous one caesarean section is safe and successful. Individual approach seems to be the best.

  3. Elective caesarean section at 38 weeks versus 39 weeks

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    Glavind, Julie; Kindberg, S F; Uldbjerg, N;

    2013-01-01

    To investigate whether elective caesarean section before 39 completed weeks of gestation increases the risk of adverse neonatal or maternal outcomes.......To investigate whether elective caesarean section before 39 completed weeks of gestation increases the risk of adverse neonatal or maternal outcomes....

  4. Emergency caesarean section in low risk nulliparous women

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    Haerskjold, Ann; Hegaard, H K; Kjaergaard, H

    2012-01-01

    The rising incidence of caesarean section (CS), including emergency caesarean section (ECS) in nulliparas is of concern. Previous CS may have implications for future pregnancies and deliveries. This article describes the prevalence and indications for ECS in a cohort of low risk nulliparas...

  5. A case of spontaneous tubal pregnancy with caesarean scar pregnancy.

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    Zhu, Jie; Shen, Yue-Ying; Zhao, Yu-Qing; Lin, Ru; Fang, Fang

    2014-01-01

    Tubal pregnancy with caesarean scar pregnancy is rare. Early, accurate diagnosis and treatment for this kind of ectopic pregnancy can lead to a decrease of maternal morbidity and mortality. Here, we report a rare case of spontaneous tubal pregnancy co-existing with caesarean scar pregnancy. After timely emergency laparoscopy and curettage, the patient was cured.

  6. Post operatory analgesia in caesarean surgery.

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    Bárbara Lucía Cabezas Poblet

    2003-12-01

    Full Text Available Background: Post-operatory pain is a spread and constant problem during the care of the surgical patient. The tendency to find new therapeutic techniques to alleviate pain has lead scientists to make and use a great variety of analgesics which are administered by different vias. The effects of narcotics on the new born are well known and the author´s worries about this problem has been the motivational point to search about the use of epidural and intratecal narcotics in the obstetric patient. Objective: To assess the use of peridural liophilized morphine in the Caesarean Section Method: A study of a series of cases was carried out at the Surgical Unit of the Gynecobstetric service of the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from February 2001 to August 2002 . This search included 120 patient who were selected to elective iterative caesarean section The variables under study were blood pressure, pulse and respiration during the pre- trans and post operative phases, onset of the anaesthetic effect and its duration, peri operatory complications , quality of the post operatory analgesia and its effect on the newborn measured by using Apgar values . The statistical procedure was developed by using the statistical package Epi Info 6. Results: The onset of the anesthetic effect and the duration of the anesthesia were not modified with the use of liophilized morphine. Vital signs remained within normal limits in most of the patients during the pre- trans and post operatory phases. The complications were: pruritus, urinary retention, nausea nad vomiting. The quality of the analgesia was satisfactory in most of the patients. The Apgar values were normal in all neonates. Conclusion: The administration of peridural liophilized morphine in elective caesarean sections is a reliable, sure and useful method in our environment.

  7. Thromboprophylaxis for women undergoing caesarean section.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

    Thromboprophylaxis for women undergoing caesarean section (CS) was introduced in the hospital in 1995. This study audited the use of tinzaparin prophylaxis in a nested cohort of women who screened negative for diabetes mellitus at 28 weeks gestation. All the women had their weight measured and BMI calculated at the first antenatal visit. Of the 284 women, 68 (24%) had a CS and all received tinzaparin. Of the 68, however, 94% received a dose lower than recommended. Compliance with prophylaxis was complete but compliance with the recommended dosage was suboptimal, which may result in venous thromboembolism after CS despite thromboprophylaxis.

  8. Speechless after general anaesthesia for caesarean section.

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    Narayanan, Aravind; Tawfic, Qutaiba Amir; Kausalya, Rajini; Mohammed, Ahmed K

    2012-06-01

    'Speechless' patient after general anesthesia may be a real horror for the anaesthetist as well as the patient and his relatives. Whatever the cause "functional or organic" the anaesthetist will be under pressure as his patient is not able to talk. Here we report a 40 years old patient who has no history of medical problems and developed aphemia after general anaesthesia for emergency caesarean section with an uneventful intra-operative course. Clinical examinations and investigations failed to reveal any clear cause and the patient returned her ability to talk and discharged home with normal voice.

  9. Labour and Childbirth After Previous Caesarean Section

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    Reif, P.; Brezinka, C.; Fischer, T.; Husslein, P.; Lang, U.; Ramoni, A.; Zeisler, H.; Klaritsch, P.

    2016-01-01

    The new expert recommendation from the Austrian Society of Obstetrics and Gynaecology (OEGGG) comprises an interpretation and summary of guidelines from the leading specialist organisations worldwide (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate). In essence it outlines alternatives to the direct pathway to elective repeat caesarean section (ERCS). In so doing it aligns with international trends, according to which a differentiated, individualised clinical approach is recommended that considers benefits and risks to both mother and child, provides detailed counselling and takes the patientʼs wishes into account. In view of good success rates (60–85 %) for vaginal birth after caesarean section (VBAC) the consideration of predictive factors during antenatal birth planning has become increasingly important. This publication provides a compact management recommendation for the majority of standard clinical situations. However it cannot and does not claim to cover all possible scenarios. The consideration of all relevant factors in each individual case, and thus the ultimate decision on mode of delivery, remains the discretion and responsibility of the treating obstetrician. PMID:28017971

  10. Caesarean delivery and risk of developing asthma in the offspring

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    Werner, Anette; Ramlau-Hansen, Cecilia Høst; Jeppesen, Simone K;

    2007-01-01

    AIM: To evaluate the association between caesarean section and risk of developing asthma. METHOD: We evaluated this association in a Danish cohort, comprising of 11,147 mothers and their babies of which 7119 mother-child pairs were included in the analyses. The mothers' reported asthma data...... on their children were linked to hospitalization records on mode of delivery. RESULTS: The adjusted odds ratio for developing asthma was 1.11 (95% CI, 0.88-1.39) for caesarean sections versus vaginal births. CONCLUSION: We found no evidence that children being delivered by caesarean section have an increased risk...

  11. Caesarean section and risk of autism across gestational age

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    Yip, Benjamin Hon Kei; Leonard, Helen; Stock, Sarah

    2017-01-01

    BACKGROUND: The positive association between caesarean section (CS) and autism spectrum disorder (ASD) may be attributed to preterm delivery. However, due to lack of statistical power, no previous study thoroughly examined this association across gestational age. Moreover, most studies did...

  12. Inconsistencies in clinical guidelines for obstetric anaesthesia for Caesarean section

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    Winther, Lars; Mitchell, A U; Møller, Ann

    2013-01-01

    Anaesthetists need evidence-based clinical guidelines, also in obstetric anaesthesia. We compared the Danish, English, American, and German national guidelines for anaesthesia for Caesarean section. We focused on assessing the quality of guideline development and evaluation of the guidelines...

  13. Techniques and materials for skin closure in caesarean section

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    Mackeen, A Dhanya; Berghella, Vincenzo; Larsen, Mie-Louise

    2012-01-01

    Caesarean section is a common operation with no agreed upon standard regarding certain operative techniques or materials to use. With regard to skin closure, the skin incision can be re-approximated by a subcuticular suture immediately below the skin layer, by an interrupted suture, or by staples....... A great variety of materials and techniques are used for skin closure after caesarean section and there is a need to identify which provide the best outcomes for women....

  14. Analysis of Caesarean-Section rates according to Robson's ten group classification system and evaluating the indications within the groups

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    Amita Ray

    2017-01-01

    Full Text Available Background: With Caesarean sections on the rise WHO proposes that health care facilities use the Robson's 10 group classification system to audit their C-sections rates. This classification would help understand the internal structure of the CS rates at individual health facilities identify key population groups, indications in each group and formulate strategies to reduce these rates. Methods: This was a cross sectional study for a period of 24 months at a tertiary care hospital in a tribal area of Kerala South India. Women who delivered during this period were included and classified into 10 Robson's classes and percentages were calculated for the overall rate, the representation of groups, contribution of groups and Caesarean percentage in each group. Results: Highest contribution was by Group 5 and Group 2. Together these two groups contributed to 38% of the total Caesareans. Followed by Group 8 and 10. All four added contributed to 63% of the section rate The least contribution was by Group 3. Groups 6, 7 and 9 by themselves did not contribute much but within their groups had a 100% C-Section rate. Conclusions: The contribution of the various Robson's Group to the absolute C-Section rates needs to be looked into. Reducing primary section rates, adequate counselling and encouraging for VBAC, changing the norms for dystocia and non-reassuring fetal status, training and encouraging obstetricians to perform versions when not contraindicated could reduce the contribution of Robson's groups towards the absolute C-Section rates.

  15. Refusal of emergency caesarean section in Ireland: a relational approach.

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    Wade, Katherine

    2014-01-01

    This article examines the issue of emergency caesarean section refusal. This raises complex legal and ethical issues surrounding autonomy, capacity, and the right to refuse treatment. In Ireland, the situation is complicated further by the constitutional right to life of the unborn. While cases involving caesarean section refusal have occurred in other jurisdictions, a case of this nature has yet to be reported in Ireland. This article examines possible ways in which the interaction of a woman's right to refuse treatment and the right to life of the unborn could be approached in Ireland in the context of caesarean section refusal. The central argument of the article is that the liberal individualistic approach to autonomy evident in the caesarean section cases in England and Wales is difficult to apply in the Irish context, due to the conflicting constitutional rights of the woman and foetus. Thus, alternative visions of autonomy which take the interests and rights of others into account in medical decision-making are examined. In particular, this article focuses on the concept of relational consent, as developed by Alasdair Maclean and examines how such an approach could be applied in the context of caesarean section refusal in Ireland. The article explains why this approach is particularly appropriate and identifies mechanisms through which such a theory of consent could be applied. It is argued that this approach enhances a woman's right to autonomy, while at the same time allows the right to life of the unborn to be defended.

  16. Caesarean birth: consumption, safety, order, and good mothering.

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    Bryant, Joanne; Porter, Maree; Tracy, Sally K; Sullivan, Elizabeth A

    2007-09-01

    This article draws on qualitative data to explore the beliefs through which decisions about caesarean birth are made and to consider how these might contribute to the increasing rate of caesarean birth. A total of 36 interviews were conducted in Australia, including 12 hospital-based midwives, 6 obstetricians, and 18 women who had experienced caesarean birth within the 2 years prior to the research interview. Data reveal a belief derived from the pervasive discourse of neo-liberalism that women are self-governing autonomous subjects in their birth experience, with entitlement to the consumption of birthing information and services, as guided by obstetricians. Feeding into this belief are coexisting discourses that serve to organise 'free choice' in terms of safe/unsafe, order/disorder, life/death; and with ontological meanings, by structuring women's mothering identities as good/bad. The neo-liberal obligation to manage risk and pursue success for both mothers and babies means that women (and others) are obliged to choose what is set up as the most obvious and sensible option: safe, ordered caesareans. The structuring of discourses in this way shows how caesareans can be positioned as a preferential means of birth.

  17. Caesarean section may have long-term consequences for both mother and child

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Krebs, Lone; Lykke, Jacob A

    2014-01-01

    The rate of caesarean section is increasing worldwide. There is scientific evidence that caesarean sections have long-term consequences in consecutive pregnancies and for mother and child. This article reviews these consequences. When consulting women before decision on mode of delivery...... it is encouraged that all these issues are taken into account and balanced to the benefits of having a caesarean section....

  18. Study of obstetric and fetal outcome of post caesarean pregnancy

    Directory of Open Access Journals (Sweden)

    Akanksha Nigam

    2015-02-01

    Conclusions: With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper antenatal counseling regarding VBAC and a well-defined management protocol in place in an effort to increase the number of VBACs and bring down the overall caesarean rates. Patients with a history of prior vaginal delivery have an increased likelihood for a successful VBAC. A successful VBAC is associated with a lower perinatal and maternal morbidity than repeat caesarean delivery, and this is relevant for counseling women about their choices after a caesarean delivery. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 215-218

  19. At what price? A cost-effectiveness analysis comparing trial of labour after previous Caesarean versus elective repeat Caesarean delivery.

    LENUS (Irish Health Repository)

    Fawsitt, Christopher G

    2013-01-01

    Elective repeat caesarean delivery (ERCD) rates have been increasing worldwide, thus prompting obstetric discourse on the risks and benefits for the mother and infant. Yet, these increasing rates also have major economic implications for the health care system. Given the dearth of information on the cost-effectiveness related to mode of delivery, the aim of this paper was to perform an economic evaluation on the costs and short-term maternal health consequences associated with a trial of labour after one previous caesarean delivery compared with ERCD for low risk women in Ireland.

  20. An overview of the health economic implications of elective caesarean section.

    Science.gov (United States)

    Petrou, Stavros; Khan, Kamran

    2013-12-01

    The caesarean section rate has continued to increase in most industrialised countries, which raises a number of economic concerns. This review provides an overview of the health economic implications of elective caesarean section. It provides a succinct summary of the health consequences associated with elective caesarean section for both the infant and the mother over the perinatal period and beyond. It highlights factors that complicate our understanding of the health consequences of elective caesarean section, including inconsistencies in definitions and coding of the procedure, failure to adopt an intention-to-treat principle when drawing comparisons, and the widespread reliance on observational data. The paper then summarises the economic costs associated with elective caesarean section. Evidence is presented to suggest that planned caesarean section may be less costly than planned vaginal birth in some clinical contexts, for example where the singleton fetus lies in a breech position at term. In contrast, elective caesarean section (or caesarean section as a whole) appears to be more costly than vaginal delivery (either spontaneous or instrumented) in low-risk or unselected populations. The paper proceeds with an overview of economic evaluations associated with elective caesarean section. All are currently based on decision-analytic models. Evidence is presented to suggest that planned trial of labour (attempted vaginal birth) following a previous caesarean section appears to be a more cost-effective option than elective caesarean section, although its cost effectiveness is dependent upon the probability of successful vaginal delivery. There is conflicting evidence on the cost effectiveness of maternal request caesareans when compared with trial of labour. The paucity of evidence on the value pregnant women, clinicians and other groups in society place on the option of elective caesarean section is highlighted. Techniques that might be used to elicit

  1. Post Repeat Lower Segment Caesarean Section Cervicovesical Fistula

    Directory of Open Access Journals (Sweden)

    Vidya A.Thobbi

    2008-12-01

    Full Text Available A 35 year old female patient G2P1L1 with previous LSCS with 9 months amenorrhea with labor pains was admitted and caesarean section was done for cephalo – pelvic disproportion with foetal distress. Patient developed cervico-vesical fistula which was successfully repaired by total abdominal hysterectomy and fistula was repaired using peritoneal flap .

  2. Evidence-based surgical techniques for caesarean section

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Secher, Niels Jørgen; Krebs, Lone

    2014-01-01

    Caesarean section (CS) is a common surgical procedure, and in Denmark 21% of deliveries is by CS. There is an increasing amount of scientific evidence to support the different surgical techniques used at CS. This article reviews the literature regarding CS techniques. There is still a lack...

  3. Prediction of scar integrity and vaginal birth after caesarean delivery.

    Science.gov (United States)

    Valentin, Lil

    2013-04-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has been published. A thin lower uterine segment at 35-40 weeks, as measured by ultrasound in women with a caesarean hysterotomy scar, increases the risk of uterine rupture or dehiscence. No cut-off for lower uterine segment thickness, however, can be suggested because of study heterogeneity, and because prospective validation is lacking. Large caesarean hysterotomy scar defects in non-pregnant women seen at ultrasound examination increase the risk of uterine rupture or dehiscence in subsequent pregnancy, but the strength of the association is unknown. To sum up, we currently lack a method that can provide a reliable estimate of the risk of uterine rupture or dehiscence during a trial of labour in women with caesarean hysterotomy scar(s).

  4. Caesarean of Lion (Panthera leo at Dulahajra Safari Park, Bangladesh

    Directory of Open Access Journals (Sweden)

    Z.M.M. Rahman

    2011-01-01

    Full Text Available A six years eight months pregnant lioness at the Dulahajara Safari Park, Chakoria, Cox’s Bazar, Bangladesh, was presented with dystocia. This paper described the pre-, intra- and postoperative procedures including anesthetic protocol carried out and performing a caesarean section to remove dead fetuses and the successful recovery of the lioness without complications.

  5. Caesarean Section and Hospitalization for Respiratory Syncytial Virus Infection

    DEFF Research Database (Denmark)

    Kristensen, Kim; Fisker, Niels; Haerskjold, Ann

    2015-01-01

    BACKGROUND AND OBJECTIVE:: Hospitalization for respiratory syncytial virus (RSV) infection and asthma share common determinants, and meta-analyses indicate that children delivered by caesarean section (CS) are at increased risk of asthma. We aimed to investigate whether birth by CS is associated ...

  6. Do Urgent Caesarean Sections Have a Circadian Rhythm?

    Science.gov (United States)

    Doğru, Serkan; Doğru, Hatice Yılmaz; Karaman, Tuğba; Şahin, Aynur; Tapar, Hakan; Karaman, Serkan; Arıcı, Semih; Özsoy, Asker Zeki; Çakmak, Bülent; İşgüder, Çiğdem Kunt; Delibaş, İlhan Bahri; Karakış, Alkan

    2016-01-01

    Objective The primary goal of the present study was to demonstrate the existence of a possible circadian variation in urgent operative deliveries. Methods All urgent caesarean sections between 1 January 2014 and 1 January 2015 with known exact onset times of operation were included in this retrospective study. Cases that were previously scheduled for elective caesarean section were excluded. Information regarding age, delivery date, onset time of operation and type of anaesthesia was collected from the database. Analyses were completed using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0 software. The statistical significance for all analyses was set at p<0.05. Results A total of 285 urgent caesarean section deliveries were included in the study. There were 126 (44.2%) deliveries during the day shift and 159 (55.8%) during the night shift. 80 patients (28.1%) received general anaesthesia and 65 (22.8%) received spinal anaesthesia in the morning shift, whereas 54 patients (18.9%) received general anaesthesia and 86 (30.2%) received spinal anaesthesia during the night shift. Conclusion The present study suggested that urgent caesarean sections revealed a circadian rhythm during the day. PMID:27366574

  7. Clinical Analysis of 45 Cases of Caesarean Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

    Hong SHI; Ai-hua FANG; Qin-fang CHEN

    2008-01-01

    Objective To summarize the clinical characteristics of caesarean scar pregnancy and to investigate its treatment.Methods Clinical case records of 45 cases of caesarean scar pregnancy from June 2003 to September 2007 were reviewed.The characteristics and management of cases were analyzed.Results The women's average age was 32.8±5.1 years.All cases had amenorrhoea.and 27 cases had vaginal bleeding from spotting to morderate.Seven cases were misdiagnosed as normal early intrauterine pregnancy or inevitable miscarriage before dilation and curettage(D & C).In case of massive bleeding,caesarean scar pregnancy was diagnosed after D & C.Bleeding was controlled and uterus was conserved in 6 cases,and 1 case underwent hysterectomy because of uncontrollable bleeding.The remaining 38 cases had ultrasound scan,which indicated scar pregnancy before primary treatment.Eight cases were primarily treated with dilation and curettage,in which only 2 cases had slight bleeding in the operation and no further treatment.Nineteen cases were primarily treated with dilation and curettage after uterine artery embolization.in which 17 cases needed no further treatment and had no complications.The success rate was 89.4%(17/19).Eleven cases were primarity treated with trichosanthin 1.2 mg intramuscular.No one encountered massive bleeding,but 7 cases of these 11 cases needed extra treatment.Conclusion Caesarean scar pregnancy must be cautious of,especially in cases of inevitable miscarriage.Dilation and curettage followed uterine artery embolization can be used as the primary treatment for caesarean scar pregnancy.

  8. At What Price? A Cost-Effectiveness Analysis Comparing Trial of Labour after Previous Caesarean versus Elective Repeat Caesarean Delivery

    NARCIS (Netherlands)

    Fawsitt, C.G.; Bourke, J.; Greene, R.A.; Everard, C.M.; Murphy, A.; Lutomski, J.E.

    2013-01-01

    BACKGROUND: Elective repeat caesarean delivery (ERCD) rates have been increasing worldwide, thus prompting obstetric discourse on the risks and benefits for the mother and infant. Yet, these increasing rates also have major economic implications for the health care system. Given the dearth of inform

  9. Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  10. Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2009-01-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  11. Indications for Caesarean sections in a rural hospital in the Highlands of Papua New Guinea.

    Science.gov (United States)

    Mark, Terence B; Radcliffe, Jim; Laman, Moses

    2014-07-01

    We retrospectively documented indications for Caesarean sections in a rural district level hospital in the highlands of Papua New Guinea. Over a 53-month study period, 745 Caesarean sections were performed. Prolonged labour, previous history of Caesarean section, cephalopelvic disproportion, malpresentation and fetal distress accounted for over 88% of Caesarean sections performed. In older mothers (aged >30 years), antepartum haemorrhage (Fisher exact test, P = 0.05) and multiple indications (P = 0.001) were leading reasons for Caesarean sections while cephalopelvic disproportion (P = 0.005) was the leading indication in younger mothers. Further prospective studies incorporating perinatal and maternal mortality rates are required to optimise the value of Caesarean sections at district level hospitals in Papua New Guinea.

  12. Can classic metaphyseal lesions follow uncomplicated caesarean section?

    Energy Technology Data Exchange (ETDEWEB)

    O' Connell, AnnaMarie [Children' s University Hospital, Radiology Department, Dublin 1 (Ireland); Donoghue, Veronica B. [Children' s University Hospital, Radiology Department, Dublin 1 (Ireland); National Maternity Hospital, Radiology Department, Dublin (Ireland)

    2007-05-15

    Classic metaphyseal lesion (CML) is the term given to a fracture that most often occurs in the posteromedial aspect of the distal femur, proximal tibia, distal tibia, and proximal humerus in infants; this finding is strongly associated with non-accidental injury. To demonstrate that the CML may occur following simple lower segment caesarean section (LSCS). A review of 22 years of an obstetric practice that delivers 8,500 babies per year. We identified three neonates born by elective LSCS, each with distal femoral metaphyseal fractures on postpartum radiographs. All caesarean sections were elective and uncomplicated. External cephalic version was not employed preoperatively. Postpartum radiographs demonstrated a fracture of the distal femoral metaphysis in each neonate, typical of a CML. We propose that a CML can occur in the setting of a simple, elective and uncomplicated LSCS where no external cephalic version is employed. (orig.)

  13. Third caesarean section in patient with myasthenia gravis

    Institute of Scientific and Technical Information of China (English)

    A Pizzo; R De Dominici; I Borrielli; FV Ardita; I Lo Monaco; E Sturlese

    2012-01-01

    Myasthenia gravis(MG) is an autoimmune neuromuscular disease, characterised by muscle weakness and fatigability of the voluntary muscles, it affects young women in the second and third decade of life.We report a case of30 years old multigravida woman with myasthenia gravis submitted to third iterative caesarean section with no adverse neonatal and maternal outcome. The course myathenia is highly variable and unpredictable during gestation and can change in subsequent pregnancies.Delivery specially, through caesarean section is very stressful and may cause severe myasthenic crisis.Although pregnancy and delivery represent particular events, that require more attention in these patients, they are not associated, in most cases, with higher risks of complications compared to normal pregnancy, delivery and postpartum period.According our experiences, in the management of myasthenic pregnant woman is necessary cooperation in a multidisciplinary team between obstetricians, neurologist, anaesthetist, and neonatologist for ensure an optimum outcome.

  14. Ectopic pregnancy in a Caesarean section scar: a case study

    Directory of Open Access Journals (Sweden)

    Piotr Niziurski

    2013-08-01

    Full Text Available Implantation of a pregnancy in a scar after Caesarean section is one of the rarest locations of ectopic pregnancies. A diagnosis and/or treatment which is too late may lead to a uterine rupture, the necessity to remove the uterus and a significant increase in morbidity among mothers. The study presents a diagnostically difficult case of a 29-year-old woman, who was diagnosed with pregnancy in its seventh week, located in a scar after a Caesarean section, with highly increased values of human chorionic gonadotropin (β-HCG concentration in blood serum. The pregnancy was removed and the wound was stitched during laparotomy, without a need to remove the uterus.

  15. Does induction really reduce the likelihood of caesarean section?

    Science.gov (United States)

    Wickham, Sara

    2014-09-01

    Two recent systematic reviews have arrived at the same, rather surprising and somewhat counter-intuitive result. That is, contrary to the belief and experience of many people who work on labour wards every day, induction of labour doesn't increase the chance of caesarean section at all. In fact, the reviewers argue, their results demonstrate that induction of labour reduces the likelihood of caesarean section. It might be that our instincts are wrong, and that we need to reconsider what we think we know. But before we rush to recommend induction as the latest tool to promote normal birth, we might want to look a bit more closely at the evidence, as I am not at all certain that this apparently straightforward conclusion is quite as cut-and-dried as it sounds.

  16. Evaluating trial of scar in patients with a history of caesarean section

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-01-01

    Full Text Available Aims: To analyze the outcome of trial of scar in patients with previous caesarean section and to assess the fetal and maternal complications after trial of scar. Patients and Methods : The study was conducted at Military Hospital, Rawalpindi, Pakistan, with 375 pregnant patients who had a previous delivery by caesarean and who had regular antenatal checkup. Data were recorded on special pro-forms designed for the purpose. Results : The results from the 375 patients who had one previous lower segment caesarean section due to non-recurrent causes were analyzed and compared with national and international studies. Indications of previous caesarean section (non-recurrent causes included malpresentations, fetal distress/cord prolapse, failure to progress, severe pregnancy-induced hypertension/eclampsia and twins with abnormal lie of the first twin. 0 218 patients reported spontaneous labor. Among these patients, 176 delivered vaginally and 42 patients had repeat caesarean sections. There were a total of 157 patients who experienced induction of labor. 97 patients were induced by cervical ripening with mechanical method, followed by artificial rupture of membranes and augmentation (if required with syntocinon infusion. 60 patients were induced with prostaglandin E 2 vaginal tablet. Conclusion : This study concludes that females with a prior caesarean are at increased risk for subsequent caesareans, regardless of mode of delivery. Eliminating vaginal-birth-after-caesarean will not eliminate the risk. Therefore, vaginal birth after caesarean should be encouraged in selected cases from obstetric units to reduce the risks of repeated caesarean sections. Failed vaginal-birth-after-caesarean can result in increased morbidity than that with elective caesarean section.

  17. The definition, aetiology, presentation, diagnosis and management of previous caesarean scar defects.

    Science.gov (United States)

    Allornuvor, G F N; Xue, M; Zhu, X; Xu, D

    2013-11-01

    Caesarean sections are the most commonly performed surgical procedures involving the uterus in fertile women. Typically, this surgery involves a transverse incision in the anterior lower uterine segment. The incidence of caesarean sections is on the increase worldwide, and consequently, the complications associated with them are becoming more common. One such complication that is gaining more attention is previous lower uterine segment caesarean scar defect (PCSD). In this review, we sought to explore the definition, aetiology, presentation, diagnosis and management of PCSD.

  18. Prediction of scar integrity and vaginal birth after caesarean delivery.

    OpenAIRE

    Valentin, Lil

    2013-01-01

    A statistically significant association with uterine rupture during a trial of labour after caesarean delivery was found in at least two studies for the following variables: inter-delivery interval (higher risk with short interval), birth weight (higher risk if 4000 g or over), induction of labour (higher risk), oxytocin dose (higher risk with higher doses), and previous vaginal delivery (lower risk). However, no clinically useful risk estimation model that includes clinical variables has bee...

  19. Caesarean section in a parturient with a spinal cord stimulator.

    LENUS (Irish Health Repository)

    Sommerfield, D

    2010-01-01

    A 35-year-old G2P1 parturient at 32 weeks of gestation with an implanted spinal cord stimulator was admitted for urgent caesarean section. Spinal anaesthesia was performed below the spinal cord stimulator leads at the L4-5 level, and a healthy female infant was delivered. A basic description of the technology and resulting implications for the parturient are discussed.

  20. Clinical Analysis of Placenta Previa Complicated with Previous Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    Liang-kun Ma; Na Han; Jian-qiu Yang; Xu-ming Bian; Jun-tao Liu

    2012-01-01

    Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section.Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period.Results There was no difference in the mean age (28.9±3.6 vs.28.1±4.5 years) and the average gravidity (2.35 ± 1.48 vs.2.21 ± 1.53) between RCS group and FCS group (all P>0.05).The RCS group had more preterm births (24.1% vs.13.2%),complete placenta previa (55.2% vs.4.9%),placenta accreta (34.5% vs.2.5%),more blood loss during caesarean section (1412±602 vs.648 ±265 mL),blood transfusion (51.7% vs.4.9%),disseminated intravascular coagulation (13.8% vs.2.1%),and obstetric hysterectomy ( 13.8 % vs.0.8 %) than the F C S group (all P< 0.05).The preterm infant rate ( 30.0% vs.13.0%),neonatal asphyxia rate (10.0% vs.4.9%),and perinatal mortality rate (6.7% vs.0.4%) of the RCS group were higher than those of the FCS group (all P<0.05).Conclusions More patients had complete placenta previa and placenta accreta,postpartum hemorrhage,transfusion,uterine packing,obstetric hysterectomy,and perinatal morbidity in the placenta previa patients with previous caesarean section.The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.

  1. Dynamic system classifier

    Science.gov (United States)

    Pumpe, Daniel; Greiner, Maksim; Müller, Ewald; Enßlin, Torsten A.

    2016-07-01

    Stochastic differential equations describe well many physical, biological, and sociological systems, despite the simplification often made in their derivation. Here the usage of simple stochastic differential equations to characterize and classify complex dynamical systems is proposed within a Bayesian framework. To this end, we develop a dynamic system classifier (DSC). The DSC first abstracts training data of a system in terms of time-dependent coefficients of the descriptive stochastic differential equation. Thereby the DSC identifies unique correlation structures within the training data. For definiteness we restrict the presentation of the DSC to oscillation processes with a time-dependent frequency ω (t ) and damping factor γ (t ) . Although real systems might be more complex, this simple oscillator captures many characteristic features. The ω and γ time lines represent the abstract system characterization and permit the construction of efficient signal classifiers. Numerical experiments show that such classifiers perform well even in the low signal-to-noise regime.

  2. 超声对剖宫产瘢痕妊娠的临床应用价值%Value of ultrasonography in the Clinical application of caesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    刘宇清; 卢琼洁; 贾保霞

    2010-01-01

    Objective To explore the value of sonography in the clinical application of caesarean scar pregnancy. Methods The ultrasound imaging of twenty-four patients with caesarean scar pregnancy and their clinical treatments were retrospectively analyzed. Results Twenty-four patients were classified into three types according to the location of pregnancy matter relation with the caesarean scar: the first type included 5 patients with pregnancy matter implanted in the caesarean scar,the second type included 13 patients in which the pregnancy matter located in uterine cavity close to the caesarean scar, and the third type included 6 patients with pregnancy matter located partly in the caesarean scar and partly in the uterine cavity. Select treatment options depending on the types and distribution of nourish blood besides the pregnancy matter. Conclusion Sonography is valuable for the diagnosis and treatment of caesarean scar pregnancy by observing the location of pregnancy natter relation with the caesarean scar and distribution of nourish blood besides the pregnancy matter.%目的 探讨超声对剖宫产术后子宫瘢痕妊娠的诊断治疗方面的临床应用.方法 回顾性分析24例诊断为子宫瘢痕妊娠患者的声像图表现及临床资料.结果 24例瘢痕妊娠病例根据妊娠物与瘢痕的位置关系分为三型:癜痕处肌层内型(5例)、瘢痕处宫腔内型(13例)及混合型(6例),根据分型及瘢痕处滋养血流分布状况选择治疗方案并超声随访.结论 超声通过观测妊娠物与瘢痕的位置关系及瘢痕处滋养血流分布状况对于瘢痕妊娠的诊断、指导治疗等方面具有重要作用.

  3. Asthma at 8 years of age in children born by caesarean section

    NARCIS (Netherlands)

    Roduit, C.; Scholtens, S.; de Jongste, J.C.; Wijga, A.H.; Gerritsen, J.; Postma, D.S.; Brunekreef, B.; Hoekstra, M.O.; Aalberse, R.; Smit, H.A.

    2009-01-01

    Background: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sens

  4. Asthma at 8 years of age in children born by caesarean section.

    NARCIS (Netherlands)

    Roduit, C.; Scholtens, S.; de Jongste, J.C.; Wijga, A.H.; Gerritsen, J.; Postma, D.S.; Brunekreef, B.; Hoekstra, M.O.; Aalberse, R.C.; Smit, H.A.

    2009-01-01

    BACKGROUND: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sens

  5. The effect of malpractice claims on the use of caesarean section.

    Science.gov (United States)

    Schifrin, Barry S; Cohen, Wayne R

    2013-04-01

    Malpractice fears are believed to influence various aspects of obstetrical practice. They seem to have contributed in small part to the rising primary caesarean section rate, but have also played a considerable role in the downtrend in vaginal birth after caesarean statistics. The rising vaginal birth after caesarean section rate between 1981 and 1995 was interrupted by a spate of lawsuits associated with broadened indications for vaginal birth after caesarean section in conjunction with requirements for immediate clinician availability. These factors dramatically reduced the availability of hospitals and clinicians willing to offer vaginal birth after caesarean section. This reversal, however, has not diminished the demand for vaginal birth after caesarean section from various stakeholders in the name of patient autonomy, clinician beneficence and optimal care. Nevertheless, as long as stringent requirements remain for clinician attendance during vaginal birth after caesarean section, and as long as the spectre of preventable error and the lingering dread of lawsuits retain their hold on obstetrical practice, caesarean section trends are unlikely to change.

  6. Is a planned caesarean section in women with cardiac disease beneficial?

    NARCIS (Netherlands)

    Ruys, Titia P. E.; Roos-Hesselink, Jolien W.; Pijuan-Domenech, Antonia; Vasario, Elena; Gaisin, Ilshat R.; Iung, Bernard; Freeman, Leisa J.; Gordon, Elaine P.; Pieper, Petronella G.; Hall, Roger; Boersma, Eric; Johnson, Mark R.

    2015-01-01

    Objectives In the general population, planned caesarean section is thought to be safer in high-risk situations as it avoids the greater risk of an emergency caesarean section. Only limited data exist on the optimal mode of delivery in women with structural heart disease. We investigated the relation

  7. Caesarean section and subsequent ectopic pregnancy: a systematic review and meta-analysis

    NARCIS (Netherlands)

    O'Neill, S.M.; Khashan, A.S.; Kenny, L.C.; Greene, R.A.; Henriksen, T.B.; Lutomski, J.E.; Kearney, P.M.

    2013-01-01

    BACKGROUND: Caesarean section rates are increasing worldwide, and the long-term effects are unknown. OBJECTIVE: To evaluate the risk of subsequent ectopic pregnancy in women with a previous caesarean section, compared with vaginal delivery. SEARCH STRATEGY: Systematic review of the literature using

  8. Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.

    LENUS (Irish Health Repository)

    McMorrow, R C N

    2011-05-01

    Transversus abdominis plane (TAP) block is an alternative to spinal morphine for analgesia after Caesarean section but there are few data on its comparative efficacy. We compared the analgesic efficacy of the TAP block with and without spinal morphine after Caesarean section in a prospective, randomized, double-blinded placebo-controlled trial.

  9. Superficial fascial system repair: an abdominoplasty technique to reduce local complications after caesarean delivery.

    Science.gov (United States)

    Al-Benna, Sammy; Al-Ajam, Yazan; Tzakas, Elias

    2009-05-01

    Abdominal incision complications are a major source of morbidity after caesarean delivery. Repair of the superficial fascial system may avert local complications after caesarean delivery by minimising tension to the skin and increasing the initial biomechanical strength of wound which has the potential to decrease early wound dehiscence and as a by-product correct suprapubic bulging.

  10. Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend.

    LENUS (Irish Health Repository)

    Unterscheider, J

    2011-08-01

    To audit caesarean sections performed at full cervical dilatation over a three year period in a tertiary referral centre in Ireland. To evaluate (i) the rate of caesarean deliveries in the second stage of labour, (ii) the indication for delivery and (iii) the associated fetal and maternal morbidity in this cohort of women.

  11. Anaesthetic consideration for caesarean delivery of a parturient without ′The Master Gland′

    Directory of Open Access Journals (Sweden)

    Tuhin Mistry

    2015-01-01

    Full Text Available We are presenting the management of a patient posted for elective caesarean delivery who conceived after ovulation induction and in vitro fertilisation, 20 years after postsurgical hypopituitarism. She had uneventful pregnancy and delivered a healthy baby by caesarean section under general anaesthesia.

  12. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola;

    2017-01-01

    INTRODUCTION: Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. METHODS......: The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. RESULTS......: In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery...

  13. Dynamic system classifier

    CERN Document Server

    Pumpe, Daniel; Müller, Ewald; Enßlin, Torsten A

    2016-01-01

    Stochastic differential equations describe well many physical, biological and sociological systems, despite the simplification often made in their derivation. Here the usage of simple stochastic differential equations to characterize and classify complex dynamical systems is proposed within a Bayesian framework. To this end, we develop a dynamic system classifier (DSC). The DSC first abstracts training data of a system in terms of time dependent coefficients of the descriptive stochastic differential equation. Thereby the DSC identifies unique correlation structures within the training data. For definiteness we restrict the presentation of DSC to oscillation processes with a time dependent frequency {\\omega}(t) and damping factor {\\gamma}(t). Although real systems might be more complex, this simple oscillator captures many characteristic features. The {\\omega} and {\\gamma} timelines represent the abstract system characterization and permit the construction of efficient signal classifiers. Numerical experiment...

  14. A rare case of thyroid storm following caesarean section

    Directory of Open Access Journals (Sweden)

    Sanjay Singh

    2016-03-01

    Full Text Available Thyroid storm in pregnancy is a rare life threatening emergency, with very high maternal and perinatal mortality and morbidity. Here we present an unusual case of a 30 year-old G2P1L1 woman, a known case of post caesarean pregnancy with hyperthyroidism who presented with severe preeclampsia and on second post op day developed thyroid storm. Early recognition and timely institution of appropriate management resulted in good outcome in this case. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 933-936

  15. Oral microflora in infants delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim....... To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. Design. This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County...

  16. At what price? A cost-effectiveness analysis comparing trial of labour after previous caesarean versus elective repeat caesarean delivery.

    Directory of Open Access Journals (Sweden)

    Christopher G Fawsitt

    Full Text Available BACKGROUND: Elective repeat caesarean delivery (ERCD rates have been increasing worldwide, thus prompting obstetric discourse on the risks and benefits for the mother and infant. Yet, these increasing rates also have major economic implications for the health care system. Given the dearth of information on the cost-effectiveness related to mode of delivery, the aim of this paper was to perform an economic evaluation on the costs and short-term maternal health consequences associated with a trial of labour after one previous caesarean delivery compared with ERCD for low risk women in Ireland. METHODS: Using a decision analytic model, a cost-effectiveness analysis (CEA was performed where the measure of health gain was quality-adjusted life years (QALYs over a six-week time horizon. A review of international literature was conducted to derive representative estimates of adverse maternal health outcomes following a trial of labour after caesarean (TOLAC and ERCD. Delivery/procedure costs derived from primary data collection and combined both "bottom-up" and "top-down" costing estimations. RESULTS: Maternal morbidities emerged in twice as many cases in the TOLAC group than the ERCD group. However, a TOLAC was found to be the most-effective method of delivery because it was substantially less expensive than ERCD (€ 1,835.06 versus € 4,039.87 per women, respectively, and QALYs were modestly higher (0.84 versus 0.70. Our findings were supported by probabilistic sensitivity analysis. CONCLUSIONS: Clinicians need to be well informed of the benefits and risks of TOLAC among low risk women. Ideally, clinician-patient discourse would address differences in length of hospital stay and postpartum recovery time. While it is premature advocate a policy of TOLAC across maternity units, the results of the study prompt further analysis and repeat iterations, encouraging future studies to synthesis previous research and new and relevant evidence under a single

  17. Classifying Returns as Extreme

    DEFF Research Database (Denmark)

    Christiansen, Charlotte

    2014-01-01

    I consider extreme returns for the stock and bond markets of 14 EU countries using two classification schemes: One, the univariate classification scheme from the previous literature that classifies extreme returns for each market separately, and two, a novel multivariate classification scheme tha...

  18. Caesarean delivery scar pregnancy [CDSP]: A case report

    Directory of Open Access Journals (Sweden)

    Purnima Deb

    2011-10-01

    Full Text Available Caesarean scar pregnancy is a rare form of ectopic pregnancy. It is a dangerous condition that can potentially lead to uterine rupture and severe haemorrhage or even a secondary abdominal pregnancy. If it progress further in pregnancy it is likely to present as placenta accrete/increta with a high morbidity and mortality. Its early diagnosis can be challenging, and the optimal treatment has not been determined. We report a case of an ectopic pregnancy in a caesarean section scar, which was initially misdiagnosed despite using ultrasound. Although the use of ultrasound in combination with serum levels of human chorionic gonadotrophin [hCG] in the diagnosis of ectopic pregnancy is well established, the diagnosis of a rare kind remains diffi cult. However, early diagnosis allows appropriate management planning to preserve uterine integrity and future fertility. The surgical treatment includes curettage, laparoscopy, laparotomy with hysterotomy and excision of the gestational mass. A medical approach with systemic and /or intralesional methotrexate application, oral mifepristone and possibly local injection of potassium chloride or tricosanthin has been proposed by itself, or combined with surgical procedures.

  19. STUDY OF OBSTETRIC AND FETAL OUTCOME OF PREGNANCY IN PREVIOUS CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Gurpreet Kaur

    2015-09-01

    Full Text Available Previous caesarean section sparks an area of controversy in Obstetrics. The management of women with previous caesarean section regarding the mode of delivery whether to opt for repeat caesarean section or vaginal delivery, is an area of debate. Very often the decision on management is not made on Principle of sound reasoning and many who choose the elective repeat caesarean section do so to circumvent the anxious moment that arise during conduct ion of labour. AIMS AND OBJECTIVE: To determine the maternal and fetal outcome in relation to type of delivery . MATERIALS AND METHOD S: A 18 month prospective observational study was conducted where in 150 patients who had a term pregnancy with a history of prior LSCS were included after obtaining their consent for participation. The obstetric and fetal outcomes of these patients in the present pregnancy were analyzed by Z test. RESULTS: Out of the 150 subjects 78 ( 52% were in age group of 26 - 30 years, 106 ( 70.67% patients belonged to the urban population, 116 ( 77.33% were booked patie nts, 107 ( 71.33% were housewives, 122 ( 81.33% belonged to middle class and 22 ( 14.67% were from high socio economic status. 67 ( 44.67% were second gravid, 112 ( 74.67% were para 1. Out of total 134 patients 29 ( 21.64% had elective caesarean section and 5 ( 3 .73% patients came as emergency admission and underwent caesarean section. Out of 134 patients, with one previous caesarean section. 32 had spontaneous onset of labour. Out of which 20 ( 68.97% had vaginal delivery and 9 ( 31.03% had repeat caesarean section. 13 patients had augmentation, 11 ( 84.62% had vaginal delivery and 2 ( 15.38% had caesarean section. In 58 patients labour was induced 29 ( 50% had section. 14 patients out of 50 who had previous 2 caesarean section only 1 ( 7.69% patient had spontane ous onset of labour and had caesarean section. 3 ( 92.86% patients had elective caesarean section. There were only 2 patients with previous 3 caesarean

  20. Thirty years of the World Health Organization's target caesarean section rate: time to move on.

    Science.gov (United States)

    Robson, Stephen J; de Costa, Caroline M

    2017-03-06

    It has been 30 years since the World Health Organization first recommended a "maximum" caesarean section (CS) rate of 15%. There are demographic differences across the 194 WHO member countries; recent analyses suggest the optimal global CS rate is almost 20%. Attempts to reduce CS rates in developed countries have not worked. The strongest predictor of caesarean delivery for the first birth of "low risk" women appears to be maternal age; a factor that continues to increase. Most women whose first baby is born by caesarean delivery will have all subsequent children by caesarean delivery. Outcomes that informed the WHO recommendation primarily relate to maternal and perinatal mortality, which are easy to measure. Longer term outcomes, such as pelvic organ prolapse and urinary incontinence, are closely related to mode of birth, and up to 20% of women will undergo surgery for these conditions. Pelvic floor surgery is typically undertaken for older women who are less fit for surgery. Serious complications such as placenta accreta occur with repeat caesarean deliveries, but the odds only reach statistical significance at the third or subsequent caesarean delivery. However, in Australia, parity is falling, and only 20% of women will have more than two births. We should aim to provide CS to women in need and to continue including women in the conversation about the benefits and disadvantages, both short and long term, of birth by caesarean delivery.

  1. Classifier in Age classification

    Directory of Open Access Journals (Sweden)

    B. Santhi

    2012-12-01

    Full Text Available Face is the important feature of the human beings. We can derive various properties of a human by analyzing the face. The objective of the study is to design a classifier for age using facial images. Age classification is essential in many applications like crime detection, employment and face detection. The proposed algorithm contains four phases: preprocessing, feature extraction, feature selection and classification. The classification employs two class labels namely child and Old. This study addresses the limitations in the existing classifiers, as it uses the Grey Level Co-occurrence Matrix (GLCM for feature extraction and Support Vector Machine (SVM for classification. This improves the accuracy of the classification as it outperforms the existing methods.

  2. Classifying insulin regimens

    DEFF Research Database (Denmark)

    Neu, A; Lange, K; Barrett, T;

    2015-01-01

    diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin...... regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad...

  3. Intelligent Garbage Classifier

    Directory of Open Access Journals (Sweden)

    Ignacio Rodríguez Novelle

    2008-12-01

    Full Text Available IGC (Intelligent Garbage Classifier is a system for visual classification and separation of solid waste products. Currently, an important part of the separation effort is based on manual work, from household separation to industrial waste management. Taking advantage of the technologies currently available, a system has been built that can analyze images from a camera and control a robot arm and conveyor belt to automatically separate different kinds of waste.

  4. Classifying Linear Canonical Relations

    OpenAIRE

    Lorand, Jonathan

    2015-01-01

    In this Master's thesis, we consider the problem of classifying, up to conjugation by linear symplectomorphisms, linear canonical relations (lagrangian correspondences) from a finite-dimensional symplectic vector space to itself. We give an elementary introduction to the theory of linear canonical relations and present partial results toward the classification problem. This exposition should be accessible to undergraduate students with a basic familiarity with linear algebra.

  5. Generalized classifier neural network.

    Science.gov (United States)

    Ozyildirim, Buse Melis; Avci, Mutlu

    2013-03-01

    In this work a new radial basis function based classification neural network named as generalized classifier neural network, is proposed. The proposed generalized classifier neural network has five layers, unlike other radial basis function based neural networks such as generalized regression neural network and probabilistic neural network. They are input, pattern, summation, normalization and output layers. In addition to topological difference, the proposed neural network has gradient descent based optimization of smoothing parameter approach and diverge effect term added calculation improvements. Diverge effect term is an improvement on summation layer calculation to supply additional separation ability and flexibility. Performance of generalized classifier neural network is compared with that of the probabilistic neural network, multilayer perceptron algorithm and radial basis function neural network on 9 different data sets and with that of generalized regression neural network on 3 different data sets include only two classes in MATLAB environment. Better classification performance up to %89 is observed. Improved classification performances proved the effectivity of the proposed neural network.

  6. Oral microflora in infants delivered vaginally and by caesarean section.

    Science.gov (United States)

    Nelun Barfod, Mette; Magnusson, Kerstin; Lexner, Michala Oron; Blomqvist, Susanne; Dahlén, Gunnar; Twetman, Svante

    2011-11-01

    BACKGROUND.  Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. AIM.  To investigate and compare the oral microbial profile between infants delivered vaginally and by C-section. DESIGN.  This is a cross-sectional case-control study. Eighty-four infants delivered either vaginally (n = 42) or by C-section (n = 42) were randomly selected from the 2009 birth cohort at the County Hospital in Halmstad, Sweden. Medically compromised and premature children (oral health need to be further investigated.

  7. Caesarean Scar Ectopic Pregnancy: Report of Two Cases.

    Science.gov (United States)

    Mahapatro, Akshaya Kumar; Shankar, Kundavi; Varma, Thankam

    2016-05-01

    Cases of Caesarean Scar Ectopic Pregnancy (CSEP) are becoming increasingly common at tertiary care hospitals because of increase in rate of CS. This condition is often complicated by life threatening bleeding, uterine rupture, which might require hysterectomy leading to permanent infertility. Management can be medical, surgical or combined depending on the clinical presentation. It includes systemic methotrexate or local uterine artery chemoembolisation, dilatation and curettage, excision of trophoblastic tissue either by laparoscopy or laparotomy with uterine repair. We report two such cases managed medically in our hospital. Both the cases presented to us were asymptomatic except amenorrhoea and were diagnosed by transvaginal sonography. First case was managed with systemic methotrexate followed by Dilatation and Curettage (D&C). Second case was managed with systemic methotrexate alone successfully.

  8. MATERNAL AND FOETAL OUTCOME OF VAGINAL BIRTH AFTER CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Thulasi

    2016-04-01

    Full Text Available OBJECTIVES OF THE STUDY 1. To identify maternal and foetal factors responsible for the success or the failure of VBAC. 2. To study maternal and perinatal outcome while giving a trial of scar. METHOD OF COLLECTION OF DATA Study was conducted at P K Das Institute of Medical Sciences hospital. 50 cases obtained during the period of January 2013 to December 2013 were studied. Inclusion Criteria 1. Multigravida with previous one lower segment caesarean section at term in early labour. 2. Singleton pregnancy. 3. Cephalic presentation. 4. Who are willing for VBAC. 5. Well-informed subjects. Exclusion Criteria 1. Known classical scar and 2 or >caesarean sections. 2. Unknown uterine scar. 3. Multiple gestation. 4. Malpresentations. 5. Cephalopelvic disproportion. 6. Subjects with medical complication/obstetric risk factors. Cases are monitored with a partogram and continuous foetal monitor. METHODOLOGY Informed consent is taken after explaining the risks, benefits and potential complications in patients’ own language while giving a trial of scar. After the exclusion criteria, patients selected for VBAC is given a trial of scar. 1. Maternal monitoring of blood pressure and pulse rate every 15 minutes is done. 2. Continuous foetal monitoring in the active phase of labour. 3. Contraction stress test will be done in the active phase of labour. Uterine contractions are monitored every 30 minutes. Partogram is used to ensure adequate progress with respect to descent of the head, cervical dilatation, moulding and caput. 4. Pelvic examination every one hour to assess the progress of labour. 5. If labour has to be induced, done with great care particularly with prostaglandins – PGE 2 gel. Progress of labour should be assessed by a senior obstetrician, particularly in an unfavourable cervix. 6. Cross-matched blood is kept ready and a good intravenous line is established. 7. Oxytocin may be used with caution, as in any labour, for induction or augmentation. 8

  9. Elective caesarean section and respiratory morbidity in the term and near-term neonate

    DEFF Research Database (Denmark)

    Hansen, Anne Kirkeby; Wisborg, Kirsten; Uldbjerg, Niels

    2007-01-01

    AIM: The aim of this review was to assess the relationship between delivery by elective caesarean section and respiratory morbidity in the term and near-term neonate. METHODS: Searches were made in the MEDLINE database, EMBASE, Cochrane database and Web of Science to identify peer-reviewed studies...... in English on elective caesarean section and respiratory morbidity in the newborn. We included studies that compared elective caesarean section to vaginal or intended vaginal delivery, with clear definition of outcome measures and information about gestational age. RESULTS: Nine eligible studies were...... identified. All studies found that delivery by elective caesarean section increased the risk of various respiratory morbidities in the newborn near term compared with vaginal delivery, although the findings were not statistically significant in all studies. It was inappropriate to carry out a meta...

  10. Maternal morbidity with caesarean section for non-progress of labour: an analytical study.

    Science.gov (United States)

    Chhabra, S

    2007-12-01

    To estimate the maternal morbidity and mortality in caesarean section for non-progress of labour, a study was conducted over a period of 16 years at Mahatma Gandhi Institute of Medical Sciences, Sevagram among 533 cases of non-progress of labour for which caesarean section was performed. A total of 34975 women delivered including 7309 cases by caesarean section. Sixteen years records divided into 4 blocks, one each of 4 years were analysed. There was no maternal mortality but 8.25% women had intra-operative complication and 42.21% had postoperative morbidity. Timely intervention can save complication of prolonged labour as well as complications for which caesarean section was done for non-progress of labour.

  11. Caesarean Section in Peru: Analysis of Trends Using the Robson Classification System.

    Directory of Open Access Journals (Sweden)

    Vilma Tapia

    Full Text Available Cesarean section rates continue to increase worldwide while the reasons appear to be multiple, complex and, in many cases, country specific. Over the last decades, several classification systems for caesarean section have been created and proposed to monitor and compare caesarean section rates in a standardized, reliable, consistent and action-oriented manner with the aim to understand the drivers and contributors of this trend. The aims of the present study were to conduct an analysis in the three Peruvian geographical regions to assess levels and trends of delivery by caesarean section using the Robson classification for caesarean section, identify the groups of women with highest caesarean section rates and assess variation of maternal and perinatal outcomes according to caesarean section levels in each group over time.Data from 549,681 pregnant women included in the Peruvian Perinatal Information System database from 43 maternal facilities in three Peruvian geographical regions from 2000 and 2010 were studied. The data were analyzed using the Robson classification and women were studied in the ten groups in the classification. Cochran-Armitage test was used to evaluate time trends in the rates of caesarean section rates and; logistic regression was used to evaluate risk for each classification.The caesarean section rate was 27% and a yearly increase in the overall caesarean section rates from 2000 to 2010 from 23.5% to 30% (time trend p<0.001 was observed. Robson groups 1, 3 (nulliparous and multiparas, respectively, with a single cephalic term pregnancy in spontaneous labour, 5 (multiparas with a previous uterine scar with a single, cephalic, term pregnancy and 7 (multiparas with a single breech pregnancy with or without previous scars showed an increase in the caesarean section rates over time. Robson groups 1 and 3 were significantly associated with stillbirths (OR 1.43, CI95% 1.17-1.72; OR 3.53, CI95% 2.95-4.2 and maternal mortality (OR

  12. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study

    DEFF Research Database (Denmark)

    Hansen, Anne Kirkeby; Wisborg, Kirsten; Uldbjerg, Niels

    2007-01-01

    OBJECTIVE: To investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections. DESIGN: Cohort study with prospectively collected data from the Aarhus birth cohort, Denmark. SETTING: Obstetric department...... and neonatal department of a university hospital in Denmark. PARTICIPANTS: All liveborn babies without malformations, with gestational ages between 37 and 41 weeks, and delivered between 1 January 1998 and 31 December 2006 (34 458 babies). MAIN OUTCOME MEASURES: Respiratory morbidity (transitory tachypnoea...

  13. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

    Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.

  14. Anaesthesia Management of Caesarean Section in Two Patients with Eisenmenger's Syndrome

    Directory of Open Access Journals (Sweden)

    G. Fang

    2011-01-01

    Full Text Available Recently two parturients with Eisenmenger's syndrome underwent caesarean section at our hospital. They were managed by a multidisciplinary team during their perioperative period. The caesarean sections were uneventfully performed, one under general anaesthesia and one with epidural anaesthesia, with delivery of two newborns with satisfactory Apgar scores. One patient died in the post-partum period, and the other did well. We discuss the anaesthetic considerations in managing these high-risk patients.

  15. Stack filter classifiers

    Energy Technology Data Exchange (ETDEWEB)

    Porter, Reid B [Los Alamos National Laboratory; Hush, Don [Los Alamos National Laboratory

    2009-01-01

    Just as linear models generalize the sample mean and weighted average, weighted order statistic models generalize the sample median and weighted median. This analogy can be continued informally to generalized additive modeels in the case of the mean, and Stack Filters in the case of the median. Both of these model classes have been extensively studied for signal and image processing but it is surprising to find that for pattern classification, their treatment has been significantly one sided. Generalized additive models are now a major tool in pattern classification and many different learning algorithms have been developed to fit model parameters to finite data. However Stack Filters remain largely confined to signal and image processing and learning algorithms for classification are yet to be seen. This paper is a step towards Stack Filter Classifiers and it shows that the approach is interesting from both a theoretical and a practical perspective.

  16. Classifying TDSS Stellar Variables

    Science.gov (United States)

    Amaro, Rachael Christina; Green, Paul J.; TDSS Collaboration

    2017-01-01

    The Time Domain Spectroscopic Survey (TDSS), a subprogram of SDSS-IV eBOSS, obtains classification/discovery spectra of point-source photometric variables selected from PanSTARRS and SDSS multi-color light curves regardless of object color or lightcurve shape. Tens of thousands of TDSS spectra are already available and have been spectroscopically classified both via pipeline and by visual inspection. About half of these spectra are quasars, half are stars. Our goal is to classify the stars with their correct variability types. We do this by acquiring public multi-epoch light curves for brighter stars (rprogram for analyzing astronomical time-series data, to constrain variable type both for broad statistics relevant to future surveys like the Transiting Exoplanet Survey Satellite (TESS) and the Large Synoptic Survey Telescope (LSST), and to find the inevitable exotic oddballs that warrant further follow-up. Specifically, the Lomb-Scargle Periodogram and the Box-Least Squares Method are being implemented and tested against their known variable classifications and parameters in the Catalina Surveys Periodic Variable Star Catalog. Variable star classifications include RR Lyr, close eclipsing binaries, CVs, pulsating white dwarfs, and other exotic systems. The key difference between our catalog and others is that along with the light curves, we will be using TDSS spectra to help in the classification of variable type, as spectra are rich with information allowing estimation of physical parameters like temperature, metallicity, gravity, etc. This work was supported by the SDSS Research Experience for Undergraduates program, which is funded by a grant from Sloan Foundation to the Astrophysical Research Consortium.

  17. Can Intrapartum Cardiotocography Predict Uterine Rupture among Women with Prior Caesarean Delivery?: A Population Based Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Malene M Andersen

    Full Text Available To compare cardiotocographic abnormalities recorded during labour in women with prior caesarean delivery (CD and complete uterine rupture with those recorded in controls with prior CD without uterine rupture.Women with complete uterine rupture during labour between 1997 and 2008 were identified in the Danish Medical Birth Registry (n = 181. Cases were validated by review of medical records and 53 cases with prior CD, trial of labour, available cardiotocogram (CTG and complete uterine rupture were included and compared with 43 controls with prior CD, trial of labour and available CTG. The CTG tracings were assessed by 19 independent experts divided into groups of three different experts for each tracing. The assessors were blinded to group, outcome and clinical data. They analyzed occurrence of defined abnormalities and classified the traces as normal, suspicious, pathological or pre-terminal according to international guidelines (FIGO.A pathological CTG during the first stage of labour was present in 77% of cases and in 53% of the controls (OR 2.58 [CI: 0.96-6.94] P = 0.066. Fetal tachycardia was more frequent in cases with uterine rupture (OR 2.50 [CI: 1.0-6.26] P = 0.053. Significantly more cases showed more than 10 severe variable decelerations compared with controls (OR 22 [CI: 1.54-314.2] P = 0.022. Uterine tachysystole was not correlated with the presence of uterine rupture.A pathological cardiotocogram should lead to particular attention on threatening uterine rupture but cannot be considered a strong predictor as it is common in all women with trial of labour after caesarean delivery.

  18. Closure versus non-closure of the peritoneum at caesarean section: short- and long-term outcomes

    OpenAIRE

    Bamigboye, Anthony A; Hofmeyr, G Justus

    2014-01-01

    Background Caesarean section is a very common surgical procedure worldwide. Suturing the peritoneal layers at caesarean section may or may not confer benefit, hence the need to evaluate whether this step should be omitted or routinely performed. Objectives The objective of this review was to assess the effects of non-closure as an alternative to closure of the peritoneum at caesarean section on intraoperative and immediate- and long-term postoperative outcomes. Search methods We searched the ...

  19. Caesarean delivery and risk of childhood leukaemia: a pooled analysis from the Childhood Leukemia International Consortium (CLIC)

    Science.gov (United States)

    Marcotte, Erin L; Thomopoulos, Thomas P; Infante-Rivard, Claire; Clavel, Jacqueline; Petridou, Eleni Th; Schüz, Joachim; Ezzat, Sameera; Dockerty, John D; Metayer, Catherine; Magnani, Corrado; Scheurer, Michael E; Mueller, Beth A; Mora, Ana M; Wesseling, Catharina; Skalkidou, Alkistis; Rashed, Wafaa M; Francis, Stephen S; Ajrouche, Roula; Erdmann, Friederike; Orsi, Laurent; Spector, Logan G

    2017-01-01

    Summary Background Results from case-control studies have shown an increased risk of acute lymphoblastic leukaemia (ALL) in young children born by caesarean delivery, and prelabour caesarean delivery in particular; however, an association of method of delivery with childhood leukaemia subtypes has yet to be established. We therefore did a pooled analysis of data to investigate the association between childhood leukaemia and caesarean delivery. Methods We pooled data from 13 case-control studies from the Childhood Leukemia International Consortium done in nine countries (Canada, Costa Rica, Egypt, France, Germany, Greece, Italy, New Zealand, and the USA) for births from 1970-2013. We analysed caesarean delivery overall and by indications that probably resulted in prelabour caesarean delivery or emergency caesarean delivery. We used multivariable logistic regression models, adjusted for child's birthweight, sex, age, ethnic origin, parental education, maternal age, and study, to estimate odds ratios (ORs) and 95% CIs for the risk of ALL and acute myeloid leukaemia (AML) in children aged 0-14 years at diagnosis. Findings The studies provided data for 8780 ALL cases, 1332 AML cases, and 23 459 controls, of which the birth delivery method was known for 8655 (99%) ALL cases, 1292 (97%) AML cases, and 23 351 (>99%) controls. Indications for caesarean delivery were available in four studies (there were caesarean deliveries for 1061 of 4313 ALL cases, 138 of 664 AML cases, and 1401 of 5884 controls). The OR for all indications of caesarean delivery and ALL was 1.06 (95% CI 0.99–1.13), and was significant for prelabour caesarean delivery and ALL (1.23 [1.04-1.47]; p=0.018). Emergency caesarean delivery was not associated with ALL (OR 1.02 [95% CI 0.81-1.30]). AML was not associated with caesarean delivery (all indications OR 0.99 [95% CI 0.84-1.17]; prelabour caesarean delivery 0.83 [0.54-1.26]; and emergency caesarean delivery 1.05 [0.63-1.77]). Interpretation Our

  20. International migration and caesarean birth: a systematic review and meta-analysis

    Science.gov (United States)

    2013-01-01

    Background Perinatal health disparities including disparities in caesarean births have been observed between migrant and non-migrant women and some literature suggests that non-medical factors may be implicated. A systematic review was conducted to determine if migrants in Western industrialized countries consistently have different rates of caesarean than receiving-country-born women and to identify the reasons that explain these differences. Methods Reports were identified by searching 12 literature databases (from inception to January 2012; no language limits) and the web, by bibliographic citation hand-searches and through key informants. Studies that compared caesarean rates between international migrants and non-migrants living in industrialized countries and that did not have a ‘fatal flaw’ according to the US Preventative Services Task Force criteria were included. Studies were summarized, analyzed descriptively and where possible, meta-analyzed. Results Seventy-six studies met inclusion criteria. Caesarean rates between migrants and non-migrants differed in 69% of studies. Meta-analyses revealed consistently higher overall caesarean rates for Sub-Saharan African, Somali and South Asian women; higher emergency rates for North African/West Asian and Latin American women; and lower overall rates for Eastern European and Vietnamese women. Evidence to explain the consistently different rates was limited. Frequently postulated risk factors for caesarean included: language/communication barriers, low SES, poor maternal health, GDM/high BMI, feto-pelvic disproportion, and inadequate prenatal care. Suggested protective factors included: a healthy immigrant effect, preference for a vaginal birth, a healthier lifestyle, younger mothers and the use of fewer interventions during childbirth. Conclusion Certain groups of international migrants consistently have different caesarean rates than receiving-country-born women. There is insufficient evidence to explain the

  1. An observational study on extraperitoneal caesarean section in present era

    Directory of Open Access Journals (Sweden)

    Sudhanshu Sekhara Nanda

    2014-06-01

    Full Text Available Background: This study was designed to find out the maternal and perinatal outcome in cases of extraperitoneal caesarean section. Total 100 women undergoing extraperitoneal cesarean section were included in the study. Methods: A detailed history taking, examination done and intra and post-operative parameters as per protocols were noted. Results: Success rate of extra peritoneal CS was 79.63%, Time taken from incision to delivery was and #8804;5 minutes in 60% cases, time taken from incision to closure was between 31-45 min in 67% cases, blood loss and #8804;500 ml in 58% cases, return of bowel function between 5-8 hours in 52%, mobilization within 24 hours in 52%, neonatal one minute APGAR score and #8805;7 in 90.91%. Conclusions: Extraperitoneal cesarean section can be applied as a surgical form of infection prophylaxis. Since it possesses a rational basis for the avoidance of serious post-operative pelvic infectious complications, this operation deserves reconsideration in the modern era. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 724-727

  2. Patterns of caesarean-section delivery in Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Yibeltal T. Bayou

    2016-03-01

    Full Text Available Setting: The study was conducted in Addis Ababa, the capital city of Ethiopia. Specifically, it was conducted in all healthcare facilities offering maternity and obstetric services.Objective: The objective of the study was to explore the patterns of caesarean-section (CS delivery in Addis Ababa.Methods: A cross-sectional survey was carried out between December 2013 and January 2014. The population for the study were women aged between 15 and 19 years of age who had given birth in the last 1–3 years before the date of data collection. The Census and Survey Processing System software was used for data capturing and analysing both descriptive and inferential statistics using Statistical Package for Social Sciences version 20.0.Results: Amongst the 835 women who delivered at health facilities, 19.2% had given birth by CS. The prevalence of CS based on medical indication was 91.3%. However, 6.9% of CS performed had no medical indication. Private health facilities performed more CSs than public health facilities, 41.1% and 11.7% respectfully. CS was high amongst women of higher socioeconomic standing.Conclusion: Overall, CS deliveries rate in Ethiopia is above the rate recommended by the World Health Organisation. Because socio-economic factors influence CS delivery, governments should play a key role in regulating performance of CSs in private institutions.

  3. Emergency and elective caesarean sections: comparison of maternal and fetal outcomes in a suburban tertiary care hospital in Puducherry

    Directory of Open Access Journals (Sweden)

    Valsa Diana

    2016-09-01

    Conclusions: It was inferred that both elective and emergency caesarean imposes certain complications to the mother and the fetes. However, maternal and fetal complications were felt very high in emergency caesarean than elective. Proper planning can help obstetric practitioners to avoid complications. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3060-3065

  4. Emergent behaviors of classifier systems

    Energy Technology Data Exchange (ETDEWEB)

    Forrest, S.; Miller, J.H.

    1989-01-01

    This paper discusses some examples of emergent behavior in classifier systems, describes some recently developed methods for studying them based on dynamical systems theory, and presents some initial results produced by the methodology. The goal of this work is to find techniques for noticing when interesting emergent behaviors of classifier systems emerge, to study how such behaviors might emerge over time, and make suggestions for designing classifier systems that exhibit preferred behaviors. 20 refs., 1 fig.

  5. Building America

    Energy Technology Data Exchange (ETDEWEB)

    Brad Oberg

    2010-12-31

    IBACOS researched the constructability and viability issues of using high performance windows as one component of a larger approach to building houses that achieve the Building America 70% energy savings target.

  6. Vaginal Birth After Caesarean Section in Low Resource Settings: The Clinical and Ethical Dilemma.

    Science.gov (United States)

    Wanyonyi, Sikolia; Muriithi, Francis G

    2015-10-01

    Vaginal birth after Caesarean section (VBAC) has long been practised in low resource settings using unconventional methods. This not only poses danger to the woman and her baby, but could also have serious legal and ethical implications. The adoption of this practice has been informed by observational studies with many deficiencies; this is so despite other studies from settings in which the standard of care is much better that show that elective repeat Caesarean section (ERCS) may actually be safer than VBAC. This raises questions about whether we should insist on a dangerous practice when there are safer alternatives. We highlight some of the challenges faced in making this decision, and discuss why the fear of ERCS may not be justified after all in low resource settings. Since a reduction in rates of Caesarean section may not be applicable in these regions, because their rates are already low, the emphasis should instead be on adequate birth spacing and safer primary operative delivery.

  7. Injury to a transplanted kidney during caesarean section: a case report.

    Science.gov (United States)

    Shrestha, Badri Man; Throssell, David; McKane, William; Raftery, Andrew Thomas

    2007-06-01

    As fertility is restored after renal transplant, more female recipients of a renal transplant successfully complete pregnancies that are safe for the mother, the fetus, and the renal allograft. Although the transplanted kidney lies in one of the iliac fossae, normal vaginal delivery is not impeded by this positioning. Caesarean section is indicated in many scenarios, primarily for obstetric reasons, particularly when the transplanted kidney lies in a position where it could be injured. Here, we report our experiences managing a rare instance of injury to a transplanted kidney during caesarean section and discuss the relevant aspects of its management. To our knowledge, this is the first report in the English literature of an injury to a transplanted kidney during caesarean section.

  8. The respiratory consequences of early-term birth and delivery by caesarean sections.

    Science.gov (United States)

    Kotecha, Sarah J; Gallacher, David J; Kotecha, Sailesh

    2016-06-01

    In England and Wales, 19% of live births in 2012 were at 37-38 weeks' gestation, equating to nearly 140 000 early-term births each year. Since caesarean sections (CS) are often performed at early-term gestations, this accounts for some of the increased proportion of the early-term births. Infants born early-term are at an increased risk of neonatal respiratory morbidity particularly if they are delivered by caesarean section. The long term lung function data are limited but available data suggest that early-term delivery is associated with respiratory morbidity in childhood. CS also appears to be associated with increased neonatal morbidity and future development of respiratory symptoms. However, future studies need to confirm the independent effects of caesarean sections and early-term deliveries particularly for long term outcomes as both are likely to affect the respiratory system differently.

  9. Ogilvie's syndrome with caecal perforation after Caesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Saha Arin K

    2009-06-01

    Full Text Available Abstract Introduction Ogilvie's syndrome describes the phenomenon of an acute colonic pseudo-obstruction without a mechanical cause. It is rare but has been reported to occur after Caesarean section. It can lead to bowel perforation or ischaemia. Case presentation A healthy, 28-year-old Caucasian woman presented 2 weeks past her expected date of delivery for her first pregnancy. She underwent an uncomplicated elective Caesarean section but developed abdominal pain and bloating postoperatively and was subsequently diagnosed with acute colonic pseudo-obstruction, also known as Ogilvie's syndrome. Conclusion This case report highlights the rare, but potentially dangerous, diagnosis of Ogilvie's syndrome after Caesarean section. It is of particular interest to obstetricians, midwifery staff and general surgeons and shows the importance of accurate diagnosis, regular abdominal reassessment and early senior input to ensure appropriate and rapid treatment.

  10. Feature Selection and Effective Classifiers.

    Science.gov (United States)

    Deogun, Jitender S.; Choubey, Suresh K.; Raghavan, Vijay V.; Sever, Hayri

    1998-01-01

    Develops and analyzes four algorithms for feature selection in the context of rough set methodology. Experimental results confirm the expected relationship between the time complexity of these algorithms and the classification accuracy of the resulting upper classifiers. When compared, results of upper classifiers perform better than lower…

  11. Conventional laparotomy for management of caesarean scar ectopic pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Nilesh C. Mhaske

    2015-10-01

    Full Text Available Increase in the rates of caesarean deliveries has led to a concurrent rise in the number of caesarean scar ectopic pregnancies (CSEP. With recent advances, diagnosis can be made at an early gestational age, hence facilitating a prompt intervention. With the varied treatment options available, choosing the right one may possess a clinical dilemma. However, in a low resource setting, conventional laparotomy may be the only option feasible. A case of CSEP managed with laparotomy is presented. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1581-1584

  12. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2011-04-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  13. Anaesthetic management of a patient with Liddle's syndrome for emergency caesarean hysterectomy.

    LENUS (Irish Health Repository)

    Hayes, N E

    2012-02-01

    We describe the anaesthetic management of a patient with Liddle\\'s syndrome during caesarean section and emergency hysterectomy for placenta accreta associated with significant intrapartum haemorrhage. Liddle\\'s syndrome is a rare autosomal dominant disorder characterised by early onset arterial hypertension and hypokalaemic metabolic alkalosis. Additional issues were the presence of short stature, limb hypertonicity and preeclampsia. Initial management with a low-dose combined spinal-epidural technique was subsequently converted to general anaesthesia due to patient discomfort. The management of Liddle\\'s syndrome in the setting of neuraxial and general anaesthesia in a patient undergoing caesarean section is discussed.

  14. Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2

    OpenAIRE

    2011-01-01

    We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obs...

  15. [Life threatening postpartal haemorrhage after rupture of the vagina, uterine cervix, caesarean section or hysterectomy].

    Science.gov (United States)

    Kozovski, I; Radoinova, D

    2010-01-01

    The authors discuss 10 cases--seven after vaginal and cervical rupture, 2 after Caesarean section and 1 after hysterectomy. Six of them died--5 after rupture of the vagina and cervix and one after Caesarean section. The lethal issue was avoidable in all cases because it was a result of untimely done or not done at all hysterectomy and other interventions, e.g., ligation of the hypogastric arteries, as well as of faulty surgical performance. Basic principles of surgical behavior in such cases are postulated.

  16. Fear of childbirth and emergency caesarean section in low-risk nulliparous women

    DEFF Research Database (Denmark)

    Jespersen, Cecilie; Hegaard, Hanne Kristine; Schroll, Anne-Mette;

    2014-01-01

    OBJECTIVE: To assess the association between fear of childbirth (FOC) and emergency caesarean section. DESIGN: A prospective cohort study of low-risk nulliparous women at term. SETTING: Nine obstetric departments in Denmark, May 2004-July 2005. POPULATION: A total of 2598 nulliparous women...... was recorded by the attending staff. Logistic regression analyses were used to estimate unadjusted and adjusted odds ratios (OR). MAIN OUTCOME MEASURES: Risk of emergency caesarean section in women who feared childbirth. RESULTS: FOC (W-DEQ sum score ≥ 85 and DFS sum score ≥ 70) was not associated...

  17. Sampling Based Average Classifier Fusion

    Directory of Open Access Journals (Sweden)

    Jian Hou

    2014-01-01

    fusion algorithms have been proposed in literature, average fusion is almost always selected as the baseline for comparison. Little is done on exploring the potential of average fusion and proposing a better baseline. In this paper we empirically investigate the behavior of soft labels and classifiers in average fusion. As a result, we find that; by proper sampling of soft labels and classifiers, the average fusion performance can be evidently improved. This result presents sampling based average fusion as a better baseline; that is, a newly proposed classifier fusion algorithm should at least perform better than this baseline in order to demonstrate its effectiveness.

  18. Classified

    CERN Multimedia

    Computer Security Team

    2011-01-01

    In the last issue of the Bulletin, we have discussed recent implications for privacy on the Internet. But privacy of personal data is just one facet of data protection. Confidentiality is another one. However, confidentiality and data protection are often perceived as not relevant in the academic environment of CERN.   But think twice! At CERN, your personal data, e-mails, medical records, financial and contractual documents, MARS forms, group meeting minutes (and of course your password!) are all considered to be sensitive, restricted or even confidential. And this is not all. Physics results, in particular when being preliminary and pending scrutiny, are sensitive, too. Just recently, an ATLAS collaborator copy/pasted the abstract of an ATLAS note onto an external public blog, despite the fact that this document was clearly marked as an "Internal Note". Such an act was not only embarrassing to the ATLAS collaboration, and had negative impact on CERN’s reputation --- i...

  19. Optimally Training a Cascade Classifier

    CERN Document Server

    Shen, Chunhua; Hengel, Anton van den

    2010-01-01

    Cascade classifiers are widely used in real-time object detection. Different from conventional classifiers that are designed for a low overall classification error rate, a classifier in each node of the cascade is required to achieve an extremely high detection rate and moderate false positive rate. Although there are a few reported methods addressing this requirement in the context of object detection, there is no a principled feature selection method that explicitly takes into account this asymmetric node learning objective. We provide such an algorithm here. We show a special case of the biased minimax probability machine has the same formulation as the linear asymmetric classifier (LAC) of \\cite{wu2005linear}. We then design a new boosting algorithm that directly optimizes the cost function of LAC. The resulting totally-corrective boosting algorithm is implemented by the column generation technique in convex optimization. Experimental results on object detection verify the effectiveness of the proposed bo...

  20. A STUDY OF HYPERBARIC BUPIVACAINE VERSUS ISOBARIC ROPIVACAINE FOR ELECTIVE CAESAREAN DELIVERIES

    Directory of Open Access Journals (Sweden)

    Radha Ramana

    2016-05-01

    Full Text Available OBJECTIVE Is to compare the anaesthetic effects of intrathecal administration of hyperbaric Bupivacaine 10 mg with isobaric Ropivacaine 15 mg for elective caesarean delivery. METHOD 100 parturients of ASA 1 and II posted for elective caesarean delivery were randomly divided into 2 groups of 50 each: Group A received intrathecal 0.5% Hyperbaric Bupivacaine 10 mg and Group B received intrathecal 0.75% isobaric Ropivacaine 15 mg. Time of onset and regression of sensory and motor blocks, haemodynamics, time of first complaint of pain, neonatal APGAR and side-effects were evaluated. RESULTS Ropivacaine group has significantly slower onset of sensory analgesia at T6 (4.45±0.03 in Ropivacaine group as against 2.38±0.36 in Bupivacaine group, p 0.05. There was no difference in the haemodynamics and neonatal APGAR. Neither of the groups had any significant intraoperative or postoperative complications. CONCLUSION Intrathecal Isobaric Ropivacaine 15 mg provides effective spinal anaesthesia for caesarean delivery. It has slower onset, shorter motor block, early sensory regression and similar postoperative analgesia and APGAR scores as compared to 10 mg of 0.5% hyperbaric bupivacaine. The shorter duration of motor block can facilitate early ambulation and makes Ropivacaine a good alternative for elective caesarean deliveries.

  1. Compromised immune response in infants at risk for type 1 diabetes born by Caesarean Section.

    Science.gov (United States)

    Puff, R; D'Orlando, O; Heninger, A-K; Kühn, D; Krause, S; Winkler, C; Beyerlein, A; Bonifacio, E; Ziegler, A-G

    2015-10-01

    Children born by Caesarean Section have a higher risk for type 1 diabetes. We aimed to investigate whether Caesarean Section leads to alterations of the immune response in children with familial risk for type 1 diabetes. We examined measures of innate and adaptive immune responses in 94 prospectively followed children, including 40 born by Caesarean Section. Proinflammatory serum cytokine concentrations were determined at age 6 months. As a measure of vaccine response, IgG1, IgG2, and IgG4 tetanus antibody titers and CD4(+) T cell proliferation against tetanus toxoid were quantified. Compared to infants born by vaginal delivery, infants born by Caesarean Section had lower concentrations of the cytokines IFN-ɣ (p=0.014) and IL-8 (p=0.005), and weaker CD4(+) T cell responses to tetanus measured in the first (p=0.007) and second year (p=0.047) of life. Overall, our findings provide evidence that the mode of delivery influences the immune status and responsiveness during childhood.

  2. Beyond the short term effects of caesarean delivery and gynaecological surgery

    NARCIS (Netherlands)

    Kok, N.

    2015-01-01

    The work presented in this thesis focuses on the risk of maternal and neonatal complications in pregnancies after previous caesarean section and strategies for the prevention of post-surgical adhesion formation after abdominal and gynaecological surgery. In Part One: "Pregnancy and delivery after ca

  3. Caesarean section delivery in Kerala, India : evidence from a national family health survey

    NARCIS (Netherlands)

    Padmadas, SS; Kumar, S; Nair, SB; Kumari, A

    2000-01-01

    Ensuring safe pregnancy and motherhood occupies a pivotal role and has been considered as one of the key issues in the framework of reproductive and child health programmes, Evidence from research studies indicate that there is a growing tendency for caesarean section deliveries especially during co

  4. Caesarean Section--A Density-Equalizing Mapping Study to Depict Its Global Research Architecture.

    Science.gov (United States)

    Brüggmann, Dörthe; Löhlein, Lena-Katharina; Louwen, Frank; Quarcoo, David; Jaque, Jenny; Klingelhöfer, Doris; Groneberg, David A

    2015-11-17

    Caesarean section (CS) is a common surgical procedure. Although it has been performed in a modern context for about 100 years, there is no concise analysis of the international architecture of caesarean section research output available so far. Therefore, the present study characterizes the global pattern of the related publications by using the NewQIS (New Quality and Quantity Indices in Science) platform, which combines scientometric methods with density equalizing mapping algorithms. The Web of Science was used as a database. 12,608 publications were identified that originated from 131 countries. The leading nations concerning research activity, overall citations and country-specific h-Index were the USA and the United Kingdom. Relation of the research activity to epidemiologic data indicated that Scandinavian countries including Sweden and Finland were leading the field, whereas, in relation to economic data, countries such as Israel and Ireland led. Semi-qualitative indices such as country-specific citation rates ranked Sweden, Norway and Finland in the top positions. International caesarean section research output continues to grow annually in an era where caesarean section rates increased dramatically over the past decades. With regard to increasing employment of scientometric indicators in performance assessment, these findings should provide useful information for those tasked with the improvement of scientific achievements.

  5. Parental height differences predict the need for an emergency Caesarean section

    NARCIS (Netherlands)

    Stulp, Gert; Verhulst, Simon; Pollet, Thomas V.; Nettle, Daniel; Buunk, Abraham P.

    2011-01-01

    More than 30% of all pregnancies in the UK require some form of assistance at delivery, with one of the more severe forms of assistance being an emergency Caesarean section (ECS). Previously it has been shown that the likelihood of a delivery via ECS is positively associated with the birth weight an

  6. Can Intrapartum Cardiotocography Predict Uterine Rupture among Women with Prior Caesarean Delivery?

    DEFF Research Database (Denmark)

    Andersen, Malene M; Thisted, Dorthe L A; Amer-Wåhlin, Isis;

    2016-01-01

    OBJECTIVE: To compare cardiotocographic abnormalities recorded during labour in women with prior caesarean delivery (CD) and complete uterine rupture with those recorded in controls with prior CD without uterine rupture. STUDY DESIGN: Women with complete uterine rupture during labour between 1997...

  7. Criteria-based audit of caesarean section in a referral hospital in rural Tanzania

    NARCIS (Netherlands)

    Heemelaar, S; Nelissen, E; Mdoe, P; Kidanto, H; van Roosmalen, J; Stekelenburg, J

    2016-01-01

    OBJECTIVE: WHO uses the Caesarean section (CS) rate to monitor implementation of emergency obstetric care (EmOC). Although CS rates are rising in sub-Saharan Africa, maternal outcome has not improved. We audited indications for CS and related complications among women with severe maternal morbidity

  8. The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis

    Directory of Open Access Journals (Sweden)

    Kaundinya Kiran Bharatam

    2015-01-01

    Conclusion: Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy.

  9. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola

    2017-01-01

    ) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal...

  10. Sequential combined spinal epidural anaesthesia for caesarean section in peripartum cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Kumari Indira

    2007-01-01

    Full Text Available Peripartum cardiomyopathy (PPCM is defined as the onset of acute heart failure without demonstrable cause in the last trimester of pregnancy or within the first 6 months after delivery.We report a case of PPCM (LVEF< 25% requiring caesarean section who was successfully managed with sequential combined spinal epidural anaesthesia.

  11. Caries prevalence in Danish pre-school children delivered vaginally and by caesarean section

    DEFF Research Database (Denmark)

    Barfod, Mette Nelun; Christensen, Lisa Bøge; Twetman, Svante Henrik Agardh;

    2012-01-01

    OBJECTIVE: The mode of delivery may significantly influence the diversity and composition of the oral microflora and facilitate early acquisition of mutans streptococci. The aim was to compare caries prevalence and experience in 3-year-old children delivered vaginally and by caesarean section (C...

  12. The half-life and exposure of cefuroxime varied in newborn infants after a Caesarean section

    DEFF Research Database (Denmark)

    Zachariassen, G.; Hyldig, N.; Joergensen, J.S.;

    2016-01-01

    Aim: No information was available on how fast intravenous cefuroxime administered to pregnant women before a Caesarean section was cleared in newborn infants. This study investigated the drug's half-life and the exposure of healthy newborn infants after their mothers received the drug. Methods....... Exposure to cefuroxime in newborn infants may influence the gut microbiota and should be investigated further....

  13. Caesarean delivery and subsequent stillbirth or miscarriage: systematic review and meta-analysis

    NARCIS (Netherlands)

    O'Neill, S.M.; Kearney, P.M.; Kenny, L.C.; Khashan, A.S.; Henriksen, T.B.; Lutomski, J.E.; Greene, R.A.

    2013-01-01

    OBJECTIVE: To compare the risk of stillbirth and miscarriage in a subsequent pregnancy in women with a previous caesarean or vaginal delivery. DESIGN: Systematic review of the published literature including seven databases: CINAHL; the Cochrane library; Embase; Medline; PubMed; SCOPUS and Web of Kno

  14. Suspected total spinal in patient having emergent Caesarean section, a case report and literature review

    Directory of Open Access Journals (Sweden)

    H. Virgin, MD

    2016-01-01

    Concluiosn: To perform spinal anaesthesia for emergent Caesarean in patients having an epidural for labour pain is a feasible option and should be considered in category 2–3 section. The dose for a convert spinal block should be assessed on an individual basis and reasonably reduced.

  15. Combining different types of classifiers

    OpenAIRE

    Gatnar, Eugeniusz

    2008-01-01

    Model fusion has proved to be a very successful strategy for obtaining accurate models in classification and regression. The key issue, however, is the diversity of the component classifiers because classification error of an ensemble depends on the correlation between its members. The majority of existing ensemble methods combine the same type of models, e.g. trees. In order to promote the diversity of the ensemble members, we propose to aggregate classifiers of different t...

  16. Optimal weighted nearest neighbour classifiers

    CERN Document Server

    Samworth, Richard J

    2011-01-01

    We derive an asymptotic expansion for the excess risk (regret) of a weighted nearest-neighbour classifier. This allows us to find the asymptotically optimal vector of non-negative weights, which has a rather simple form. We show that the ratio of the regret of this classifier to that of an unweighted $k$-nearest neighbour classifier depends asymptotically only on the dimension $d$ of the feature vectors, and not on the underlying population densities. The improvement is greatest when $d=4$, but thereafter decreases as $d \\rightarrow \\infty$. The popular bagged nearest neighbour classifier can also be regarded as a weighted nearest neighbour classifier, and we show that its corresponding weights are somewhat suboptimal when $d$ is small (in particular, worse than those of the unweighted $k$-nearest neighbour classifier when $d=1$), but are close to optimal when $d$ is large. Finally, we argue that improvements in the rate of convergence are possible under stronger smoothness assumptions, provided we allow nega...

  17. Incidence and risk factors for caesarean wound infection in Lagos Nigeria

    Directory of Open Access Journals (Sweden)

    Gab-Okafor Chidinma V

    2009-09-01

    Full Text Available Abstract Background Post caesarean wound infection is not only a leading cause of prolonged hospital stay but a major cause of the widespread aversion to caesarean delivery in developing countries. In order to control and prevent post caesarean wound infection in our environment there is the need to access the relative contribution of each aetiologic factor. Though some studies in our environment have identified factors associated with post caesarean wound infection, none was specifically designed to address these issues prospectively or assess the relative contribution of each of the risk factors. Findings Prospective multicentre study over a period of 56 months in Lagos Nigeria. All consecutive and consenting women scheduled for caesarean section and meeting the inclusion criteria were enrolled into the study. Cases were all subjects with post caesarean wound infection. Those without wound infection served as controls. Data entry and analysis were performed using EPI-Info programme version 6 and SPSS for windows version 10.0. Eight hundred and seventeen women were enrolled into the study. Seventy six (9.3% of these cases were complicated with wound infection. The proportion of subjects with body mass index greater than 25 was significantly higher among the subjects with wound infection (51.3% than in the subjects without wound infection (33.9% p = 0.011. There were also significantly higher proportions of subjects with prolonged rupture of membrane (p = 0.02, prolonged operation time (p = 0.001, anaemia (p = 0.031 and multiple vaginal examinations during labour (0.021 among the women that had wound infection compared to the women that did not have wound infection. After adjustment for confounders only prolonged rupture of membrane (OR = 4.45, prolonged operation time (OR = 2.87 and body max index > 25 (2.34 retained their association with post caesarean wound infection. Conclusion Effort should be geared towards the prevention of prolonged

  18. Outcomes of induction of labour in women with previous caesarean delivery: a retrospective cohort study using a population database.

    Directory of Open Access Journals (Sweden)

    Sarah J Stock

    Full Text Available BACKGROUND: There is evidence that induction of labour (IOL around term reduces perinatal mortality and caesarean delivery rates when compared to expectant management of pregnancy (allowing the pregnancy to continue to await spontaneous labour or definitive indication for delivery. However, it is not clear whether IOL in women with a previous caesarean section confers the same benefits. The aim of this study was to describe outcomes of IOL at 39-41 weeks in women with one previous caesarean delivery and to compare outcomes of IOL or planned caesarean delivery to those of expectant management. METHODS AND FINDINGS: We performed a population-based retrospective cohort study of singleton births greater than 39 weeks gestation, in women with one previous caesarean delivery, in Scotland, UK 1981-2007 (n = 46,176. Outcomes included mode of delivery, perinatal mortality, neonatal unit admission, postpartum hemorrhage and uterine rupture. 40.1% (2,969/7,401 of women who underwent IOL 39-41 weeks were ultimately delivered by caesarean. When compared to expectant management IOL was associated with lower odds of caesarean delivery (adjusted odds ratio [AOR] after IOL at 39 weeks of 0.81 [95% CI 0.71-0.91]. There was no significant effect on the odds of perinatal mortality but greater odds of neonatal unit admission (AOR after IOL at 39 weeks of 1.29 [95% CI 1.08-1.55]. In contrast, when compared with expectant management, elective repeat caesarean delivery was associated with lower perinatal mortality (AOR after planned caesarean at 39 weeks of 0.23 [95% CI 0.07-0.75] and, depending on gestation, the same or lower neonatal unit admission (AOR after planned caesarean at 39 weeks of 0.98 [0.90-1.07] at 40 weeks of 1.08 [0.94-1.23] and at 41 weeks of 0.77 [0.60-1.00]. CONCLUSIONS: A more liberal policy of IOL in women with previous caesarean delivery may reduce repeat caesarean delivery, but increases the risks of neonatal complications.

  19. Textbook America.

    Science.gov (United States)

    Karp, Walter

    1980-01-01

    Focuses on how political attitudes have been influenced by American history textbooks at various times throughout history. Excerpts from traditional and revisionist textbooks are presented, with emphasis on "America Revised" by Frances FitzGerald. Journal available from Harper's Magazine Co., 2 Park Ave., New York, NY 10016. (DB)

  20. Impact of Bifidobacterium lactis supplementation on fecal microbiota in infants delivered vaginally compared to Caesarean section

    Directory of Open Access Journals (Sweden)

    Tetty Yuniaty

    2013-03-01

    Full Text Available AbstractBackground It has been reported that infants born by Caesarean section have altered gut microbiota, with lower numbers of bifidobacteria and Bacteroides, compared to that of infants who were delivered vaginally. Probiotic supplementation has been reported to have beneficial effects on the immune response, generally in relation to allergies.Objective To assess the effect of Bifidobacterium lactis (B. lactis supplementation on the presence of B. lactis and bifidobacteria counts in stool of infants during the first 2 months of life.Methods We conducted an observational study of 122 healthy, breast-fed infants delivered vaginally or by Caesarean section. Infants assigned to the test group received breast milk and formula supplemented with the B. lactis probiotics. Infants in the control group received breast milk and formula without probiotics. The presence of B. lactis and stool bifidobacteria counts were determined at 1 month and 2 months of age. Growth, morbidity, serum immune markers, and stool immunoglobulin (Ig A were also assessed.Results B. lactis was more frequently detected in the stool of infants who received breast milk and probiotic-supplemented formula than in stool of infants who received breast milk and non-supplemented formula, both at 1 month and 2 months of age (OR 1,263; 95%CI 11 to 151,030; P=0.003. Of infants who received probiotic-supplemented formula, B. lactis was detected in 80% of those delivered by Caesarean section and in 38% of those delivered vaginally, at the 1-month mark. In infants delivered by Caesarean section, the mean stool bifidobacteria level at 1 month was significantly higher in the probiotic-supplemented group compared to that of the non-supplemented group (P=0.021.Conclusion Eearly bifidobacteria supplementation of infants, particularly those delivered by Caesarean section, is associated with higher levels of stool bifidobacteria. Anthropometric data suggests beneficial effects of bifidobacteria

  1. Impact of Bifidobacterium lactis supplementation on fecal microbiota in infants delivered vaginally compared to Caesarean section

    Directory of Open Access Journals (Sweden)

    Tetty Yuniaty

    2013-03-01

    Full Text Available Background It has been reported that infants born by Caesarean section have altered gut microbiota, with lower numbers of bifidobacteria and Bacteroides, compared to that of infants who were delivered vaginally. Probiotic supplementation has been reported to have beneficial effects on the immune response, generally in relation to allergies. Objective To assess the effect of Bifidobacterium lactis (B. lactis supplementation on the presence of B. lactis and bifidobacteria counts in stool of infants during the first 2 months of life. Methods We conducted an observational study of 122 healthy, breast-fed infants delivered vaginally or by Caesarean section. Infants assigned to the test group received breast milk and formula supplemented with the B. lactis probiotics. Infants in the control group received breast milk and formula without probiotics. The presence of B. lactis and stool bifidobacteria counts were determined at 1 month and 2 months of age. Growth, morbidity, serum immune markers, and stool immunoglobulin (Ig A were also assessed. Results B. lactis was more frequently detected in the stool of infants who received breast milk and probiotic-supplemented formula than in stool of infants who received breast milk and non-supplemented formula, both at 1 month and 2 months of age (OR 1,263; 95%CI 11 to 151,030; P=0.003. Of infants who received probiotic-supplemented formula, B. lactis was detected in 80% of those delivered by Caesarean section and in 38% of those delivered vaginally, at the 1-month mark. In infants delivered by Caesarean section, the mean stool bifidobacteria level at 1 month was significantly higher in the probiotic-supplemented group compared to that of the non-supplemented group (P=0.021. Conclusion Eearly bifidobacteria supplementation of infants, particularly those delivered by Caesarean section, is associated with higher levels of stool bifidobacteria. Anthropometric data suggests beneficial effects of bifidobacteria

  2. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan

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    Zaman Shakila

    2010-01-01

    Full Text Available Abstract Background Public hospitals in developing countries, rather than the preventive and primary healthcare sectors, are the major consumers of healthcare resources. Imbalances in rational, equitable and efficient allocation of scarce resources lie in the scarcity of research & information on economic aspects of health care. The objective of this study was to determine the average cost of a spontaneous vaginal delivery and Caesarean section in a tertiary level government hospital in Islamabad, Pakistan and to estimate the out of pocket expenditures to households using these services. Methods This hospital based cost accounting cross sectional study determines the average cost of vaginal delivery and Caesarean section from two perspectives, the patient's and the hospital. From the patient's perspective direct and indirect expenditures of 133 post-partum mothers (65 delivered by Caesarean section & 68 by spontaneous vaginal delivery admitted in the maternity general ward were determined. From the hospital perspective the step down methodology was adopted, capital and recurrent costs were determined from inputs and cost centers. Results The average cost for a spontaneous vaginal delivery from the hospital's side was 40 US$ (2688 rupees and from the patient's perspective was 79 US$ (5278 rupees. The average cost for a Caesarean section from the hospital side was 162 US$ (10868 rupees and 204 US$ (13678 rupees from the patient's side. Average monthly household income was 141 ± 87 US$ for spontaneous vaginal delivery and 168 ± 97 US$ for Caesarean section. Three fourth (74% of households had a monthly income of less than 149 US$ (10000 rupees. Conclusion The apparently "free" maternity care at government hospitals involves substantial hidden and unpredicted costs. The anticipated fear of these unpredicted costs may be major factor for many poor households to seek cheaper alternate maternity healthcare.

  3. Hybrid classifiers methods of data, knowledge, and classifier combination

    CERN Document Server

    Wozniak, Michal

    2014-01-01

    This book delivers a definite and compact knowledge on how hybridization can help improving the quality of computer classification systems. In order to make readers clearly realize the knowledge of hybridization, this book primarily focuses on introducing the different levels of hybridization and illuminating what problems we will face with as dealing with such projects. In the first instance the data and knowledge incorporated in hybridization were the action points, and then a still growing up area of classifier systems known as combined classifiers was considered. This book comprises the aforementioned state-of-the-art topics and the latest research results of the author and his team from Department of Systems and Computer Networks, Wroclaw University of Technology, including as classifier based on feature space splitting, one-class classification, imbalance data, and data stream classification.

  4. 3D Bayesian contextual classifiers

    DEFF Research Database (Denmark)

    Larsen, Rasmus

    2000-01-01

    We extend a series of multivariate Bayesian 2-D contextual classifiers to 3-D by specifying a simultaneous Gaussian distribution for the feature vectors as well as a prior distribution of the class variables of a pixel and its 6 nearest 3-D neighbours.......We extend a series of multivariate Bayesian 2-D contextual classifiers to 3-D by specifying a simultaneous Gaussian distribution for the feature vectors as well as a prior distribution of the class variables of a pixel and its 6 nearest 3-D neighbours....

  5. Delivery by caesarean section and risk of childhood obesity: analysis of a Peruvian prospective cohort

    Directory of Open Access Journals (Sweden)

    Rodrigo M. Carrillo-Larco

    2015-06-01

    Full Text Available Objectives. We aimed to assess if Caesarean section is a risk factor for overnutrition in early- and late-childhood, and to assess the magnitude of the effect of child- versus family-related variables in these risk estimates.Methods. Longitudinal data from Peruvian children from the Young Lives Study was used. Outcomes assessed were overweight, obesity, overnutrition (overweight plus obesity, and central obesity (waist circumference at the age 5 (first follow-up and 7 (second follow-up years. The exposure of interests was delivery by Caesarean section. Relative risks (RR and 95% confidence intervals (95% CI were calculated using multivariable models adjusted for child-related (e.g., birth weight and family-related (e.g., maternal nutritional status variables.Results. At baseline, mean age was 11.7 (± 3.5 months and 50.1% were boys. Children born by Caesarean section were 15.6%. The 10.5% of the children were overweight and 2.4% were obese. For the obesity outcome, data from 6,038 and 9,625 children-years was included from baseline to the first and second follow-up, respectively. Compared to those who did not experience Caesarean delivery, the risk of having obesity was higher in the group born by Caesarean: RRs were higher at early-childhood (first follow-up: 2.25; 95% CI [1.36–3.74] than later in life (second follow-up: 1.57; 95% CI [1.02–2.41]. Family-related variables had a greater effect in attenuating the risk estimates for obesity at the first, than at the second follow-up.Conclusion. Our results suggest a higher probability of developing obesity, but not overweight, among children born by Caesarean section delivery. The magnitude of risk estimates decreased over time, and family-related variables had a stronger effect on the risk estimates at early-childhood.

  6. Effect of Planned Early Recommended Ambulation Technique on Selected Post caesarean Biophysiological Health Parameters

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    Jyoti V. Dube

    2014-01-01

    Full Text Available Background: Caesarean section has been a part of human culture since ancient times. It has been used effectively throughout the 20th century and among the major abdominal surgeries, it is the most common, oldest worldwide surgery performed in obstetrics. Despite the life saving advantages, there are several adverse consequences of caesarean delivery for a woman and to her household. The rate and risk of these complications increases due to the increasing incidence mainly in countries like India. The role of nurse midwife is to act in the best interest of patient and newborn and make the patient independent in carrying out the activities of daily living as soon as possible. This can lead to a faster recovery and shorter hospital stay. Also it can indirectly help in reducing the complications associated with prolonged bed rest and can improve the maternal newborn bonding. Aim and Objectives: The present study was done to evaluate the effect of planned early ambulation on selected biophysiological health parameters of post caesarean patients. Material and Methods: The study included total 500 study subjects, 250 in experimental and 250 in control group. Quasi experimental approach with multiple time series design was adopted for the study. The experimental group was given an early planned recommended ambulation technique starting from the day of surgery. This consisted of deep breathing exercise, cough exercise, leg exercise and early mobilization. Over and above, the routine general health care was given by the doctors and nurses. The control group received only by routine general care by doctors and nurses and mobilization on third post operative day as per strategy adopted by the hospital. The deep breathing exercises, coughing exercises and leg exercises were not given routinely and hence were not given to the control group. Post caesarean biophysiological parameters chart was used to assess the selected parameters for first five post operative

  7. Classifying Cereal Data (Earlier Methods)

    Science.gov (United States)

    The DSQ includes questions about cereal intake and allows respondents up to two responses on which cereals they consume. We classified each cereal reported first by hot or cold, and then along four dimensions: density of added sugars, whole grains, fiber, and calcium.

  8. Maximum margin Bayesian network classifiers.

    Science.gov (United States)

    Pernkopf, Franz; Wohlmayr, Michael; Tschiatschek, Sebastian

    2012-03-01

    We present a maximum margin parameter learning algorithm for Bayesian network classifiers using a conjugate gradient (CG) method for optimization. In contrast to previous approaches, we maintain the normalization constraints on the parameters of the Bayesian network during optimization, i.e., the probabilistic interpretation of the model is not lost. This enables us to handle missing features in discriminatively optimized Bayesian networks. In experiments, we compare the classification performance of maximum margin parameter learning to conditional likelihood and maximum likelihood learning approaches. Discriminative parameter learning significantly outperforms generative maximum likelihood estimation for naive Bayes and tree augmented naive Bayes structures on all considered data sets. Furthermore, maximizing the margin dominates the conditional likelihood approach in terms of classification performance in most cases. We provide results for a recently proposed maximum margin optimization approach based on convex relaxation. While the classification results are highly similar, our CG-based optimization is computationally up to orders of magnitude faster. Margin-optimized Bayesian network classifiers achieve classification performance comparable to support vector machines (SVMs) using fewer parameters. Moreover, we show that unanticipated missing feature values during classification can be easily processed by discriminatively optimized Bayesian network classifiers, a case where discriminative classifiers usually require mechanisms to complete unknown feature values in the data first.

  9. Anaesthetic Management of Parturient with Acute Atrial Fibrillation for Emergency Caesarean Section

    Directory of Open Access Journals (Sweden)

    Madhu Gupta

    2013-01-01

    Full Text Available A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate their cardiac symptoms. They may present with complications like congestive cardiac failure, atrial fibrillation, or pulmonary thromboembolism during the antenatal, intrapartum, or postpartum period. Here we discuss the management of parturient woman with high maternal and fetal risk presenting for emergency caesarean. The merits of regional anaesthesia and the importance of invasive monitoring are also discussed.

  10. Epidural volume extension in combined spinal epidural anaesthesia for elective caesarean section: a randomised controlled trial.

    Science.gov (United States)

    Loubert, C; O'Brien, P J; Fernando, R; Walton, N; Philip, S; Addei, T; Columb, M O; Hallworth, S

    2011-05-01

    We investigated the effect of epidural volume extension on spinal blockade in pregnant women undergoing elective caesarean section with a combined spinal-epidural technique. We randomly allocated 90 healthy subjects to three groups to receive spinal hyperbaric bupivacaine 7.5 mg (group B7.5), spinal hyperbaric bupivacaine 7.5 mg immediately followed by epidural volume extension with saline 5 ml (group B7.5-EVE) or spinal hyperbaric bupivacaine 10 mg without epidural volume extension (group B10). We evaluated the height of the block every 5 min for 15 min following the spinal injection. The overall sensory block level increased with time (p epidural volume extension with 5 ml saline as part of a combined spinal epidural technique in term parturients undergoing elective caesarean section.

  11. Unusual case of persistent Horner's syndrome following epidural anaesthesia and caesarean section.

    Science.gov (United States)

    Goel, Shubhra; Burkat, Cat Nguyen

    2011-01-01

    This is a rare case of persistent Horner's syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) of head, neck, and chest were unremarkable. Medline search using terms Horner's, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles describing Horner's syndrome in obstetric epidural anesthesia, of which 11 were following Caesarean section. The increased incidence of Horner's syndrome in the setting of epidural anesthesia in pregnancy may be related to epidural venous engorgement and cephalic spread of the local anaesthetic, with disruption in the oculosympathetic pathway. It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner's syndrome in a postpartum female. Rarely, the ptosis may be permanent and require surgical intervention.

  12. ANESTHETIC MANAGEMENT OF AN ANEMIC PARTURIENT WITH SEVERE KYPHOSCOLIOSIS AND BILATERAL POLIOMYELITIS FOR EMERGENCY CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Sujay

    2014-05-01

    Full Text Available Anesthesia for emergency caesarean section for a pregnant patient with severe dorsolumbar kyphoscoliosis and severe anemia is associated with potential risks for both mother and the fetus due to alterations in maternal physiology and the pathological changes associated with kyphoscoliosis. In an emergency situation, the anesthesiologist has to quickly choose the anesthetic technique depending on the cardiopulmonary status of the patient and feasibility. We present a case of a 20 year old parturient in labour with severe kyphoscoliosis and severe anemia who was posted for emergency caesarean section. In view of severe anemia, anticipated technical difficulties with central neuraxial blocks and emergency situation, she was administered general anesthesia (GA with uneventful recovery.

  13. Epidural top-up solutions for emergency caesarean section: a comparison of preparation times.

    Science.gov (United States)

    Lucas, D N; Borra, P J; Yentis, S M

    2000-04-01

    We compared the preparation times of three solutions commonly used for epidural top-up for emergency Caesarean section. Twenty-two anaesthetists were asked to prepare fresh solutions in random order as quickly as possible: 0.5% bupivacaine 20 ml (B); 2% lidocaine 20 ml with 1:200,000 epinephrine (LE); and 0.5% bupivacaine 10 ml and 2% lidocaine 10 ml with 1:200,000 epinephrine and 8.4% sodium bicarbonate 2 ml (BLEB). Preparation times for B were approximately half of those for LE, which in turn were approximately half of those for BLEB (P = 0.0001). If local anaesthetic solutions with additives such as epinephrine or bicarbonate are prepared just before emergency Caesarean section, any possible reduction in onset time that they might afford may be offset by the additional preparation time required.

  14. Unusual case of persistent Horner′s syndrome following epidural anaesthesia and caesarean section

    Directory of Open Access Journals (Sweden)

    Shubhra Goel

    2011-01-01

    Full Text Available This is a rare case of persistent Horner′s syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI/magnetic resonance angiography (MRA of head, neck, and chest were unremarkable. Medline search using terms Horner′s, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles describing Horner′s syndrome in obstetric epidural anesthesia, of which 11 were following Caesarean section. The increased incidence of Horner′s syndrome in the setting of epidural anesthesia in pregnancy may be related to epidural venous engorgement and cephalic spread of the local anaesthetic, with disruption in the oculosympathetic pathway. It is important to include recent epidural anesthesia within the differential diagnosis of acute Horner′s syndrome in a postpartum female. Rarely, the ptosis may be permanent and require surgical intervention.

  15. Vaginal prostaglandin gel to induce labour in women with one previous caesarean section.

    LENUS (Irish Health Repository)

    Agnew, G

    2012-02-01

    This retrospective study reviewed the mode of delivery when vaginal prostaglandins were used to induce labour in women with a single previous lower segment caesarean section. Over a 4-year period, PGE 2 gel was used cautiously in low doses in 54 women. Induction with PGE 2 gel was associated with an overall vaginal birth after caesarean section (VBAC) rate of 74%, which compared favourably with the 74% VBAC rate in women who went into spontaneous labour (n = 1969). There were no adverse outcomes recorded after the prostaglandin inductions but the number reported are too small to draw any conclusions about the risks, such as uterine rupture. We report our results because they may be helpful in assessing the chances of a successful VBAC in the uncommon clinical circumstances where prostaglandin induction is being considered.

  16. [Caesarean section in conflict with the patient's right to self-determination?].

    Science.gov (United States)

    Blondeau, Marie-José C E; Koorengevel, Kathelijne M; Schneider, A J Tom; van der Knijff-van Dortmont, A L M J Anouk; Dondorp, Wybo J

    2015-01-01

    Competent patients have the right to refuse treatment and healthcare workers should acknowledge their wishes. In the Netherlands there are conflicting (constitutional) rights of the foetus and of mentally ill patients. This paper describes the legal and ethical problems in the case of a mentally ill patient at 37 weeks of pregnancy who refused an obstetric examination. The patient refused to cooperate and have her physical condition and mental status examined. Her refusal endangered the life of the foetus. The obstetrician decided to perform a caesarean section, even if this would be in conflict with the patient's right to self-determination. In these cases no legal framework exists for providing the best medical care. New legislation should be drawn up to prevent similar cases occurring in the future. If a caesarean section is in conflict with a patient's right to self-determination, it should always be performed as a last resort.

  17. 76 FR 34761 - Classified National Security Information

    Science.gov (United States)

    2011-06-14

    ... Classified National Security Information AGENCY: Marine Mammal Commission. ACTION: Notice. SUMMARY: This... information, as directed by Information Security Oversight Office regulations. FOR FURTHER INFORMATION CONTACT..., ``Classified National Security Information,'' and 32 CFR part 2001, ``Classified National Security......

  18. Classifying self-gravitating radiations

    CERN Document Server

    Kim, Hyeong-Chan

    2016-01-01

    We study static systems of self-gravitating radiations confined in a sphere by using numerical and analytic calculations. We classify and analyze the solutions systematically. Due to the scaling symmetry, any solution can be represented as a segment of a solution curve on a plane of two-dimensional scale invariant variables. We find that a system can be conveniently parametrized by three parameters representing the solution curve, the scaling, and the system size, instead of the parameters defined at the outer boundary. The solution curves are classified to three types representing regular solutions, conically singular solutions with, and without an object which resembles an event horizon up to causal disconnectedness. For the last type, the behavior of a self-gravitating system is simple enough to allow analytic calculations.

  19. Role of tranexamic acid in reducing blood loss during and after caesarean section

    Directory of Open Access Journals (Sweden)

    Simran Kaur Bhatia

    2015-01-01

    Full Text Available Introduction: Association between caesarean section and intra operative and post operative bleeding is known. Post-partum hemorrhage is still a leading cause for maternal morbidity and mortality. This study will evaluate the efficacy and safety of tranexamic acid in reducing the blood loss after placental delivery following lower segment caesarean section (LSCS and note any adverse effects. Materials and Methods: A total of 100 women, who underwent elective or emergency primary caesarean section at term between 37 and 41 weeks have been studied prospectively. They were divided into two groups. In the study group of 50, tranexamic acid 1 gm IV was given 20 minutes before making incision for caesarean section and the control group of 50 did not receive tranexamic acid. Statistical Analysis: For quantitative outcomes, the t-test was used to test for difference in the two groups. For categorical outcomes, chi square and odds ratio with 95% confidence interval were used as applicable. Results: The patient characteristics, namely age, height, weight, gestational age and gravidity in two groups were similar which was statistically insignificant. Hemoglobin decreased slightly after birth in both groups but no statistical difference between two groups was noticed. There was no episode of thrombosis in the study. Tranexamic acid significantly reduced the quantity of the blood loss from time of placental delivery to 2 hours postpartum (P < 0.001 and from end of LSCS to 2 hours postpartum (P < 0.001. However, there was no statistical difference in quantity of blood loss from time of placental delivery to end of LSCS in both groups (P < 0.001. Conclusion: A safe dose of tranexamic acid has an effective role in reducing blood loss during LSCS without causing adverse reaction. Thus, drug can be used effectively in reducing maternal morbidity and mortality during LSCS.

  20. CORONIS - International study of caesarean section surgical techniques: the follow-up study

    OpenAIRE

    Abalos, E; Oyarzun, E; Addo, V.; Sharma, JB; Matthews, J; Oyieke, J; Masood, SN; El Sheikh, MA; Brocklehurst, P.; Farrell, B; Gray, S; Hardy, P.; Jamieson, N; Juszczak, E.; Spark, P

    2013-01-01

    BACKGROUND: The CORONIS Trial was a 2×2×2×2×2 non-regular, fractional, factorial trial of five pairs of alternative caesarean section surgical techniques on a range of short-term outcomes, the primary outcome being a composite of maternal death or infectious morbidity. The consequences of different surgical techniques on longer term outcomes have not been well assessed in previous studies. Such outcomes include those related to subsequent pregnancy: mode of delivery; abnormal placentation (e....

  1. Anesthetic management of caesarean section in a patient with double outlet right ventricle

    OpenAIRE

    Rohith Krishna; Umesh Goneppanavar

    2012-01-01

    Double outlet right ventricle (DORV) is a rare congenital heart defect involving the great arteries. In DORV, both aorta and pulmonary artery arise from the right ventricle resulting in admixture of blood. We report a 22-year-old parturient with DORV and severe pulmonary stenosis who underwent caesarean delivery at 36 weeks gestation with low dose combined spinal-epidural anesthesia. This lady was assessed by echocardiogram to have situs inversus, dextrocardia, severe pulmonary artery stenosi...

  2. Anaesthetic management of peripartum cardiomyopathy for emergency caesarean section: A case report

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2014-06-01

    Full Text Available Peripartum cardiomyopathy is a rare but life threatening condition. Anaesthetic management of a patient with peripartum cardiomyopathy for caesarean section is a major challenge for anaesthesiologist. Timely diagnosis of the condition, institution of appropriate medication regimen, a carefully chosen anaesthetic technique and vigilant perioperative monitoring are essential for optimizing outcome in these patients. The goals of anaesthetic management include maintenance of optimal ventricular preload and afterload while avoiding any anaesthesia induced myocardial depression.

  3. Caesarean section in a parturient with Carpenter syndrome and corrected Tetralogy of Fallot.

    Science.gov (United States)

    Bhardwaj, M; Grange, C

    2013-07-01

    Carpenter syndrome is an extremely rare congenital disorder characterized by craniofacial malformations, syndactyly, cardiac defects and obesity. Even after surgical correction of cardiac abnormalities, intrapartum care of a parturient with this condition can be challenging because of progression of residual cardiac defects compounded by the haemodynamic changes of pregnancy. We describe the anaesthetic management for caesarean section of a parturient with Carpenter syndrome and corrected Tetralogy of Fallot. Additional complicating issues included worsening cardiac function, asthma, needle-phobia and osteoarthritis.

  4. Perioperative Anaesthetic Management of Caesarean Delivery in a Parturient with Portal Gastropathy

    Directory of Open Access Journals (Sweden)

    Ashwini H Ramaswamy

    2014-12-01

    Full Text Available Portal hypertensive gastropathy occurs both in cirrhotic and non cirrhotic patients leading to haemetemesis secondary to oesophageal varices. The hyper dynamic circulatory state of pregnancy in these patients poses special problems necessitating specialized care preferably in a tertiary care centre. We report the perioperative anaesthetic management for elective caesarean section in a 32-year-old pregnant lady at 39 weeks gestation with portal gastropathy secondary to periportal fibrosis of the liver.

  5. PREVENTION OF SURGICAL WOUND INFECTION IN OBESE WOMEN UNDERGOING CAESAREAN SECTION: A RANDOMISED CONTROLLED TRIAL

    DEFF Research Database (Denmark)

    Hyldig, Nana; Vinter, Christina Anne; Kruse, Marie;

    2016-01-01

    Aim: Obese women undergoing caesarean section are at increased risk of surgical wound infection, which may lead to reduced quality of life, and increased health care cost. The aim is to evaluate the effect of incisional Negative Pressure Wound Therapy applied prophylactically in obese women......: The study is on-going. We expect to find a 50% reduction of wound infection when using iNPWT compared to standard dressings in this high-risk subpopulation....

  6. ANALYSIS OF BAYESIAN CLASSIFIER ACCURACY

    Directory of Open Access Journals (Sweden)

    Felipe Schneider Costa

    2013-01-01

    Full Text Available The naïve Bayes classifier is considered one of the most effective classification algorithms today, competing with more modern and sophisticated classifiers. Despite being based on unrealistic (naïve assumption that all variables are independent, given the output class, the classifier provides proper results. However, depending on the scenario utilized (network structure, number of samples or training cases, number of variables, the network may not provide appropriate results. This study uses a process variable selection, using the chi-squared test to verify the existence of dependence between variables in the data model in order to identify the reasons which prevent a Bayesian network to provide good performance. A detailed analysis of the data is also proposed, unlike other existing work, as well as adjustments in case of limit values between two adjacent classes. Furthermore, variable weights are used in the calculation of a posteriori probabilities, calculated with mutual information function. Tests were applied in both a naïve Bayesian network and a hierarchical Bayesian network. After testing, a significant reduction in error rate has been observed. The naïve Bayesian network presented a drop in error rates from twenty five percent to five percent, considering the initial results of the classification process. In the hierarchical network, there was not only a drop in fifteen percent error rate, but also the final result came to zero.

  7. Energy-Efficient Neuromorphic Classifiers.

    Science.gov (United States)

    Martí, Daniel; Rigotti, Mattia; Seok, Mingoo; Fusi, Stefano

    2016-10-01

    Neuromorphic engineering combines the architectural and computational principles of systems neuroscience with semiconductor electronics, with the aim of building efficient and compact devices that mimic the synaptic and neural machinery of the brain. The energy consumptions promised by neuromorphic engineering are extremely low, comparable to those of the nervous system. Until now, however, the neuromorphic approach has been restricted to relatively simple circuits and specialized functions, thereby obfuscating a direct comparison of their energy consumption to that used by conventional von Neumann digital machines solving real-world tasks. Here we show that a recent technology developed by IBM can be leveraged to realize neuromorphic circuits that operate as classifiers of complex real-world stimuli. Specifically, we provide a set of general prescriptions to enable the practical implementation of neural architectures that compete with state-of-the-art classifiers. We also show that the energy consumption of these architectures, realized on the IBM chip, is typically two or more orders of magnitude lower than that of conventional digital machines implementing classifiers with comparable performance. Moreover, the spike-based dynamics display a trade-off between integration time and accuracy, which naturally translates into algorithms that can be flexibly deployed for either fast and approximate classifications, or more accurate classifications at the mere expense of longer running times and higher energy costs. This work finally proves that the neuromorphic approach can be efficiently used in real-world applications and has significant advantages over conventional digital devices when energy consumption is considered.

  8. Effects of caesarean section on maternal health in low risk nulliparous women: a prospective matched cohort study in Shanghai, China

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    Gao Xiao-ling

    2010-12-01

    Full Text Available Abstract Background Rates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. A critical examination of this issue in relation to maternal outcomes is important. At present there are no clinical trials to help assess the risks and benefits of caesarean section in low risk women. To fill the gap left by trials, this indication-matched cohort study was carried out to examine prospectively the outcomes of caesarean section on women with no absolute obstetric indication compared with similar women who had vaginal delivery. Methods An indication-matched cohort study was undertaken to compare maternal outcomes following caesarean section with those undergoing vaginal delivery, in which the two groups were matched for non-absolute indications. 301 nulliparous women with caesarean section were matched successfully with 301 women who delivered vaginally in the Maternal and Children's Hospitals (MCHs in Shanghai, China. Logistic regression model or binomial regression model was used to estimate the relative risk (RR directly. Adjusted RRs were calculated adjusting for propensity score and medical indications. Results The incidence of total complications was 2.2 times higher in the caesarean section group during hospitalization post-partum, compared with the vaginal delivery group (RR = 2.2; 95% CI: 1.1-4.4. The risk of haemorrhage from the start of labour until 2 hours post-partum was significantly higher in the caesarean group (RR = 5.6; 95% CI: 1.2-26.9. The risk of chronic abdominal pain was significantly higher for the caesarean section group (RR = 3.6; 95% CI: 1.2-10.9 than for the vaginal delivery group within 12 months post-partum. The two groups had similar incidences of anaemia and complicating infections such as wound complications

  9. Ropivacaine 7.5 mg/mL for Caesarean Section

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    N. K. Nguyen

    2010-01-01

    Full Text Available Background. Pain after Caesarean delivery is partly related to Pfannenstiel incision, which can be infiltrated with local anaesthetic solutions. Methods. A double- blind randomized control trial was designed to assess the analgesic efficacy of 7.5 mg/mL ropivacaine solution compared to control group, in two groups of one hundred and forty four parturients for each group, who underwent Caesarean section under spinal anaesthesia: group R (ropivacaine group and group C (control group. All parturients also received spinal sufentanil (2.5 g. Results. Ropivacaine infiltration in the Pfannenstiel incision for Caesarean delivery before wound closure leads to a reduction of 30% in the overall consumption of analgesics (348 550 mg for group R versus 504 426 mg for group C with <.05, especially opioids in the first 24 hours, but also significantly increases the time interval until the first request for an analgesic (4 h 20 min ± 2 h 26 for group R versus 2 h 42 ± 1 h 30 for group C. The P values for the two groups were: <.0001 for paracetamol, <.0001 for ketoprofen and P for nalbuphine which was the most significant. There is no significant difference in the threshold of VAS in the two series. Conclusion. This technique can contribute towards a programme of early rehabilitation in sectioned mothers, with earlier discharge from the post-labour suite.

  10. Study of drug control over postoperative hemorrhage after selective caesarean section

    Institute of Scientific and Technical Information of China (English)

    Teng Li-rong; Bian Xu-ming; Zhai Gui-rong; Wang Xin; Chen Qian; Zhang Xiao-wei

    2006-01-01

    Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.

  11. Successful vaginal birth after caesarean section in patient with Ehler-Danlos syndrome type 2.

    Science.gov (United States)

    Maraj, Hemant; Mohajer, Michelle; Bhattacharjee, Deepannita

    2011-12-01

    We present the case of a 31-year-old woman with Ehler-Danlos syndrome (EDS) type 2. She had a previous caesarean section and went on to have an uncomplicated vaginal birth in her last pregnancy. To our knowledge, this is the first case of a successful vaginal birth after caesarean section in a patient with EDS. EDS is a multisystem disorder involving a genetic defect in collagen and connective-tissue synthesis and structure. It is a heterogeneous group of 11 different inherited disorders. Obstetric complications in these patients include miscarriages, stillbirths, premature rupture of the membranes, preterm labour, uterine prolapse, uterine rupture and severe postpartum haemorrhage. There has been much controversy over the appropriate mode of delivery. Abdominal deliveries are complicated by delayed wound healing and increased perioperative blood loss. Vaginal deliveries may be complicated by tissue friability causing extensive perineal tears, pelvic floor and bladder lesions. Our case highlights that in specific, controlled situations it is possible to have a vaginal delivery even after previous caesarean section in patients with EDS.

  12. Antepartum uterine rupture in previous caesarean sections presenting as advanced extrauterine pregnancies: lessons learnt.

    Science.gov (United States)

    Ramphal, Surandhra R; Moodley, Jagidesa

    2009-03-01

    In present day obstetric practice, rupture of a previously scarred uterus should be uncommon. It occurs in uterine pregnancy is made. We present a series of 7 cases, all of whom had one or more previous caesarean sections, were haemodynamically stable and were being managed expectantly, to illustrate the fact that ruptured uterus should be strongly considered in the differential diagnosis, even when the clinical signs and sonography are suggestive of an advanced extra-uterine pregnancy. The lessons in these cases fall into the following categories: 1. Ruptured uteri can occur in non-labouring women with previous lower segment caesarean sections. 2. Absence of signs of peritonism is possibly due to the fact that the pregnancy is extruded through the uterine rupture with the amniotic sac being intact and there is little or no bleeding into the abdominal cavity or vaginally. 3. Imaging techniques should focus on the size of the uterus, as an enlarged uterus in the background of an advanced extra-uterine pregnancy in a previously scarred uterus is highly suggestive of uterine rupture. Clinicians must strongly consider ruptured uteri in non labouring women with previous caesarean sections even when imaging modalities suggest an advanced extrauterine pregnancy. This will lead to earlier surgical treatment and appropriate information being provided to patients.

  13. Risk adjustment for inter-hospital comparison of caesarean delivery rates in low-risk deliveries.

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    Elisa Stivanello

    Full Text Available BACKGROUND: Caesarean delivery (CD rates have been frequently used as quality measures for maternity service comparisons. More recently, primary CD rates (CD in women without previous CD or CD rates within selected categories such as nulliparous, term, cephalic singleton deliveries (NTCS have been used. The objective of this study is to determine the extent to which risk adjustment for clinical and socio-demographic variables is needed for inter-hospital comparisons of CD rates in women without previous CD and in NTCS deliveries. METHODS: Hospital discharge records of women who delivered in Emilia-Romagna Region (Italy from January, 2007 to June 2009 and in Tuscany Region for year 2009 were linked with birth certificates. Adjusted RRs of CD in women without a previous Caesarean and NTCS were estimated using Poisson regression. Percentage differences in RR before and after adjustment were calculated and hospital rankings, based on crude and adjusted RRs, were examined. RESULTS: Adjusted RR differed substantially from crude RR in women without a previous Caesarean and only marginally in NTCS group. Hospital ranking was markedly affected by adjustment in women without a previous CD, but less in NTCS. CONCLUSION: Risk adjustment is warranted for inter-hospital comparisons of primary CD rates but not for NTCS CD rates. Crude NTCS CD rates are a reliable estimate of adjusted NTCS CD.

  14. Alternative management in a case of placenta accreta with previous caesarean

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    Rajani M. Parikh

    2012-12-01

    Full Text Available The rate of caesarean is increasing day by day, and with it the chance of repeat caesarean. This has led to a rise in the chance of occurrence of placenta accreta. Control of bleeding is the main goal in such cases, which usually necessitates hysterectomy. But alternative methods are useful when retaining fertility is important. We present this case of a 30 yr old female who was admitted as a case of central placenta previa with previous caesarean. Per operatively, placenta was attached along the incision and baby was delivered by separating the placenta attached above the upper margin of incision. On attempting to remove the placenta attached to lower part of incision, it was found to be adherent along the previous scar. So placenta was removed piece meal, some part was left behind. Box sutures were taken over that part and uterine packing was done to control the bleeding. Post operatively the patient was fine and given injection Methotrexate on 8th day following the regime of 1, 3, 5, 7 days. She failed to expulse the placenta by 6wks, so D&E was done and retained products were removed. Leaving the placenta in situ followed by Methotrexate and interval removal of placenta can thus be helpful in conserving the uterus and hence, the fertility. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 58-60

  15. Alterations in head shape of newborn infants after caesarean section or vaginal delivery.

    Science.gov (United States)

    Souza, S W; Ross, J; Milner, R D

    1976-08-01

    Alterations of head shape in preterm, small-for-dates, and term normal infants were studied by measuring occipitofrontal circumference (OFC), biparietal diameter (BPD), and occipitofrontal diameter (OFD) at intervals after birth. In 9 preterm infants born by elective caesarean section ther was a 5-2% reduction in BPD and 2-0% reduction in OFC at the age of 7 days. In 18 term infants born by elective caesarean section these changes were 2-4% and 0% respectively in BPD and OFC. In 25 preterm infants born by vertex vaginal delivery there was a significant fall in OFC of 0-7% at the age of 7 days and of 2-4% in BPD, but no significant change in OFD. In 19 small-for-dates infants born vaginally OFC increased 1-0% and OFD 2-7% at 7 days, but BPD decreased 2-5%. After the first week all three measurements increased in both groups of vaginal deliveries. The results show that shrinkage and biparietal flattening of the skull occur during the first week of life in preterm and term infants born by caesarean section and in preterm infants born vaginally. This fact should be borne in mind when comparing the measurements of an infant's head size with published norms.

  16. Effect of phenylephrine vs. ephedrine on frontal lobe oxygenation during caesarean section with spinal anesthesia

    DEFF Research Database (Denmark)

    Foss, Visti T; Christensen, Robin; Rokamp, Kim Z

    2014-01-01

    BACKGROUND: During caesarean section spinal anesthesia may provoke maternal hypotension that we prevent by administration of phenylephrine and/or ephedrine. Phenylephrine is however reported to reduce the near infrared spectroscopy-determined frontal lobe oxygenation (ScO2) but whether that is th......BACKGROUND: During caesarean section spinal anesthesia may provoke maternal hypotension that we prevent by administration of phenylephrine and/or ephedrine. Phenylephrine is however reported to reduce the near infrared spectroscopy-determined frontal lobe oxygenation (ScO2) but whether...... that is the case for patients exposed to spinal anesthesia is not known. OBJECTIVES: To evaluate the impact of phenylephrine vs. ephedrine on ScO2during caesarean section with spinal anesthesia in a single center, open-label parallel-group study with balanced randomization of 24 women (1:1). Secondary aims were...... anesthesia, ephedrine maintains frontal lobe oxygenation and maternal heart rate with a similar increase in fetal heart rate as elicited by phenylephrine. TRIAL REGISTRATION: Clinical trials NCT 01509521 and EudraCT 2001 006103 35....

  17. Elective induction of labour increases caesarean section rate in low risk multiparous women.

    Science.gov (United States)

    Jacquemyn, Y; Michiels, I; Martens, G

    2012-04-01

    The aim of this study was to compare the risk of secondary caesarean section in induced versus spontaneous labour in the second delivery of low risk women who had a vaginal delivery in their first pregnancy. The data were retrospective cohort from an existing regional database, comparing term (between 37 and 42 gestational weeks) second deliveries in cephalic position in women who had previously given vaginal birth. Diabetes, hypertension and multiple pregnancy were excluded as were those with a birth weight less than 2500 g or more than 4500 g. The difference was not significant when induction was performed after 41 weeks. The results showed a total number of 29693 deliveries were included, 21243 in spontaneous labour and 8450 after induction of labour. In the spontaneous group 312 (1.5%) underwent secondary caesarean section, as compared to 237 (2.8%) in the induced group, p elective induction of labour in low risk women who have previously given vaginal birth is associated with an almost doubled rate of secondary caesarean section if performed before 41 weeks.

  18. Rates of caesarean section and instrumental vaginal delivery in nulliparous women after low concentration epidural infusions or opioid analgesia: systematic review

    OpenAIRE

    Liu, E H C; Sia, A T H

    2004-01-01

    Objective To compare the effects of low concentration epidural infusions of bupivacaine with parenteral opioid analgesia on rates of caesarean section and instrumental vaginal delivery in nulliparous women.

  19. A study on mode of delivery and conduct of labour in women with vaginal birth after caesarean section in Dhulikhel Hospital.

    Science.gov (United States)

    Tamrakar, S R; Chawla, C D

    2010-06-01

    Vaginal birth after caesarean section is the delivery of a baby through the vagina after a previous cesarean delivery. For this to be conducted safely and responsibly emergency obstetric care must be available. To study the different modes of delivery in Dhulikhel Hospital (DH), evaluate the frequency of attempted and successful vaginal birth after caesarean section and, in the VBAC group, to identify those factors that may influence outcome and safety. The study was a retrospective study of all women who were delivered via different routes and the subgroup who underwent attempted vaginal birth after caesarean section in DH from January 2007 to December 2009. In this study factors associated with the successful VBAC were also analyzed. During the study period a total of 4215 deliveries conducted in DH and a total of 890 lower segment caesarean sections (21.1% of all deliveries) were performed. Of the 890 caesareans performed, 743 were primary and 147 were repeat (69 were repeat elective and 78 were repeat emergency). In this period an additional 33 women with previous lower segment caesarean sections had a successful vaginal delivery. Hence 18.3% (33/180) vaginal birth after caesarean sections was conducted successfully among women with previous caesarean). The results of this study indicate that vaginal birth after caesarean section is a clear feature of obstetric practice in DH. This is possible because of the vigilance in managing these women and the availability in this hospital setting of resources for immediate cesarean section.

  20. The CORONIS Trial. International study of caesarean section surgical techniques: a randomised fractional, factorial trial

    Directory of Open Access Journals (Sweden)

    2007-10-01

    Full Text Available Abstract Background Caesarean section is one of the most commonly performed operations on women throughout the world. Rates have increased in recent years – about 20–25% in many developed countries. Rates in other parts of the world vary widely. A variety of surgical techniques for all elements of the caesarean section operation are in use. Many have not yet been rigorously evaluated in randomised controlled trials, and it is not known whether any are associated with better outcomes for women and babies. Because huge numbers of women undergo caesarean section, even small differences in post-operative morbidity rates between techniques could translate into improved health for substantial numbers of women, and significant cost savings. Design CORONIS is a multicentre, fractional, factorial randomised controlled trial and will be conducted in centres in Argentina, Ghana, India, Kenya, Pakistan and Sudan. Women are eligible if they are undergoing their first or second caesarean section through a transverse abdominal incision. Five comparisons will be carried out in one trial, using a 2 × 2 × 2 × 2 × 2 fractional factorial design. This design has rarely been used, but is appropriate for the evaluation of several procedures which will be used together in clinical practice. The interventions are: • Blunt versus sharp abdominal entry • Exteriorisation of the uterus for repair versus intra-abdominal repair • Single versus double layer closure of the uterus • Closure versus non-closure of the peritoneum (pelvic and parietal • Chromic catgut versus Polyglactin-910 for uterine repair The primary outcome is death or maternal infectious morbidity (one or more of the following: antibiotic use for maternal febrile morbidity during postnatal hospital stay, antibiotic use for endometritis, wound infection or peritonitis or further operative procedures; or blood transfusion. The sample size required is 15,000 women in total; at least 7,586 women

  1. Caesarean delivery and subsequent stillbirth or miscarriage: systematic review and meta-analysis.

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    Sinéad M O'Neill

    Full Text Available OBJECTIVE: To compare the risk of stillbirth and miscarriage in a subsequent pregnancy in women with a previous caesarean or vaginal delivery. DESIGN: Systematic review of the published literature including seven databases: CINAHL; the Cochrane library; Embase; Medline; PubMed; SCOPUS and Web of Knowledge from 1945 until November 11(th 2011, using a detailed search-strategy and cross-checking of reference lists. STUDY SELECTION: Cohort, case-control and cross-sectional studies examining the association between previous caesarean section and subsequent stillbirth or miscarriage risk. Two assessors screened titles to identify eligible studies, using a standardised data abstraction form and assessed study quality. DATA SYNTHESIS: 11 articles were included for stillbirth, totalling 1,961,829 pregnancies and 7,308 events. Eight eligible articles were included for miscarriage, totalling 147,017 pregnancies and 12,682 events. Pooled estimates across the stillbirth studies were obtained using random-effect models. Among women with a previous caesarean an increase in odds of 1.23 [95% CI 1.08, 1.40] for stillbirth was yielded. Subgroup analyses including unexplained stillbirths yielded an OR of 1.47 [95% CI 1.20, 1.80], an OR of 2.11 [95% CI 1.16, 3.84] for explained stillbirths and an OR of 1.27 [95% CI 0.95, 1.70] for antepartum stillbirths. Only one study reported adjusted estimates in the miscarriage review, therefore results are presented individually. CONCLUSIONS: Given the recent revision of the National Institute for Health and Clinical Excellence guidelines (NICE, providing women the right to request a caesarean, it is essential to establish whether mode of delivery has an association with subsequent risk of stillbirth or miscarriage. Overall, compared to vaginal delivery, the pooled estimates suggest that caesarean delivery may increase the risk of stillbirth by 23%. Results for the miscarriage review were inconsistent and lack of adjustment

  2. Defining and Classifying Interest Groups

    DEFF Research Database (Denmark)

    Baroni, Laura; Carroll, Brendan; Chalmers, Adam;

    2014-01-01

    The interest group concept is defined in many different ways in the existing literature and a range of different classification schemes are employed. This complicates comparisons between different studies and their findings. One of the important tasks faced by interest group scholars engaged...... in large-N studies is therefore to define the concept of an interest group and to determine which classification scheme to use for different group types. After reviewing the existing literature, this article sets out to compare different approaches to defining and classifying interest groups with a sample...

  3. Variability in caesarean section rates for very preterm births at 28-31 weeks of gestation in 10 European regions: results of the MOSAIC project

    DEFF Research Database (Denmark)

    Zeitlin, Jennifer; Di Lallo, Dominico; Blondel, Béatrice;

    2010-01-01

    Given the continuing debate about the benefits of caesarean section for very preterm infants, we sought to describe caesarean section rates for infants between 28 and 31 weeks of gestation in European regions and their association with regional mortality and short-term morbidity....

  4. Variability in caesarean section rates for very preterm births at 28-31 weeks of gestation in 10 European regions: results of the MOSAIC project.

    NARCIS (Netherlands)

    Zeitlin, J.; Lallo, D. Di; Blondel, B.; Weber, T.; Schmidt, S.; Kunzel, W.; Kollee, L.A.A.; Papiernik, E.

    2010-01-01

    OBJECTIVE: Given the continuing debate about the benefits of caesarean section for very preterm infants, we sought to describe caesarean section rates for infants between 28 and 31 weeks of gestation in European regions and their association with regional mortality and short-term morbidity. STUDY DE

  5. Per-operative cerebral near-infrared spectroscopy (NIRS) predicts maternal hypotension during elective caesarean delivery in spinal anaesthesia

    DEFF Research Database (Denmark)

    Berlac, P A; Rasmussen, Yvonne Hovmann

    2005-01-01

    BACKGROUND: Spinal anaesthesia-induced maternal hypotension is common during elective caesarean section. This study evaluated whether cerebral near-infrared spectroscopy predicts maternal hypotension, defined as a 25% reduction in systolic blood pressure or heart rate or presentation of clinical...... symptoms. METHOD: Thirty-eight ASA I-II parturients scheduled for elective caesarean section with spinal anaesthesia were monitored by near-infrared spectroscopy for changes in cerebral oxygenation (ScO(2)) with the recordings blinded to the anaesthesiologist. RESULTS: There was a 5% decrease in ScO(2......-infrared spectroscopy to predict hypotension was 1.00, with a specificity 0.85 and a predictability of 0.91. CONCLUSION: The results demonstrate a relationship between ScO(2) and impending hypotension during low-dose spinal anaesthesia for elective caesarean section. We suggest that immediate measures are taken...

  6. Comparison of scar thickness measurements using trans-vaginal sonography and MRI in cases of pregnancy with previous caesarean section. Do they correlate with actual scar thickness?

    Science.gov (United States)

    Singh, N; Tripathi, R; Mala, Y M; Dixit, R; Tyagi, S; Batra, A

    2013-11-01

    The aim of this study was to evaluate scar thickness in cases of pregnancy with previous caesarean section, by trans-vaginal sonography (TVS) and magnetic resonance imaging (MRI), and to correlate precision of radiologically-measured scar thickness with actual measurement of scar thickness. A total of 35 pregnant patients with previous caesarean section planned for elective caesarean section, were evaluated prospectively. Their scar thickness was measured by TVS and MRI on the day of elective repeat caesarean section. These measurements were correlated with each other and with scar thickness measured during elective repeat caesarean section by using a caliper. The correlation coefficients between scar thickness measured by TVS and MRI with peroperative evaluation with a caliper, were +0.72 and +0.59, respectively. The study concluded that as MRI is a costlier modality and TVS has better correlation coefficient with actual scar thickness, TVS can be considered to be the better modality for antenatal scar thickness measurement.

  7. GOAL ORIENTED ANAESTHETIC MANAGEMENT FOR CAESAREAN SECTION IN A PARTURIENT WITH PITUITARY TUMOUR

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    Sushma

    2015-03-01

    Full Text Available BACKGROUND AND OBJECTIVE: Anesthesia for Pregnancy with pituitary tumours is a challenge to an Anesthesiologist , requires careful preoperative assessment and meticulous perioperative management to achieve optimal safety of mother and fetus. There are very limited studies in literature to guide the anaesthetic management of such patients. Here we report the successful Anaesthetic management of a parturient with pituitary tumour with epilepsy posted for emergency caesarean section. PRESENTATION, DIAGNOSIS, MANAGEMENT: A 25 year young woman, G2P1L1, a known epileptic, diagnosed with pituitary macroadenoma presented at 40 weeks of gestation with severe Oligohydramnios (AFI - 4cm was posted for an emergency caesarean section. Following consultation with the obstetrician, neonato logist and the neurosurgeon the decision was made to proceed with caesarean section under general anesthesia. Rapid sequence induction and intubation was performed with inj Thiopentone sodium and inj Rocuronium and was maintained with Isoflurane, titrated to maintain the stability of mean arterial pressure until extraction. A live 4. 25kgs male child was born with Apgar scores of 8 and 9 at 1 and 5 mins respectively. Following extraction 10U run as infusion in Ringers lactate. Intraoperative analgesia was a dministered after extraction. Dexmedetomedine infusion was used. Postoperative period was uneventful. DISCUSSION & CONCLUSION: Management of obstetric patients with pituitary tumour is complex, requiring knowledge of the physiological effects of pregnancy on tumour size and labour on intracranial pressure. General anesthesia combined with multimodal balanced analgesia is associated with a favorable outcome. General anaesthesia using Thiopentone, Fentanyl, Dexmedetomedine and titrated dose of Isoflurane was used in our case were found to be safe with adequate hemodynamic stability and postoperative pain control. A team approach involving the Anaesthethesiologist

  8. SURGICAL SITE INFECTION FOLLOWING LOWER SEGMENT CAESAREAN SECTION IN A TERTIARY CARE HOSPITAL

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    Nishi Roshini

    2016-03-01

    Full Text Available AIM OF THE STUDY To identify infection rates and risk factors associated with Surgical Site Infection (SSI following Caesarean Section. DESIGN OF THE STUDY Case control study. PLACE OF STUDY Academic Tertiary Care Obstetrics and Gynaecology Centre with 60 Beds. PATIENTS All women who delivered by caesarean section in Govt. Medical College, Thrissur, during 1st June 2010 to 30th September 2011. METHODS Wound infections were identified during hospital stay using the criteria of the Centres for Disease Control and Prevention, National Nosocomial Infections Surveillance System. A case control study of 50 patients with wound infection after Lower Segment Caesarean Section (LSCS was undertaken between 1st June 2010 and 30th September 2011. The control group comprised of 50 patients selected randomly from among those who had LSCS during the study period with no wound infection. The CDC definition describes three levels of SSI (Superficial incisional, Deep incisional and Organ or Space infection. Comparisons for categorical variables were performed using the X2 or Fisher exact test. Continuous variables were compared using the 2-tailed Student ‘t’ test and p 0.05 was considered significant. RESULTS The overall wound infection rate in the study was 3.5%, (50 among 1410 Lower Transverse CS. Obesity, Hypertension and Poorly Controlled Diabetes are associated with significant risk for development of SSI. The commonest presentation of SSI in LSCS was fever 40 (80% followed by local pain and induration 25 (50%. SSI was detected on 6±3 days. Average duration of hospital stay among SSI was 22.78±10.2 days. Staphylococcus aureus was the commonest pathogen for SSI in our series. The increase in the presence of (Methicillin Resistant Staphylococcus Aureus MRSA (20.83% might alter the pattern of prophylactic antibiotic given preoperatively in the near future. CONCLUSIONS Increased incidence of drug resistant organisms needs proper attention and strategies for

  9. Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.

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    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: The Australian Private Health Insurance Incentive (PHII policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA. METHODS AND FINDINGS: All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3 decrease in public birth rates, a 51% (45.1 to 56.4 increase in private birth rates, a 5% (-5.3 to -5.1 and 8% (-8.9 to -7.9 decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1 increase in caesarean sections with labour and 10% (8.0 to 11.7 increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5, but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1. CONCLUSIONS: Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.

  10. Comparison of Morphine Suppository and Diclofenac Suppository for Pain Management After Elective Caesarean Section

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    Atossa Mahdavi

    2016-12-01

    Full Text Available This study investigated efficacy and side effects of Morphine suppository for pain management after the first elective caesarean delivery in comparison to Diclofenac suppository. One hundred women aged 18-40 with term pregnancies undergoing elective caesarean section for the first time participated in this prospective project. Exclusion criteria included drug sensitivity, fetal malformations or defects, and complications during the cesarean operation. After same spinal anesthesia and same surgical techniques and in the recovery room patients consecutively received 100 mg diclofenac suppository or 10 mg morphine suppository. The pain severity was rated by “Numerical Rating Scale.” There was not the difference between two groups in terms of basal information. Pain score was significantly different between two groups in the first 12 hours (5.66 ±1.36 in morphine group and 3.63±0.96 in diclofenac group but not in the second 12 hour period. Considering pain scores every two hours in first 12 hours and every 4 hours in second 12 hours, morphine group had higher scores in comparison to diclofenac group. Also, the morphine group required pethidine injection sooner than the other group. The time giving first pethidine injection was 3.28±2.16 hours after operation in morphine group and 5.24±4.07 hours after operation (P<0.05. This study demonstrated that diclofenac suppository in comparison to morphine suppository decreased subjective pain scores in the first twenty-four hours after elective caesarean section which reached statistical significance in the first twelve hours. Although in diclofenac group, pethidine injection was prescribed significantly later.

  11. Local anaesthetic wound infiltration used for caesarean section pain relief: a meta-analysis

    Science.gov (United States)

    Li, Xiangnan; Zhou, Miao; Shi, Xuan; Yang, Haiqin; Li, Yonghua; Li, Jian; Yang, Mei; Yuan, Hongbin

    2015-01-01

    Purpose: Local anaesthetic wound infiltration techniques were reported to reduce opiate requirements and pain scores in women undergoing caesarean section (CS). However, the results were conflicting. The primary aim of this meta-analysis was to assess whether local analgesia could reduce pain intensity when injected via wound catheters. Methods: A search of randomized clinical trials (RCTs) evaluating local analgesia in caesarean surgery in PubMed, EMBASE and the Cochrane database was performed. Cumulative morphine consumption and pain scores at rest at different time point after surgery were extracted and synthesized using random or fixed model for meta-analysis. Subgroup analysis was performed according to incision type and administration regimen. Results: Nine RCTs with a total of 512 patients were included. Cumulative morphine consumption was lower in LA group compared with placebo group in the first 12 h (SMD = -0.736, 95% CI (-1.105, -0.368)), 24 h (SMD = -0.378, 95% CI (-0.624, -0.132)) and 48 h after surgery (SMD = -0.913, 95% CI (-1.683 to -0.143)). Lower morphine consumption was observed in the first 6 h after surgery but the reduction failed to meet the common level of significance. Pain scores was significantly reducedat 12 h but not 6 h after surgery in the LA group compared with placebo group. At 24 h and 48 h after surgery, the pain sore was lower but the difference did not meet the common level of significance. Lower rate of post-operative nausea was observed in the LA group. Conclusions: Local anaesthetic wound infiltration can reduce morphine requirements and the rate of patients suffer nausea but not pain scores after caesarean section. Further procedure-specific RCTs were encouraged to confirm the efficacy of local anaesthetic wound infiltration techniques. PMID:26309720

  12. A comparison of sexual outcomes in primiparous women experiencing vaginal and caesarean births

    Directory of Open Access Journals (Sweden)

    Khajehei M

    2009-01-01

    Full Text Available Background and Objective: We conducted this study to evaluate and compare postpartum sexual functioning after vaginal and caesarean births. Materials and Methods: This was a cross-sectional study that was carried out in postnatal health care in a hospital. A total of 50 primiprous women who had given birth 6-12 months ago and came to the hospital for postnatal care were asked to join the study. Forty of the women completed the entire questionnaire. Among these women, 20 delivered spontaneously with mediolateral episiotomy and 20 had elective caesarean section. Sexual function was evaluated by a validated, self-created questionnaire. A statistical evaluation was carried out by SPSS v.11. A two-part self-created validated questionnaire for data collection was administered regarding sexual function prior to pregnancy and 6-12 months postpartum. Results: The median time to restart intercourse in the normal vaginal delivery with episiotomy (NVD/epi group was 40 days and in the caesarean section (C/S group was 10 days postpartum. The most common problems in the NVD/epi group was decreased libido (80%, sexual dissatisfaction (65%, and vaginal looseness (55%. In the C/S group, the most common problems were vaginal dryness (85%, sexual dissatisfaction (60%, and decreased libido (35%. There were clinically significant differences between the two groups regarding sexual outcomes, but these differences were not statically significant. Conclusion: Postnatal sexual problems were very common after both NVD/epi and C/S. Because sexual problems are so prevalent during the postpartum period, clinicians should draw more attention to the women′s sexual life and try to improve their quality of life after delivery.

  13. Influence of anesthesia techniques of caesarean section on memory, perception and speech

    Directory of Open Access Journals (Sweden)

    Volkov O.O.

    2014-06-01

    Full Text Available In obstetrics postoperative cognitive dysfunctions may take place after caesarean section and vaginal delivery with poor results both for mother and child. The goal was to study influence of anesthesia techniques following caesarian section on memory, perception and speech. Having agreed with local ethics committee and obtained informed consent depending on anesthesia method, pregnant women were divided into 2 groups: 1st group (n=31 had spinal anesthesia, 2nd group (n=34 – total intravenous anesthesia. Spinal anesthesia: 1.8-2.2 mLs of hyperbaric 0.5% bupivacaine. ТIVА: Thiopental sodium (4 mgs kg-1, succinylcholine (1-1.5 mgs kg-1. Phentanyl (10-5-3 µgs kg-1 hour and Diazepam (10 mgs were used after newborn extraction. We used Luria’s test for memory assessment, perception was studied by test “recognition of time”. Speech was studied by test "name of fingers". Control points: 1 - before the surgery, 2 - in 24h after the caesarian section, 3 - on day 3 after surgery, 4 - at discharge from hospital (5-7th day. The study showed that initially decreased memory level in expectant mothers regressed along with the time after caesarean section. Memory is restored in 3 days after surgery regardless of anesthesia techniques. In spinal anesthesia on 5-7th postoperative day memory level exceeds that of used in total intravenous anesthesia. The perception and speech do not depend on the term of postoperative period. Anesthesia technique does not influence perception and speech restoration after caesarean sections.

  14. Anaesthetic management for caesarean section in a case of previously operated with residual pituitary tumour

    Directory of Open Access Journals (Sweden)

    Prerana N Shah

    2011-01-01

    Full Text Available Successful anaesthetic management for caesarean section in a case with previous pituitary tumour resection, with residual tumour, is reported. The pituitary gland undergoes global hyperplasia during pregnancy. Functional pituitary tumours may exhibit symptomatic enlargement during pregnancy. Growth hormone secreting tumour is associated with acromegaly which has associated anaesthetic implications of difficult airway, systemic hypertension, and diabetes and electrolyte imbalance. Intracranial space occupying lesions can increase intra cranial pressure and compromise cerebral perfusion or cause herniation. We report management of this case.

  15. Impact single versus double layer uterine closure in caesarean section to uterine rupture

    OpenAIRE

    Budi Iman Santoso; Raymond Surya; Rima Irwinda

    2016-01-01

    Caesarean section (CS) is one of the most frequent delivery methods in the world whereas the rates of CS were varied according to developing (from 3.5 to 29.2%) and developed countries (21.1%). The study aims to known the impact of single versus double layer uterine closure to uterine rupture in the history of cesarean section (CS). In this case report, the clinical question is single versus double-layer uterine closure on the previous CS, gives better outcome to reduce the risk of uterine ru...

  16. Evaluation of “J”-shaped Uterine Incision during Caesarean Section in Patients with Placenta Previa:A Retrospective Study

    Institute of Scientific and Technical Information of China (English)

    邹丽; 钟少平; 赵茵; 朱剑文; 陈莉娟

    2010-01-01

    This study evaluated the efficacy and safety of "J"-shaped uterine incision for caesarean section for patients diagnosed with placenta previa.A total of 55 consecutive cases of placenta previa treated in Union Hospital were retrospectively analyzed over a period of two years and 10 months.The subjects were divided into two groups with respect to the uterine incision.Twenty-four pregnant women with placenta previa who were indicated for caesarean section underwent the procedure using a new "J"-shaped uterine...

  17. GeoCorps America

    Science.gov (United States)

    Dawson, M.

    2011-12-01

    GeoCorps America, a program of the Geological Society of America's (GSA) Education and Outreach Department, provides short-term geoscience jobs in America's most amazing public lands. These jobs are hosted on federal lands managed by GeoCorps' three partner agencies: the National Park Service (NPS), the U.S. Forest Service (USFS), and the Bureau of Land Management (BLM). Agency staff submit to GSA position descriptions that help meet their geoscience needs. GSA advertises the positions online, recruits applicants from its 24,000+ members, and coordinates the placement of the candidates selected by agency staff. The typical GeoCorps position lasts for three months, pays a stipend of $2,750, and provides either free housing or a housing allowance. Some GeoCorps positions are classified as "Guest Scientist" positions, which generally last longer, involve larger payments, and require a higher level of expertise. Most GeoCorps positions occur during the spring/summer, but an increasing number of positions are being offered during the fall/winter. GeoCorps positions are open to geoscientists of all levels, from undergraduates through retired professionals. GeoCorps projects involve field and laboratory-based geoscience research, but some projects focus on developing educational programs and materials for staff, volunteers, and the public. The subject areas covered by GeoCorps projects include geology, hydrology, paleontology, mapping/GIS, soils, geo-hazards, cave/karst science, and more. GeoCorps positions have taken place at over 125 different locations nationwide, including Grand Canyon National Park, Sierra National Forest, and Craters of the Moon National Monument. In 2011, GeoCorps began offering GeoCorps Diversity Internships and GeoCorps American Indian Internships. The introduction of these programs doubled the level of diversity among GeoCorps participants. This increase in diversity is helping GSA and its partner agencies in meeting its mutual goal of

  18. 75 FR 707 - Classified National Security Information

    Science.gov (United States)

    2010-01-05

    ... National Security Information Memorandum of December 29, 2009--Implementation of the Executive Order ``Classified National Security Information'' Order of December 29, 2009--Original Classification Authority #0... 13526 of December 29, 2009 Classified National Security Information This order prescribes a...

  19. Aggregation Operator Based Fuzzy Pattern Classifier Design

    DEFF Research Database (Denmark)

    Mönks, Uwe; Larsen, Henrik Legind

    2009-01-01

    This paper presents a novel modular fuzzy pattern classifier design framework for intelligent automation systems, developed on the base of the established Modified Fuzzy Pattern Classifier (MFPC) and allows designing novel classifier models which are hardware-efficiently implementable. The perfor....... The performances of novel classifiers using substitutes of MFPC's geometric mean aggregator are benchmarked in the scope of an image processing application against the MFPC to reveal classification improvement potentials for obtaining higher classification rates....

  20. 15 CFR 4.8 - Classified Information.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Classified Information. 4.8 Section 4... INFORMATION Freedom of Information Act § 4.8 Classified Information. In processing a request for information..., the information shall be reviewed to determine whether it should remain classified. Ordinarily...

  1. Anaesthesia for a patient with Eisenmenger′s syndrome undergoing caesarean section

    Directory of Open Access Journals (Sweden)

    T Gurumurthy

    2012-01-01

    Full Text Available Eisenmenger′s syndrome is a cyanotic congenital heart disease that includes pulmonary hypertension with reversed or bidirectional shunt associated with septal defects or patent ductus arteriosus. The decreased systemic vascular resistance associated with pregnancy increases the degree of right to left shunting, thereby carrying substantial risk to both the mother and the foetus. The maternal mortality rate of pregnancy in the presence of Eisenmenger′s syndrome is reported to be as high as 30-70%. We present a case of a 22-year-old primigravida with Eisenmenger′s syndrome who gave birth at 37 weeks of gestation via caesarean section to a live female baby under general anaesthesia. On the third post-operative day, the patient developed tachycardia, tachypnoea, hypotension and decrease in oxygen saturation despite supplemental oxygen, clinically suspected pulmonary thromboembolism. We describe the anaesthetic management for caesarean section and its complications in a patient with Eisenmenger′s syndrome. Although pregnancy should be discouraged in women with Eisenmenger′s syndrome, it can be successful.

  2. [Macrosomia, shoulder dystocia and elongation of the brachial plexus: what is the role of caesarean section?

    Science.gov (United States)

    Kehila, Mehdi; Derouich, Sadok; Touhami, Omar; Belghith, Sirine; Abouda, Hassine Saber; Cheour, Mariem; Chanoufi, Mohamed Badis

    2016-01-01

    The delivery of a macrosomic infant is associated with a higher risk for maternofoetal complications. Shoulder dystocia is the most feared fetal complication, leading sometimes to a disproportionate use of caesarean section. This study aims to evaluate the interest of preventive caesarean section. We conducted a retrospective study of 400 macrosomic births between February 2010 and December 2012. We also identified cases of infants with shoulder dystocia occurred in 2012 as well as their respective birthweight. Macrosomic infants weighed between 4000g and 4500g in 86.25% of cases and between 4500 and 5000 in 12.25% of cases. Vaginal delivery was performed in 68% of cases. Out of 400 macrosomic births, 9 cases with shoulder dystocia were recorded (2.25%). All of these cases occurred during vaginal delivery. The risk for shoulder dystocia invaginal delivery has increased significantly with the increase in birth weight (p dystocia affectd macrosoic infants in 58% of cases. Shoulder dystocia is not a complication exclusively associated with macrosomia. Screening for risky deliveries and increasing training of obstetricians on maneuvers in shoulder dystocia seem to be the best way to avoid complications.

  3. Management of Neuraxial Anaesthesia for Emergent Caesarean Section for Placenta Previa.

    Science.gov (United States)

    Günaydın, Berrin; Kurdoğlu, Mertihan; Güler, İsmail; Bashiri, Mehrnoosh; Büyüktaşkın, Fırat; Keleşoğlu, Mine Dağgez; İnan, Gözde

    2016-02-01

    Abnormal placental attachments, such as placenta accreta, increta or percrata, can result in increased morbidity and mortality because of the risk of severe postpartum haemorrhage. We aimed to present the management of spinal anaesthesia and surgical approach for emergent caesarean section because of vaginal bleeding in a multiparous pregnant woman with placenta previa at 36 weeks' gestation. Hyperbaric bupivacaine 12 mg, fentanyl 10 μg and morphine 150 μg were intrathecally administered for spinal anaesthesia. Oxytocin, methyl ergonovin and tranexamic acid were administered after umbilical cord clamping. Breech delivery of the baby was provided by a vertical incision to the uterus for avoiding placental harm. Subtotal hysterectomy was performed leaving the placenta in situ. Two units of red blood cells were transfused during the operation, lasting approximately 40 min. The patient was uneventfully discharged on the postoperative fourth day. In conclusion, a single-shot spinal anaesthesia was successfully maintained without conversion to general anaesthesia until the end of the hysterectomy in the patient in whom placenta increta was observed during caesarean delivery.

  4. Service Quality of Delivered Care from the Perception of Women with Caesarean Section and Normal Delivery

    Directory of Open Access Journals (Sweden)

    Jafar S. Tabrizi

    2014-12-01

    Full Text Available Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance based on importance and performance of service quality aspects from the postpartum women‟s perspective.A hierarchical regression analysis was applied in two steps using the enter method to examine the associations between demographics and SQ scores. Data were analysed using the SPSS-17 software. Results: “Confidentiality”, “autonomy”, “choice of care provider” and “communication” achieved scores at the highest level of quality; and “support group”, “prompt attention”, “prevention and early detection”, “continuity of care”, “dignity”, “safety”, “accessibility and “basic amenities” got service quality score less than eight. Statistically significant relationship was found between service quality score and continuity of care (P=0.008. Conclusion: A notable gap between the participants‟ expectations and what they have actually received in most aspects of provided care. So, there is an opportunityto improve the quality of delivered care.

  5. Anaesthetic management for combined emergency caesarean section and craniotomy tumour removal

    Directory of Open Access Journals (Sweden)

    Dewi Y Bisri

    2017-01-01

    Full Text Available Presentation of primary intracranial tumour during pregnancy is extremely rare. Symptoms of brain tumour include nausea, vomiting, headache and seizures which mimic symptoms of pregnancy-related hyperemesis or eclampsia. In very few cases, craniotomy tumour removal is performed earlier or even simultaneously with foetal delivery. A 40-year-old woman at 32 weeks of gestation in foetal distress presented to the emergency room with decreased level of consciousness Glasgow Coma Scale 6 (E2M2V2. Computed tomographic scan revealed a mass lesion over the left temporoparietal region with midline shift and intratumoural bleeding. In view of high risk of herniation and foetal distress, she underwent emergency caesarean section followed by craniotomy tumour removal. In parturient with brain tumour, combined surgery of tumour removal and caesarean section is decided based on clinical symptoms, type of tumour and foetal viability. Successful anaesthetic management requires a comprehensive knowledge of physiology and pharmacology, individually tailored to control intracranial pressure while ensuring the safety of mother and foetus.

  6. Use of Electrocautery for Coagulation and Wound Complications in Caesarean Sections

    Directory of Open Access Journals (Sweden)

    Cristiane M. Moreira

    2014-01-01

    Full Text Available Objective. To evaluate the safety of electrocautery for coagulation during Caesarean sections. Study Design. A randomized, controlled, clinical pilot study was performed at a university maternity hospital. After admission for delivery and decision to perform a C-section, volunteers were randomized to either the intervention group (use of electrocautery for coagulation or nonintervention group. The women were examined at the time of postpartum discharge (day 3, at days 7 to 10, and again at days 30 to 40 for signs of infection, hematoma, seroma, or dehiscence. Data were analyzed using an intention-to-treat analysis, and risk ratios were calculated. Results. No significant differences were found between the two groups. Only 2.8% of patients in the intervention group developed surgical wound complications during hospitalization. However, 7 to 10 days following discharge, these rates reached 23.0% and 15.4% in the intervention and nonintervention groups, respectively (RR = 1.50, 95% CI = 0.84–2.60. Conclusion. Further studies should confirm whether the use of electrocautery for coagulation does not increase the risk of surgical wound complications in patients undergoing Caesarean sections.

  7. Quality of caesarean delivery services and documentation in first-line referral facilities in Afghanistan: a chart review

    Directory of Open Access Journals (Sweden)

    Kim Young-Mi

    2012-03-01

    Full Text Available Abstract Background Increasing appropriate use and documentation of caesarean section (CS has the potential to decrease maternal and perinatal mortality in settings with low CS rates. We analyzed data collected as part of a comprehensive needs assessment of emergency obstetric and newborn care (EmONC facilities in Afghanistan to gain a greater understanding of the clinical indications, timeliness, and outcomes of CS deliveries. Methods Records were reviewed at 78 government health facilities expected to function as EmONC providers that were located in secure areas of the country. Information was collected on the three most recent CS deliveries in the preceding 12 months at facilities with at least one CS delivery in the preceding three months. After excluding 16 facilities with no recent CS deliveries, the sample includes 173 CS deliveries at 62 facilities. Results No CS deliveries were performed in the previous three months at 21% of facilities surveyed; all of these were lower-level facilities. Most CS deliveries (88% were classified as emergencies, and only 12% were referrals from another facility. General anesthesia was used in 62% of cases, and spinal or epidural anesthesia in 34%. Only 28% of cases were managed with a partograph. Surgery began less than one hour after the decision for a CS delivery in just 30% of emergency cases. Among the 173 cases, 27 maternal deaths, 28 stillbirths, and 3 early neonatal deaths were documented. In cases of maternal and fetal death, the most common indications for CS delivery were placenta praevia or abruption and malpresentation. In 62% of maternal deaths, the fetus was stillborn or died shortly after birth. In 48% of stillbirths, the fetus had a normal heart rate at the last check. Information on partograph use was missing in 38% of cases, information on parity missing in 23% of cases and indications for cesareans missing in 9%. Conclusions Timely referral within and to EmONC facilities would decrease

  8. Effect of caesarean section on maternal and foetal outcomes in acute fatty liver of pregnancy: a systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Hong-Yan; Jiang, Qing; Shi, Hao; Xu, Yun-Qing; Shi, Ai-Chao; Sun, Yuan-Li; Li, Jian; Ning, Qin; Shen, Guan-Xin

    2016-07-08

    Several studies have reported a positive association between caesarean section for expeditious pregnancy termination and perinatal outcomes in acute fatty liver of pregnancy (AFLP); however, the risks remain unclear and independent studies have reported conflicting findings. In this meta-analysis, we aimed to confirm the relationship between caesarean section and perinatal outcomes in AFLP. The PubMed, Embase, and China National Knowledge Infrastructure databases were searched (until July 17, 2015) for observational clinical studies focusing on the association between caesarean section and perinatal outcomes in AFLP. Data were extracted and processed independently by 2 authors. We also compared caesarean section with vaginal delivery to further investigate this relationship. We observed that 2 of the 3 primary outcomes in caesarean section exhibited positive effects-the maternal mortality rate was 44% lower (relative risk [RR], 0.56 [0.41-0.76]) and perinatal mortality rate was also reduced (RR, 0.52 [0.38-0.71]), compared to those for vaginal delivery. We did not find any associations between caesarean section and perinatal outcomes in AFLP in terms of neonatal mortality type and maternal multiple organ complications. These findings emphasise the significant prognostic value and clinical implications of caesarean section in AFLP, and suggest that the adverse outcomes should be reduced.

  9. Midwife-led Care Model for Reducing Caesarean Rate: A Novel Concept for Worldwide Birth units where Standard Obstetric Care Still Dominates

    Directory of Open Access Journals (Sweden)

    Hong Zhou

    2012-01-01

    Full Text Available Caesarean rate has been increasing year by year in China and other countries in the world. In fact, caesarean section is associated with increased risk of maternal mortality and serious foetal pulmonary morbidity. To reduce caesarean rate, obstetricians in physician-based birth units get used to take early intervention for any delay in labour progress that could cause dystocia. However, standard obstetric care enhanced by obstetric power has not consistently been shown to reduce rate of caesarean delivery. Other than physician-based model, midwife-led model of care is aiming to promote normal birth by use of midwives’ skills as well as continuous support rather than augmentation of labour through excessive medical treatment. Midwife-led care model is novel to worldwide birth units where standard obstetric care still dominates. It has made some headway in efforts to reduce caesarean rate. The fact that standard obstetric care of childbirth have not consistently reduced rate of caesarean delivery encourages us for creating the hypotheses that midwife-led care model satisfying puerpera with care and support could minimise unnecessary obstetric intervention and facilitate vaginal birth, and finally reduces caesarean rate. This hypothesis, if confirmed, might have the potential to be disseminated elsewhere in the world, where most women still take standard obstetric care. Moreover, it has political implications for the national health-care policymaking.

  10. Effect of caesarean section on maternal and foetal outcomes in acute fatty liver of pregnancy: a systematic review and meta-analysis

    Science.gov (United States)

    Wang, Hong-Yan; Jiang, Qing; Shi, Hao; Xu, Yun-Qing; Shi, Ai-Chao; Sun, Yuan-Li; Li, Jian; Ning, Qin; Shen, Guan-Xin

    2016-01-01

    Several studies have reported a positive association between caesarean section for expeditious pregnancy termination and perinatal outcomes in acute fatty liver of pregnancy (AFLP); however, the risks remain unclear and independent studies have reported conflicting findings. In this meta-analysis, we aimed to confirm the relationship between caesarean section and perinatal outcomes in AFLP. The PubMed, Embase, and China National Knowledge Infrastructure databases were searched (until July 17, 2015) for observational clinical studies focusing on the association between caesarean section and perinatal outcomes in AFLP. Data were extracted and processed independently by 2 authors. We also compared caesarean section with vaginal delivery to further investigate this relationship. We observed that 2 of the 3 primary outcomes in caesarean section exhibited positive effects—the maternal mortality rate was 44% lower (relative risk [RR], 0.56 [0.41–0.76]) and perinatal mortality rate was also reduced (RR, 0.52 [0.38–0.71]), compared to those for vaginal delivery. We did not find any associations between caesarean section and perinatal outcomes in AFLP in terms of neonatal mortality type and maternal multiple organ complications. These findings emphasise the significant prognostic value and clinical implications of caesarean section in AFLP, and suggest that the adverse outcomes should be reduced. PMID:27387594

  11. The efficacy of the systemic methotrexate treatment in caesarean scar ectopic pregnancy: A quantitative review of English literature.

    Science.gov (United States)

    Bodur, S; Özdamar, Ö; Kılıç, S; Gün, I

    2015-04-01

    To determine the efficacy and safety of primary medical treatment with systemic methotrexate (MTX) in caesarean scar ectopic pregnancy, we conducted a Medline/PubMed search on the relevant English literature from January 1978 to January 2012. The search yielded 27 publications of 40 cases of caesarean scar ectopic pregnancy. The literature search showed a very liberal use of systemic MTX treatment with unfavourable outcomes, although the major determinant of the clinical efficacy was found in here to be β-hCG level together with embryonic cardiac activity (ECA) status. A caesarean scar ectopic pregnancy presented with a serum β-hCG concentration of ≤ 12,000 mIU/ml (odds ratio, OR 5.68, 95% confidence interval, CI, 1.37-23.48) and absence of ECA (OR 4.80, 95% CI, 1.14-20.08) was found to be associated with higher efficacy rate of primary systemic MTX treatment. Administration of primary systemic MTX treatment was found to be ideal for a caesarean scar ectopic pregnancy presented before 8 weeks' gestation, with a β-hCG concentration of ≤ 12,000 mIU/ml together with an absent ECA (OR 14.52, 95% CI, 2.36-89.09).

  12. Comparison of Efficacy and Safety of Intramuscular Piroxicam and Tramadol for Post-operative Pain in Patients Undergoing Caesarean Delivery

    Science.gov (United States)

    Thippeswamy, Tejashree; Bengalorkar, Girish M; Mariyappa, Narayanaswamy

    2016-01-01

    Introduction Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child. Aim To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain. Materials and Methods Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia. Severity of pain was assessed using Visual Analogue Scale (VAS) and side-effects to study drugs were noted. Rescue analgesic butorphanol 2mg was administered if VAS score was more than four. Patient’s satisfaction score was assessed at 12 hours post-operatively. Results Mean age in piroxicam and tramadol groups were 23.32±3.43 and 22.03±2.0 years respectively. Significant reduction in pain was observed at 2, 4, 8, 12 and 24 hours in both groups (ppiroxicam group compared to tramadol. Twenty-one and 12 patients in tramadol and piroxicam groups received rescue analgesic respectively. Sedation and nausea was significantly higher in tramadol group (ppiroxicam group. Conclusion Intra-muscular piroxicam was effective in reducing post-caesarean section pain for 24 hours with minimal side-effects compared to tramadol. PMID:28050391

  13. Analysis of Situation of the Caesarean Section Rate in Sichuan%四川省剖宫产现状分析

    Institute of Scientific and Technical Information of China (English)

    吴方银; 肖兵; 熊庆; 曹静; 潘惊萍

    2012-01-01

    目的 分析四川省剖宫产现状,为制定相关政策提供依据.方法 对四川省2009年剖宫产资料进行回顾分析.结果 全省剖宫产率为38.17%;乡镇级、县级、市级医疗保健机构剖宫产率分别为42.81%、50.20%、62.93%;非医学指征剖宫产占剖宫产总数的30.96%.结论 剖宫产率与经济发展水平、医疗保健机构级别成正相关,非医学指征剖宫产升高是剖宫产率上升的重要原因.%OBJECTIVE To analyze the present status of caesarean section in Sichuan Province, and supply evidences for government to make policy. METHODS A retrospective review of the data of caesarean section in 2009 was carried out. RESULTS The caesarean birth rate in Sichuan Province was 38.17%. The caesarean section rate to the Medical Health Establishment at village, county and municipal level was 42.81%, 50.20% and 62.93%, respectively. The caesarean section without medical signs constituted about 30.96% of the total caesarean section. CONCLUSION The level of economic development and the composition of Medical Health Establishment was positive correlation with the caesarean section rate. The rising caesarean section without medical signs was an important cause of the raising rate of Caesarean Section.

  14. Little People of America

    Science.gov (United States)

    ... information. World Dwarf Games 2017 Welcome to Little People of America Little People of America (LPA) is a nonprofit organization that provides support and information to people of short stature and their families. LPA is ...

  15. 22 CFR 125.3 - Exports of classified technical data and classified defense articles.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Exports of classified technical data and... IN ARMS REGULATIONS LICENSES FOR THE EXPORT OF TECHNICAL DATA AND CLASSIFIED DEFENSE ARTICLES § 125.3 Exports of classified technical data and classified defense articles. (a) A request for authority...

  16. Pavement Crack Classifiers: A Comparative Study

    Directory of Open Access Journals (Sweden)

    S. Siddharth

    2012-12-01

    Full Text Available Non Destructive Testing (NDT is an analysis technique used to inspect metal sheets and components without harming the product. NDT do not cause any change after inspection; this technique saves money and time in product evaluation, research and troubleshooting. In this study the objective is to perform NDT using soft computing techniques. Digital images are taken; Gray Level Co-occurrence Matrix (GLCM extracts features from these images. Extracted features are then fed into the classifiers which classifies them into images with and without cracks. Three major classifiers: Neural networks, Support Vector Machine (SVM and Linear classifiers are taken for the classification purpose. Performances of these classifiers are assessed and the best classifier for the given data is chosen.

  17. Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.

    LENUS (Irish Health Repository)

    McMorrow, R C N

    2012-02-01

    BACKGROUND: Transversus abdominis plane (TAP) block is an alternative to spinal morphine for analgesia after Caesarean section but there are few data on its comparative efficacy. We compared the analgesic efficacy of the TAP block with and without spinal morphine after Caesarean section in a prospective, randomized, double-blinded placebo-controlled trial. METHODS: Eighty patients were randomized to one of four groups to receive (in addition to spinal anaesthesia) either spinal morphine 100 microg (S(M)) or saline (S(S)) and a postoperative bilateral TAP block with either bupivacaine (T(LA)) 2 mg kg(-1) or saline (T(S)). RESULTS: Pain on movement and early morphine consumption were lowest in groups receiving spinal morphine and was not improved by TAP block. The rank order of median pain scores on movement at 6 h was: S(M)T(LA) (20 mm)Caesarean section. The addition of TAP block with bupivacaine 2 mg kg(-1) to spinal morphine did not further improve analgesia.

  18. Comparing different classifiers for automatic age estimation.

    Science.gov (United States)

    Lanitis, Andreas; Draganova, Chrisina; Christodoulou, Chris

    2004-02-01

    We describe a quantitative evaluation of the performance of different classifiers in the task of automatic age estimation. In this context, we generate a statistical model of facial appearance, which is subsequently used as the basis for obtaining a compact parametric description of face images. The aim of our work is to design classifiers that accept the model-based representation of unseen images and produce an estimate of the age of the person in the corresponding face image. For this application, we have tested different classifiers: a classifier based on the use of quadratic functions for modeling the relationship between face model parameters and age, a shortest distance classifier, and artificial neural network based classifiers. We also describe variations to the basic method where we use age-specific and/or appearance specific age estimation methods. In this context, we use age estimation classifiers for each age group and/or classifiers for different clusters of subjects within our training set. In those cases, part of the classification procedure is devoted to choosing the most appropriate classifier for the subject/age range in question, so that more accurate age estimates can be obtained. We also present comparative results concerning the performance of humans and computers in the task of age estimation. Our results indicate that machines can estimate the age of a person almost as reliably as humans.

  19. Can Caesarean section improve child and maternal health? The case of breech babies.

    Science.gov (United States)

    Jensen, Vibeke Myrup; Wüst, Miriam

    2015-01-01

    This paper examines the health effects of Caesarean section (CS) for children and their mothers. We use exogenous variation in the probability of CS in a fuzzy regression discontinuity design. Using administrative Danish data, we exploit an information shock for obstetricians that sharply altered CS rates for breech babies. We find that CS decreases the child's probability of having a low APGAR score and the number of family doctor visits in the first year of life. We find no significant effects for severe neonatal morbidity or hospitalizations. While mothers are hospitalized longer after birth, we find no effects of CS for maternal post-birth complications or infections. Although the change in mode of delivery for the marginal breech babies increases direct costs, the health benefits show that CS is the safest option for these children.

  20. Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.

    LENUS (Irish Health Repository)

    Tadrous, R

    2012-02-01

    Sturge-Weber syndrome consists of facial capillary malformation (port-wine stain) and abnormal blood vessels in the brain or eye. Seizures, developmental delay and intracranial and airway angiomata are principal concerns. We report a 28-year-old primiparous woman at 41 weeks of gestation with Sturge-Weber syndrome who developed unilateral weakness, aphasia, blurred vision and confusion. Preeclampsia was excluded. Neuroimaging showed left sided cerebral oedema and a right parieto-occipital lesion, most likely an angioma. Caesarean section was planned to avoid the risk of angioma rupture during labour. General anesthesia was avoided due to the haemodynamic response to laryngoscopy and reports of seizure-related mortality. Despite the possibility of raised intracranial pressure and precipitation of cerebral herniation, a lumbar epidural block was administered but failed. A subarachnoid block was successfully performed and a healthy infant delivered. The choice of anaesthesia was strongly influenced by detailed radiological investigations and multidisciplinary participation.

  1. Anaesthesia for caesarean section in a patient with Sturge-Weber syndrome following acute neurological deterioration.

    LENUS (Irish Health Repository)

    Tadrous, R

    2011-07-01

    Sturge-Weber syndrome consists of facial capillary malformation (port-wine stain) and abnormal blood vessels in the brain or eye. Seizures, developmental delay and intracranial and airway angiomata are principal concerns. We report a 28-year-old primiparous woman at 41 weeks of gestation with Sturge-Weber syndrome who developed unilateral weakness, aphasia, blurred vision and confusion. Preeclampsia was excluded. Neuroimaging showed left sided cerebral oedema and a right parieto-occipital lesion, most likely an angioma. Caesarean section was planned to avoid the risk of angioma rupture during labour. General anesthesia was avoided due to the haemodynamic response to laryngoscopy and reports of seizure-related mortality. Despite the possibility of raised intracranial pressure and precipitation of cerebral herniation, a lumbar epidural block was administered but failed. A subarachnoid block was successfully performed and a healthy infant delivered. The choice of anaesthesia was strongly influenced by detailed radiological investigations and multidisciplinary participation.

  2. Acute Chest Syndrome in Sickle Cell Disease Patients Post Caesarean Delivery

    Directory of Open Access Journals (Sweden)

    YM Zhang

    2016-02-01

    Full Text Available Sickle cell disease (SCD is the most common inherited disease worldwide and is associated with anaemia and intermittent painful crisis. Pregnant women who are affected are known to have increased maternal and fetal mortality and morbidity. Acute chest syndrome (ACS is an uncommon but serious complication in pregnant women with SCD that can lead to death. We present two cases of patients with SCD, both of whom had severe ACS within 24 hours post Caesarean section. By accurate diagnosis and appropriate management by a multidisciplinary team, both mothers and fetuses had excellent outcomes. It is suggested that prompt recognition of ACS in a pregnant woman with SCD and collaborative medical and obstetric management are essential to optimize maternal and fetal outcomes.

  3. The experiences of parents where pregnancy ended in an unplanned caesarean section

    Directory of Open Access Journals (Sweden)

    C. C. Ceronio

    1995-05-01

    Full Text Available The purpose of this study to determine the experiences of parents prior to, during and following an unplanned caesarean section. Parents who experienced this event had mixed emotions. The related occurrences may have influenced their behaviour and consequently their relationships with their spouses, themselves and their environment. These continually interacted with each other and thus needed to be looked at in context. 'The Nursing of the Whole Person Theory’ ensured a holistic approach to the parents. Unstructured, in-depth interviews held with five mothers and five fathers, respectively, on day three post-delivery, were transcribed and analysed. At six weeks a follow-up semi-structured questionnaire was answered by these same respondents and analysed The experiences of the parents were then compared,

  4. Uteroplacental blood flow measured by placental scintigraphy during epidural anaesthesia for caesarean section

    Energy Technology Data Exchange (ETDEWEB)

    Skjoeldebrand, A.; Eklund, J.; Johansson, H.; Lunell, N.-O.; Nylund, L.; Sarby, B.; Thornstroem, S. (Departments of Anaesthesiology, Obstetrics and Gynaecology and Medical Physics, Karolinska Institute at Huddinge University Hospital, Stockholm (Sweden))

    1990-01-01

    The uteroplacental blood flow was measured before and during epidural anaesthesia for caesarean section in 11 woman. The blood flow was measured with dynamic placental scintigraphy. After an i.v. injection of indium-113m chloride, the gamma radiation over the placenta was recorded with a computer-linked scintillation camera. The uteroplacental blood flow could be calculated from the isotope accumulation curve. The anaesthesia was performed with bupivacaine plain 0.5%, 18-22 ml and a preload of a balanced electrolyte solution 10 ml/kg b.w. was given. The placental blood flow decreased in eight patients and increased in three with a median change of -21%, not being statistically significant. No correlation between maternal blood pressure and placental blood flow was found. (author).

  5. [Skin-to-skin caesarean section: a hype or better patient care?

    Science.gov (United States)

    Korteweg, F J; de Boer, H D; van der Ploeg, J M; Buiter, H D; van der Ham, D P

    2017-01-01

    A caesarean section (CS) is one of the most common surgical procedures performed in the world, for which there are minimal variations in the surgical approach. During the last few years the "skin-to-skin" CS, also coined "natural" or "gentle" CS, is on the rise; parental participation, slow delivery and direct skin-to-skin contact are important aspects. Most Dutch hospitals offer some form of "skin-to-skin" CS but there are local differences in availability and performance of the procedure. Since 2011, the standard procedure in the Martini Hospital in Groningen is the "skin-to-skin" CS (for both elective and emergency CS, 24/7). We describe our method and share our retrospective data, and demonstrate that this procedure does not result in more complications for mother or baby.

  6. Mathematical Model for the Secretion of Oxytocin after Vaginal Delivery or Caesarean in Breastfeeding Women

    Directory of Open Access Journals (Sweden)

    Dr. S. Lakshmi

    2014-05-01

    Full Text Available Oxytocin, which is produced in the supraoptic (SON and paraventricular (PVN nuclei of the hypothalamus, is released in to circulation from magnocellular neurons which extend down to the posterior pituitary. In addition, oxytocin is produced and released from parvocellular neurons in the PVN, which project to many areas within the brain such as other parts of the hypothalamus, the amygdala , the striatum, the raphenuclei, the LC, the vagal motor and sensory nuclei, the dorsal horn of the spinal cord as well as the preganglionic sympathetic neurons of the intermediolateral column of the spinal cord . The structure of the nonapeptide oxytocin differs by only two amino acids from that of vasopressin, which is produced in separate neurons of the PVN and SON. Only one oxytocin receptor, i.e. the uterine type of receptor, has been identified. This type of receptor also has been demonstrated in the central nervous system. Oxytocin release into the nervous system during the early postpartum period may strengthen the expression of maternal behaviors and prolong breastfeeding. Comparisons between woman following vaginal delivery (VD versus caesarean section (CS suggest that exposure to oxytocin during labor and in the postpartal period can influence the subsequent function of oxytocin-producing neurons during the lactation period. In the Mathematical model, both the cases are compared by finding the Renewal density and Failure Density functions. Renewal density is higher if we compare the caesarean case with vaginal delivery during the labor and in the early post partum period. In a similar manner, we obtain the bounds of the failure density functions in both the cases. MATHEMATICAL SUBJECT CLASSIFICATION: 60GXX, 60E05.

  7. A Study of Post-Caesarean Section Wound Infections in a Regional Referral Hospital, Oman

    Directory of Open Access Journals (Sweden)

    Hansa Dhar

    2014-05-01

    Full Text Available Objectives: The aim of this study was to determine the incidence of surgical site infections (SSI in patients undergoing a Caesarean section (CS and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patient’s quality of life by increasing morbidity and extending hospital stays. Methods: A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean (PCS SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSI. Controls (220 were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSI. Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection. Results: The total number of PCS wound infections was 211 (2.66%. There was a four-fold higher incidence of premature rupture of the membranes (37, 17.53% and a three-fold higher incidence of diabetes (32, 15.16% in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus (66, 31.27% and the Gram-negative Escherichia coli group (40, 18.95%. The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 (19.90%, while 47 (22.27% yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted. Conclusion: Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques.

  8. Where are the Sunday babies? III. Caesarean sections, decreased weekend births, and midwife involvement in Germany

    Science.gov (United States)

    Lerchl, Alexander

    2008-02-01

    A previous study has shown a marked and continuing decline in weekend births in Germany between 1988 and 2003 (Lerchl, Naturwissenschaften 92:592-594, 2005). The present study was performed to investigate the possible influence of caesarean sections (CS) on weekend birth number and on the involvement of midwives in births for all 16 German states for the year 2003. In total, data from 706,721 births were sorted according to weekday of births and state, respectively, and the weekend births avoidance rates were calculated. Weekend births were consistently less frequent than births during the week, with an average of -15.3% for all states and due to fewer births on Saturdays (-13.6%) and Sundays (-16.7%). Between the states, weekend births avoidance rates ranged from -11.6% (Bremen) to -24.2% (Saarland). The proportion of CS was 25.5% for all states, ranging from 19.2% (Sachsen and Sachsen-Anhalt) to 30.5% (Saarland). CS and weekend births avoidance rates were significantly correlated, consistent with the hypothesis that primary (planned) CS are regularly scheduled on weekdays. The number of births per midwife (BPM) was calculated according to the number of active members in the states’ professional midwives’ organizations. The mean number of BPM was 59.5, ranging from 45.2 (Bremen) to 82.4 (Sachsen-Anhalt). CS and BPM were significantly correlated, consistent with the hypothesis that higher CS ratios are associated with lower midwife involvement in births. It is concluded that the decline in weekend births and lower involvement of midwives are caused, at least in part, by an increased number of caesarean sections.

  9. A review of learning vector quantization classifiers

    CERN Document Server

    Nova, David

    2015-01-01

    In this work we present a review of the state of the art of Learning Vector Quantization (LVQ) classifiers. A taxonomy is proposed which integrates the most relevant LVQ approaches to date. The main concepts associated with modern LVQ approaches are defined. A comparison is made among eleven LVQ classifiers using one real-world and two artificial datasets.

  10. DETECTION OF A RARE BLOOD GROUP “BOMBAY (OH PHENOTYPE” IN A POST CAESAREAN PREGNANCY WITH ANAEMIA - A RARE CASE REPORT FROM EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Anindya Kumar

    2013-10-01

    Full Text Available ABSTRACT: The Bombay blood group is a very rare blood group discovered almost 60 years back. We report here, a high risk case of Post Caesarean pregnancy with anaemia with Bombay Blood Group

  11. Deconvolution When Classifying Noisy Data Involving Transformations

    KAUST Repository

    Carroll, Raymond

    2012-09-01

    In the present study, we consider the problem of classifying spatial data distorted by a linear transformation or convolution and contaminated by additive random noise. In this setting, we show that classifier performance can be improved if we carefully invert the data before the classifier is applied. However, the inverse transformation is not constructed so as to recover the original signal, and in fact, we show that taking the latter approach is generally inadvisable. We introduce a fully data-driven procedure based on cross-validation, and use several classifiers to illustrate numerical properties of our approach. Theoretical arguments are given in support of our claims. Our procedure is applied to data generated by light detection and ranging (Lidar) technology, where we improve on earlier approaches to classifying aerosols. This article has supplementary materials online.

  12. Caesarean Section Frequency among Immigrants, Second- and Third-Generation Women, and Non-Immigrants: Prospective Study in Berlin/Germany.

    Directory of Open Access Journals (Sweden)

    Matthias David

    Full Text Available The frequency of caesarean section delivery varies between countries and social groups. Among other factors, it is determined by the quality of obstetrics care. Rates of elective (planned and emergency (in-labor caesareans may also vary between immigrants (first generation, their offspring (second- and third-generation women, and non-immigrants because of access and language barriers. Other important points to be considered are whether caesarean section indications and the neonatal outcomes differ in babies delivered by caesarean between immigrants, their offspring, and non-immigrants.A standardized interview on admission to delivery wards at three Berlin obstetric hospitals was performed in a 12-month period in 2011/2012. Questions on socio-demographic and care aspects and on migration (immigrated herself vs. second- and third-generation women vs. non-immigrant and acculturation status were included. Data was linked with information from the expectant mothers' antenatal records and with perinatal data routinely documented in the hospital. Regression modeling was used to adjust for age, parity and socio-economic status.The caesarean section rates for immigrants, second- and third-generation women, and non-immigrant women were similar. Neither indications for caesarean section delivery nor neonatal outcomes showed statistically significant differences. The only difference found was a somewhat higher rate of crash caesarean sections per 100 births among first generation immigrants compared to non-immigrants.Unlike earlier German studies and current studies from other European countries, this study did not find an increased rate of caesarean sections among immigrants, as well as second- and third-generation women, with the possible exception of a small high-risk group. This indicates an equally high quality of perinatal care for women with and without a migration history.

  13. The impact of hospital revenue on the increase in Caesarean sections in Norway. A panel data analysis of hospitals 1976-2005

    Directory of Open Access Journals (Sweden)

    Hagen Terje P

    2011-10-01

    Full Text Available Abstract Background There has been a marked increase in the number of Caesarean sections in many countries during the last decades. In several countries, Caesarean sections are carried out in more than 20 per cent of births. These high Caesarean section rates give cause for concern, both from an economic and a medical perspective. A general opinion among epidemiologists is that the increase in the number of Caesarean sections during the last decade has been greater than could be expected in relation to medical risk factors. Therefore, other explanations must be sought. We studied one potential explanation; the effect that the increase in hospital revenue per bed during the period 1976-2005 has had on the Caesarean section rate in Norway. During this period, hospital revenue increased by about 260% (adjusted for inflation. Methods The analyses were carried out using data from the Medical Birth Registry 1976-2005 from Norway. The data were merged with data about hospital revenue, which were obtained from Statistics Norway. The analyses were carried out using annual data from 46 hospitals. A fixed effect regression model was estimated. Relevant medical control variables were included. Results The elasticity of the Caesarean section rate with respect to hospital revenue per bed was 0.13 (p Conclusion The increase in hospital revenue explains only a small part of the increase in the Caesarean section rate in Norway during the last three decades. The increase in the Caesarean section rate is considerably greater than could be expected, based on the increase in hospital revenue alone. The strength of our study is that we have estimated a cause and effect relationship. This was done by using fixed effects for hospitals, a lagged revenue variable and by including an extensive set of control variables for the risk factors of the mother and the baby.

  14. An examination of women experiencing obstetric complications requiring emergency care: perceptions and sociocultural consequences of caesarean sections in Bangladesh.

    Science.gov (United States)

    Khan, Rasheda; Blum, Lauren S; Sultana, Marzia; Bilkis, Sayeda; Koblinsky, Marge

    2012-06-01

    Little is known about the physical and socioeconomic postpartum consequences of women who experience obstetric complications and require emergency obstetric care (EmOC), particularly in resource-poor countries such as Bangladesh where historically there has been a strong cultural preference for births at home. Recent increases in the use of skilled birth attendants show socioeconomic disparities in access to emergency obstetric services, highlighting the need to examine birthing preparation and perceptions of EmOC, including caesarean sections. Twenty women who delivered at a hospital and were identified by physicians as having severe obstetric complications during delivery or immediately thereafter were selected to participate in this qualitative study. Purposive sampling was used for selecting the women. The study was carried out in Matlab, Bangladesh, during March 2008-August 2009. Data-collection methods included in-depth interviews with women and, whenever possible, their family members. The results showed that the women were poorly informed before delivery about pregnancy-related complications and medical indications for emergency care. Barriers to care-seeking at emergency obstetric facilities and acceptance of lifesaving care were related to apprehensions about the physical consequences and social stigma, resulting from hospital procedures and financial concerns. The respondents held many misconceptions about caesarean sections and distrust regarding the reason for recommending the procedure by the healthcare providers. Women who had caesarean sections incurred high costs that led to economic burdens on family members, and the blame was attributed to the woman. The postpartum health consequences reported by the women were generally left untreated. The data underscore the importance of educating women and their families about pregnancy-related complications and preparing families for the possibility of caesarean section. At the same time, the health systems

  15. Implementation of guidelines on oxytocin use at caesarean section: a survey of practice in Great Britain and Ireland.

    LENUS (Irish Health Repository)

    Sheehan, Sharon R

    2012-02-01

    OBJECTIVE: Caesarean section is one of the most commonly performed major operations on women worldwide. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. Various clinical guidelines address oxytocin use at the time of caesarean section. We previously reported wide variation in practice amongst clinicians in the United Kingdom in the use of oxytocin at caesarean section. The aim of this current study was to determine whether the variation in approach is universal across the individual countries of Great Britain and Ireland and whether this reflects differences in interpretation and implementation of clinical practice guidelines. STUDY DESIGN: We conducted a survey of practice in the five individual countries of Great Britain and Ireland. A postal questionnaire was sent to all lead consultant obstetricians and anaesthetists with responsibility for the labour ward. We explored the use of oxytocin bolus and infusion, the measurement of blood loss at caesarean section and the rates of major haemorrhage. Existing clinical guidelines from the National Institute for Clinical Excellence (NICE), the Royal College of Obstetricians and Gynaecologists (RCOG) and ALSO (Advanced Life Support in Obstetrics) were used to benchmark reported practice against recommended practice for the management of blood loss at caesarean section. RESULTS: The response rate was 82% (391 respondents). Use of a 5 IU oxytocin bolus was reported by 346 respondents (85-95% for individual countries). In some countries, up to 14% used a 10 IU oxytocin bolus despite recommendations against this. Routine use of an oxytocin infusion varied greatly between countries (11% lowest-55% highest). Marked variations in choice of oxytocin regimens were noted with inconsistencies in the country-specific recommendations, e.g. NICE (which covers England and Wales) recommends a 30 IU oxytocin infusion over 4h, but only 122 clinicians (40%) used this. CONCLUSIONS

  16. Logarithmic learning for generalized classifier neural network.

    Science.gov (United States)

    Ozyildirim, Buse Melis; Avci, Mutlu

    2014-12-01

    Generalized classifier neural network is introduced as an efficient classifier among the others. Unless the initial smoothing parameter value is close to the optimal one, generalized classifier neural network suffers from convergence problem and requires quite a long time to converge. In this work, to overcome this problem, a logarithmic learning approach is proposed. The proposed method uses logarithmic cost function instead of squared error. Minimization of this cost function reduces the number of iterations used for reaching the minima. The proposed method is tested on 15 different data sets and performance of logarithmic learning generalized classifier neural network is compared with that of standard one. Thanks to operation range of radial basis function included by generalized classifier neural network, proposed logarithmic approach and its derivative has continuous values. This makes it possible to adopt the advantage of logarithmic fast convergence by the proposed learning method. Due to fast convergence ability of logarithmic cost function, training time is maximally decreased to 99.2%. In addition to decrease in training time, classification performance may also be improved till 60%. According to the test results, while the proposed method provides a solution for time requirement problem of generalized classifier neural network, it may also improve the classification accuracy. The proposed method can be considered as an efficient way for reducing the time requirement problem of generalized classifier neural network.

  17. A Sequential Algorithm for Training Text Classifiers

    CERN Document Server

    Lewis, D D; Lewis, David D.; Gale, William A.

    1994-01-01

    The ability to cheaply train text classifiers is critical to their use in information retrieval, content analysis, natural language processing, and other tasks involving data which is partly or fully textual. An algorithm for sequential sampling during machine learning of statistical classifiers was developed and tested on a newswire text categorization task. This method, which we call uncertainty sampling, reduced by as much as 500-fold the amount of training data that would have to be manually classified to achieve a given level of effectiveness.

  18. Gangs in Central America

    Science.gov (United States)

    2008-10-17

    Citizen Security held in July 2008 indicated that Guatemala now has the second highest murder rate in Central America (roughly 45 per 100,000 people...training regional security forces.48 In recent years, the U.S. Southern Command has taken a leading role in discussing the problem of citizen security in...the results CRS-19 51 “Memo: The Merida Initiative and Citizen Security in Mexico and Central America,” Washington Office on Latin America, March 2008

  19. Classifiers based on optimal decision rules

    KAUST Repository

    Amin, Talha

    2013-11-25

    Based on dynamic programming approach we design algorithms for sequential optimization of exact and approximate decision rules relative to the length and coverage [3, 4]. In this paper, we use optimal rules to construct classifiers, and study two questions: (i) which rules are better from the point of view of classification-exact or approximate; and (ii) which order of optimization gives better results of classifier work: length, length+coverage, coverage, or coverage+length. Experimental results show that, on average, classifiers based on exact rules are better than classifiers based on approximate rules, and sequential optimization (length+coverage or coverage+length) is better than the ordinary optimization (length or coverage).

  20. An Efficient and Effective Immune Based Classifier

    Directory of Open Access Journals (Sweden)

    Shahram Golzari

    2011-01-01

    Full Text Available Problem statement: Artificial Immune Recognition System (AIRS is most popular and effective immune inspired classifier. Resource competition is one stage of AIRS. Resource competition is done based on the number of allocated resources. AIRS uses a linear method to allocate resources. The linear resource allocation increases the training time of classifier. Approach: In this study, a new nonlinear resource allocation method is proposed to make AIRS more efficient. New algorithm, AIRS with proposed nonlinear method, is tested on benchmark datasets from UCI machine learning repository. Results: Based on the results of experiments, using proposed nonlinear resource allocation method decreases the training time and number of memory cells and doesn't reduce the accuracy of AIRS. Conclusion: The proposed classifier is an efficient and effective classifier.

  1. Local Component Analysis for Nonparametric Bayes Classifier

    CERN Document Server

    Khademi, Mahmoud; safayani, Meharn

    2010-01-01

    The decision boundaries of Bayes classifier are optimal because they lead to maximum probability of correct decision. It means if we knew the prior probabilities and the class-conditional densities, we could design a classifier which gives the lowest probability of error. However, in classification based on nonparametric density estimation methods such as Parzen windows, the decision regions depend on the choice of parameters such as window width. Moreover, these methods suffer from curse of dimensionality of the feature space and small sample size problem which severely restricts their practical applications. In this paper, we address these problems by introducing a novel dimension reduction and classification method based on local component analysis. In this method, by adopting an iterative cross-validation algorithm, we simultaneously estimate the optimal transformation matrices (for dimension reduction) and classifier parameters based on local information. The proposed method can classify the data with co...

  2. Individual and institutional determinants of caesarean section in referral hospitals in Senegal and Mali: a cross-sectional epidemiological survey

    OpenAIRE

    2012-01-01

    Abstract Background Two years after implementing the free-CS policy, we assessed the non-financial factors associated with caesarean section (CS) in women managed by referral hospitals in Senegal and Mali. Methods We conducted a cross-sectional survey nested in a cluster trial (QUARITE trial) in 41 referral hospitals in Senegal and Mali (10/01/2007–10/01/2008). Data were collected regarding women’s characteristics and on available institutional resources. Individual and institutional factors ...

  3. Trends in and socio-demographic factors associated with caesarean section at a large Tanzanian hospital, 2000 to 2013

    OpenAIRE

    2014-01-01

    Introduction: Caesarean section (CS) can prevent maternal or fetal complications. Sub-Saharan Africa has the lowest CS levels in the world but large variations are seen between and within countries. The tertiary hospital, Kilimanjaro Christian Medical Centre (KCMC) in Tanzania has had a high level of CS over years. Objectives: To examine trends in the socio-demographic background of babies born at KCMC from year 2000 to 2013, and trends in the CS percentage, and to identify socio-demographic ...

  4. [Idiopathic intracranial hypertension: a caesarean with epidural anaesthesia after bringing the cerebrospinal fluid pressure back to normal].

    Science.gov (United States)

    Pérez Rodríguez, M; de Carlos Errea, J; Dorronsoro Auzmendi, M; Batllori Gastón, M

    2013-12-01

    Idiopathic intracranial hypertension is diagnosed by exclusion. Because of its uncertain physiopathology and infrequent occurrence, its anaesthetic management is not well defined. The patient in this case is a pregnant woman with this disease with no lumbar-peritoneal shunt who was referred for non-urgent caesarean section, consisting of CSF drainage and pressure normalisation before the administration of epidural anaesthesia. We believe this technique can de effective to achieve adequate blockage and increased patient comfort, as well as improving postoperative recovery.

  5. Caesarean section: could different transverse abdominal incision techniques influence postpartum pain and subsequent quality of life? A systematic review.

    Science.gov (United States)

    Gizzo, Salvatore; Andrisani, Alessandra; Noventa, Marco; Di Gangi, Stefania; Quaranta, Michela; Cosmi, Erich; D'Antona, Donato; Nardelli, Giovanni Battista; Ambrosini, Guido

    2015-01-01

    The choice of the type of abdominal incision performed in caesarean delivery is made chiefly on the basis of the individual surgeon's experience and preference. A general consensus on the most appropriate surgical technique has not yet been reached. The aim of this systematic review of the literature is to compare the two most commonly used transverse abdominal incisions for caesarean delivery, the Pfannenstiel incision and the modified Joel-Cohen incision, in terms of acute and chronic post-surgical pain and their subsequent influence in terms of quality of life. Electronic database searches formed the basis of the literature search and the following databases were searched in the time frame between January 1997 and December 2013: MEDLINE, EMBASE Sciencedirect and the Cochrane Library. Key search terms included: "acute pain", "chronic pain", "Pfannenstiel incision", "Misgav-Ladach", "Joel Cohen incision", in combination with "Caesarean Section", "abdominal incision", "numbness", "neuropathic pain" and "nerve entrapment". Data on 4771 patients who underwent caesarean section (CS) was collected with regards to the relation between surgical techniques and postoperative outcomes defined as acute or chronic pain and future pregnancy desire. The Misgav-Ladach incision was associated with a significant advantage in terms of reduction of post-surgical acute and chronic pain. It was indicated as the optimal technique in view of its characteristic of reducing lower pelvic discomfort and pain, thus improving quality of life and future fertility desire. Further studies which are not subject to important bias like pre-existing chronic pain, non-standardized analgesia administration, variable length of skin incision and previous abdominal surgery are required.

  6. Classifying Genomic Sequences by Sequence Feature Analysis

    Institute of Scientific and Technical Information of China (English)

    Zhi-Hua Liu; Dian Jiao; Xiao Sun

    2005-01-01

    Traditional sequence analysis depends on sequence alignment. In this study, we analyzed various functional regions of the human genome based on sequence features, including word frequency, dinucleotide relative abundance, and base-base correlation. We analyzed the human chromosome 22 and classified the upstream,exon, intron, downstream, and intergenic regions by principal component analysis and discriminant analysis of these features. The results show that we could classify the functional regions of genome based on sequence feature and discriminant analysis.

  7. Searching and Classifying non-textual information

    OpenAIRE

    Arentz, Will Archer

    2004-01-01

    This dissertation contains a set of contributions that deal with search or classification of non-textual information. Each contribution can be considered a solution to a specific problem, in an attempt to map out a common ground. The problems cover a wide range of research fields, including search in music, classifying digitally sampled music, visualization and navigation in search results, and classifying images and Internet sites.On classification of digitally sample music, as method for ex...

  8. Classifying the Quantum Phases of Matter

    Science.gov (United States)

    2015-01-01

    2013), arXiv:1305.2176. [10] J. Haah, Lattice quantum codes and exotic topological phases of matter , arXiv:1305.6973. [11[ M. Hastings and S...CLASSIFYING THE QUANTUM PHASES OF MATTER CALIFORNIA INSTITUTE OF TECHNOLOGY JANUARY 2015 FINAL TECHNICAL REPORT...REPORT 3. DATES COVERED (From - To) JAN 2012 – AUG 2014 4. TITLE AND SUBTITLE CLASSIFYING THE QUANTUM PHASES OF MATTER 5a. CONTRACT NUMBER FA8750-12-2

  9. COMBINING CLASSIFIERS FOR CREDIT RISK PREDICTION

    Institute of Scientific and Technical Information of China (English)

    Bhekisipho TWALA

    2009-01-01

    Credit risk prediction models seek to predict quality factors such as whether an individual will default (bad applicant) on a loan or not (good applicant). This can be treated as a kind of machine learning (ML) problem. Recently, the use of ML algorithms has proven to be of great practical value in solving a variety of risk problems including credit risk prediction. One of the most active areas of recent research in ML has been the use of ensemble (combining) classifiers. Research indicates that ensemble individual classifiers lead to a significant improvement in classification performance by having them vote for the most popular class. This paper explores the predicted behaviour of five classifiers for different types of noise in terms of credit risk prediction accuracy, and how could such accuracy be improved by using pairs of classifier ensembles. Benchmarking results on five credit datasets and comparison with the performance of each individual classifier on predictive accuracy at various attribute noise levels are presented. The experimental evaluation shows that the ensemble of classifiers technique has the potential to improve prediction accuracy.

  10. A multi-class large margin classifier

    Institute of Scientific and Technical Information of China (English)

    Liang TANG; Qi XUAN; Rong XIONG; Tie-jun WU; Jian CHU

    2009-01-01

    Currently there are two approaches for a multi-class support vector classifier (SVC). One is to construct and combine several binary classifiers while the other is to directly consider all classes of data in one optimization formulation. For a K-class problem (K>2), the first approach has to construct at least K classifiers, and the second approach has to solve a much larger op-timization problem proportional to K by the algorithms developed so far. In this paper, following the second approach, we present a novel multi-class large margin classifier (MLMC). This new machine can solve K-class problems in one optimization formula-tion without increasing the size of the quadratic programming (QP) problem proportional to K. This property allows us to construct just one classifier with as few variables in the QP problem as possible to classify multi-class data, and we can gain the advantage of speed from it especially when K is large. Our experiments indicate that MLMC almost works as well as (sometimes better than) many other multi-class SVCs for some benchmark data classification problems, and obtains a reasonable performance in face recognition application on the AR face database.

  11. Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

    Science.gov (United States)

    Nanda, Smiti; Gupta, Anjali; More, Hemant

    2016-01-01

    Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems. PMID:27631023

  12. ASSESSMENT OF PREVIOUS LOWER SEGMENT CAESAREAN SECTION SCAR BY ULTRA SONOGRAPY: IT'S INFLUENCE ON MODE OF DELIVERY AND FOETOMATERNAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Geeta Vandana

    2015-04-01

    Full Text Available BACKGROUND & PURPOSE OF STUDY: The present study is a prospective study to evaluate the usefulness of ultrasonographic measurement of the thickness of the lower uterine segment of post caesarean pregnancy at term for predicting the risk of intrapartum dehiscence. METHODS: T his study was conducted in the D epartment of OBGYN, King George Hospital, Andhra Medical College, Visakhapatnam, from March 2011 to August 2012. All the pregnant women with previous one cesarean section attending Ante Natal Clinic for confinement were included in the s tudy after giving consent. RESULTS: The out of 100 cases of post caesarean pregnancy, 42 elective LSCS were done in 14 cases, and VBAC in 17 cases. Out of 58 emergency LSCS repeat elective LSCS were done in 26 cases and 5 cases underwent VBAC. There was no case of perinatal mortality or rupture in the present study. CONCLUSION: There was significant thinning of lower uterine segment in emergency caesarean group. The 3.5mm mean of LUS thickness was taken as cut off value. There is 46% chance of uterine dehis cence when thickness is 3.5mm. If the thickness of lower uterine segment is >3.5mm the possibility of dehiscence during subsequent trials of labor is very small. Hence t ransvaginal deliv ery can be undertaken with more confidence.

  13. What are the Differences between Bayesian Classifiers and Mutual-Information Classifiers?

    CERN Document Server

    Hu, Bao-Gang

    2011-01-01

    In this study, both Bayesian classifiers and mutual information classifiers are examined for binary classifications with or without a reject option. The general decision rules in terms of distinctions on error types and reject types are derived for Bayesian classifiers. A formal analysis is conducted to reveal the parameter redundancy of cost terms when abstaining classifications are enforced. The redundancy implies an intrinsic problem of "non-consistency" for interpreting cost terms. If no data is given to the cost terms, we demonstrate the weakness of Bayesian classifiers in class-imbalanced classifications. On the contrary, mutual-information classifiers are able to provide an objective solution from the given data, which shows a reasonable balance among error types and reject types. Numerical examples of using two types of classifiers are given for confirming the theoretical differences, including the extremely-class-imbalanced cases. Finally, we briefly summarize the Bayesian classifiers and mutual-info...

  14. Intrapartum caesarean rates differ significantly between ethnic groups--relationship to induction.

    LENUS (Irish Health Repository)

    Ismail, Khadijah I

    2012-01-31

    OBJECTIVE: Given international variation in obstetric practices and outcomes, comparison of labour outcomes in different ethnic groups could provide important information regarding the underlying reasons for rising caesarean delivery rates. Increasing numbers of women from Eastern European countries are now delivering in Irish maternity hospitals. We compared labour outcomes between Irish and Eastern European (EE) women in a large tertiary referral center. STUDY DESIGN: This was a prospective consecutive cohort study encompassing a single calendar year. The cohort comprised 5550 Irish and 867 EE women delivered in a single institution in 2009. Women who had multiple pregnancies, breech presentation, and elective or pre-labour caesarean sections (CS) were excluded. Data obtained from birth registers included maternal age, nationality, parity, gestation, onset of labour, mode of delivery and birth weight. RESULTS: The overall intrapartum CS rate was 11.4% and was significantly higher in Irish compared to EE women (11.8% vs. 8.8%; p=0.008). The proportion of primiparas was lower in Irish compared to EE women (44.8% vs. 63.6%; p<0.0001). The intrapartum CS rate was almost doubled in Irish compared to EE primiparas (20.7% vs. 11.0%; p<0.0001). Analysis of primiparas according to labour onset revealed a higher intrapartum CS rate in Irish primiparas in both spontaneous (13.5% vs. 7.2%; p<0.0001) and induced labour (29.5% vs. 19.3%; p=0.005). Irish women were older with 19.7% of primiparas aged more than 35, compared to 1.6% of EE women (p<0.0001). The primigravid CS rate in Irish women was significantly higher in women aged 35 years or older compared women aged less than 35 (30.6% vs. 18.3%; p<0.0001) consistent in both spontaneous and induced labour. The primiparous induction rate was 45.4% in Irish women compared to 32% in EE women, and more Irish women were induced before 41 weeks gestation. CONCLUSION: The results highlight that primigravid intrapartum CS rates were

  15. Clinician-centred interventions to increase vaginal birth after caesarean section (VBAC): a systematic review.

    LENUS (Irish Health Repository)

    Lundgren, Ingela

    2015-02-05

    BackgroundThe number of caesarean sections (CS) is increasing globally, and repeat CS after a previous CS is a significant contributor to the overall CS rate. Vaginal birth after caesarean (VBAC) can be seen as a real and viable option for most women with previous CS. To achieve success, however, women need the support of their clinicians (obstetricians and midwives). The aim of this study was to evaluate clinician-centred interventions designed to increase the rate of VBAC.MethodsThe bibliographic databases of The Cochrane Library, PubMed, PsychINFO and CINAHL were searched for randomised controlled trials, including cluster randomised trials that evaluated the effectiveness of any intervention targeted directly at clinicians aimed at increasing VBAC rates. Included studies were appraised independently by two reviewers. Data were extracted independently by three reviewers. The quality of the included studies was assessed using the quality assessment tool, `Effective Public Health Practice Project¿. The primary outcome measure was VBAC rates.Results238 citations were screened, 255 were excluded by title and abstract. 11 full-text papers were reviewed; eight were excluded, resulting in three included papers. One study evaluated the effectiveness of antepartum x-ray pelvimetry (XRP) in 306 women with one previous CS. One study evaluated the effects of external peer review on CS birth in 45 hospitals, and the third evaluated opinion leader education and audit and feedback in 16 hospitals. The use of external peer review, audit and feedback had no significant effect on VBAC rates. An educational strategy delivered by an opinion leader significantly increased VBAC rates. The use of XRP significantly increased CS rates.ConclusionsThis systematic review indicates that few studies have evaluated the effects of clinician-centred interventions on VBAC rates, and interventions are of varying types which limited the ability to meta-analyse data. A further limitation is that

  16. The utility of clinical care pathways in determining perinatal outcomes for women with one previous caesarean section; a retrospective service evaluation

    Directory of Open Access Journals (Sweden)

    Karuga Robinson N

    2010-10-01

    Full Text Available Abstract Background The rising rates of primary caesarean section have resulted in a larger obstetric population with scarred uteri. Subsequent pregnancies in these women are risk-prone and may complicate. Besides ensuring standardised management, care pathways could be used to evaluate for perinatal outcomes in these high risk pregnancies. We aim to demonstrate the use of a care pathway for vaginal birth after caesarean section as a service evaluation tool to determine perinatal outcomes. Methods A retrospective service evaluation by review of delivery case notes and records was undertaken at the Aga Khan University Hospital, Nairobi, Kenya between January 2008 and December 2009 Women with ≥2 previous caesarean sections, previous classical caesarean section, multiple gestation, breech presentation, severe pre-eclampsia, transverse lie, placenta praevia, conditions requiring induction of labour and incomplete records were excluded. Outcome measures included the proportion of eligible women who opted for test of scar (ToS, success rate of vaginal birth after caesarean section (VBAC; proportion on women opting for elective repeat caesarean section (ERCS and their perinatal outcomes. Results A total of 215 women with one previous caesarean section were followed up using a standard care pathway. The median parity (minimum-maximum was 1.01234. The other demographic characteristics were comparable. Only 44.6% of eligible mothers opted to have a ToS. The success rate for VBAC was 49.4% with the commonest (31.8% reason for failure being protracted active phase of labour. Maternal morbidity was comparable for the failed and successful VBAC group. The incidence of hemorrhage was 2.3% and 4.4% for the successful and failed VBAC groups respectively. The proportion of babies with acidotic arterial PH ( Conclusions Besides ensuring standardised management, care pathways could be objective audit and service evaluation tools for determining perinatal outcomes.

  17. America's Children and the Environment

    Science.gov (United States)

    ... Protection Agency Search Search America's Children and the Environment (ACE) Share Facebook Twitter Google+ Pinterest Contact Us ... of updates to ACE . America's Children and the Environment (ACE) America's Children and the Environment (ACE) is ...

  18. An analysis of variations of indications and maternal-fetal prognosis for caesarean section in a tertiary hospital of Beijing

    Science.gov (United States)

    Liu, Yajun; Wang, Xin; Zou, Liying; Ruan, Yan; Zhang, Weiyuan

    2017-01-01

    Abstract In recent decades, we have observed a remarkable increase in the rate of caesarean section (CS) in both developed and developing countries, especially in China. According to the World Health Organization (WHO) systematic review, if the increase in CS rate was between 10% and 15%, the maternal and neonatal mortality was decreased. However, above this level, increasing the rate of CS is no longer associated with reduced mortality. To date, no consensus has been reached on the main factors driving the cesarean epidemic. To reduce the progressively increasing rate of CS, we should find indications for the increasing CS rate. The aim of our study was to estimate the change of CS rate of Beijing Obstetrics and Gynecology Hospital and to find the variation of the indications. From January 1995 to December 2014, the CS rate of Beijing Obstetrics and Gynecology Hospital was analyzed. For our analysis, we selected 14,642 and 16,335 deliveries respectively that occurred during the year 2011 and 2014, to analyze the difference of indications, excluding incomplete data and miscarriages or termination of pregnancy before 28 weeks of gestation because of fatal malformations, intrauterine death, or other reasons. The average CS rate during the past 20 years was 51.15%. The highest caesarean delivery rate was 60.69% in 2002; however, the caesarean delivery rate declined to 34.53% in 2014. The obviously different indications were caesarean delivery on maternal request and previous CS delivery. The rate of CS due to maternal request in 2014 was decreased by 8.16% compared with the year 2011. However, the percentage of pregnancy women with a previous CS delivery increased from 9.61% to 20.42% in 3 years. Along with the decline of CS rate, the perinatal mortality and the rate of neonatal asphyxia decreased in 2014 compared with that in 2011. After a series of measures, the CS rate declined indeed. Compared with 2011, the perinatal mortality and the rate of neonatal asphyxia

  19. Evaluation of blood reservation and use for caesarean sections in a tertiary maternity unit in south western Nigeria

    Directory of Open Access Journals (Sweden)

    Oshodi Yussuf A

    2010-09-01

    Full Text Available Abstract Background Haemorrhage from obstetric causes is the most common cause of maternal mortality in the developing world. Prevention of mortality from haemorrhage will necessarily involve prompt blood transfusions among other life saving measures. There are however limited stocks of fresh or stored blood in many health care facilities in Sub Saharan Africa. Caesarean section has been identified as a common indication for blood transfusion in obstetrics practice and its performance is often delayed by non availability of blood in our centre. An evaluation of blood reservation and use at caesarean sections in a tertiary maternity unit in Lagos, south western Nigeria should therefore assist in formulating the most rational blood transfusion policies. Methods Case records of 327 patients who had elective and emergency caesarian sections at the Lagos State University Teaching Hospital between 1st October and 31st December 2007 were reviewed. Data pertaining to age, parity, booking status, type and indication for Caesarean section, pre- and post-operative packed cell volume, blood loss at surgery, units of blood reserved in the blood bank, unit(s of blood transfused and duration of hospital stay was extracted and the data analysed. Results There were 1056 deliveries out of which 327 (31% were by Caesarean section. During the study period, a total of 654 units of blood were reserved in the blood bank and subsequently made available in theatre. Out of this number, only 89 (13.6% were transfused to 41 patients. Amongst those transfused, twenty-six (54% were booked and 31 (75.6% had primary caesarian section. About 81% of those transfused had emergency caesarean section. The most common indication for surgery among those transfused were placenta praevia (9 patients with 21 units of blood and cephalo-pelvic disproportion (8 patients with 13 units. Conclusion Even though a large number of units of blood was reserved and made available in the theatre at

  20. Averaged Extended Tree Augmented Naive Classifier

    Directory of Open Access Journals (Sweden)

    Aaron Meehan

    2015-07-01

    Full Text Available This work presents a new general purpose classifier named Averaged Extended Tree Augmented Naive Bayes (AETAN, which is based on combining the advantageous characteristics of Extended Tree Augmented Naive Bayes (ETAN and Averaged One-Dependence Estimator (AODE classifiers. We describe the main properties of the approach and algorithms for learning it, along with an analysis of its computational time complexity. Empirical results with numerous data sets indicate that the new approach is superior to ETAN and AODE in terms of both zero-one classification accuracy and log loss. It also compares favourably against weighted AODE and hidden Naive Bayes. The learning phase of the new approach is slower than that of its competitors, while the time complexity for the testing phase is similar. Such characteristics suggest that the new classifier is ideal in scenarios where online learning is not required.

  1. Evolving Classifiers: Methods for Incremental Learning

    CERN Document Server

    Hulley, Greg

    2007-01-01

    The ability of a classifier to take on new information and classes by evolving the classifier without it having to be fully retrained is known as incremental learning. Incremental learning has been successfully applied to many classification problems, where the data is changing and is not all available at once. In this paper there is a comparison between Learn++, which is one of the most recent incremental learning algorithms, and the new proposed method of Incremental Learning Using Genetic Algorithm (ILUGA). Learn++ has shown good incremental learning capabilities on benchmark datasets on which the new ILUGA method has been tested. ILUGA has also shown good incremental learning ability using only a few classifiers and does not suffer from catastrophic forgetting. The results obtained for ILUGA on the Optical Character Recognition (OCR) and Wine datasets are good, with an overall accuracy of 93% and 94% respectively showing a 4% improvement over Learn++.MT for the difficult multi-class OCR dataset.

  2. Reinforcement Learning Based Artificial Immune Classifier

    Directory of Open Access Journals (Sweden)

    Mehmet Karakose

    2013-01-01

    Full Text Available One of the widely used methods for classification that is a decision-making process is artificial immune systems. Artificial immune systems based on natural immunity system can be successfully applied for classification, optimization, recognition, and learning in real-world problems. In this study, a reinforcement learning based artificial immune classifier is proposed as a new approach. This approach uses reinforcement learning to find better antibody with immune operators. The proposed new approach has many contributions according to other methods in the literature such as effectiveness, less memory cell, high accuracy, speed, and data adaptability. The performance of the proposed approach is demonstrated by simulation and experimental results using real data in Matlab and FPGA. Some benchmark data and remote image data are used for experimental results. The comparative results with supervised/unsupervised based artificial immune system, negative selection classifier, and resource limited artificial immune classifier are given to demonstrate the effectiveness of the proposed new method.

  3. Dynamic Bayesian Combination of Multiple Imperfect Classifiers

    CERN Document Server

    Simpson, Edwin; Psorakis, Ioannis; Smith, Arfon

    2012-01-01

    Classifier combination methods need to make best use of the outputs of multiple, imperfect classifiers to enable higher accuracy classifications. In many situations, such as when human decisions need to be combined, the base decisions can vary enormously in reliability. A Bayesian approach to such uncertain combination allows us to infer the differences in performance between individuals and to incorporate any available prior knowledge about their abilities when training data is sparse. In this paper we explore Bayesian classifier combination, using the computationally efficient framework of variational Bayesian inference. We apply the approach to real data from a large citizen science project, Galaxy Zoo Supernovae, and show that our method far outperforms other established approaches to imperfect decision combination. We go on to analyse the putative community structure of the decision makers, based on their inferred decision making strategies, and show that natural groupings are formed. Finally we present ...

  4. Use of oxytocin during Caesarean section at Princess Marina Hospital, Botswana: An audit of clinical practice

    Directory of Open Access Journals (Sweden)

    Billy M. Tsima

    2013-01-01

    Full Text Available Background: Oxytocin is widely used for the prevention of postpartum haemorrhage. In the setting of Caesarean section (CS, the dosage and mode of administrating oxytocin differs according to different guidelines. Inappropriate oxytocin doses have been identified as contributory to some cases of maternal deaths. The main aim of this study was to audit the current standard of clinical practice with regard to the use of oxytocin during CS at a referral hospital in Botswana.Methods: A clinical audit of pregnant women having CS and given oxytocin at the time of the operation was conducted over a period of three months. Data included indications for CS, oxytocin dose regimen, prescribing clinician’s designation, type of anaesthesia for the CS and estimated blood loss.Results: A total of 139 case records were included. The commonest dose was 20 IU infusion (31.7%. The potentially dangerous regimen of 10 IU intravenous bolus of oxytocin was used in 12.9% of CS. Further doses were utilized in 57 patients (41%. The top three indications for CS were fetal distress (36 patients, 24.5%, dystocia (32 patients, 21.8% and a previous CS (25 patients, 17.0%. Estimated blood loss ranged from 50 mL – 2000 mL.Conclusion: The use of oxytocin during CS in the local setting does not follow recommended practice. This has potentially harmful consequences. Education and guidance through evidence based national guidelines could help alleviate the problem.

  5. Decisions to Perform Emergency Caesarean Sections at a University Hospital; Do obstetricians agree?

    Directory of Open Access Journals (Sweden)

    Gowri Vaidyanathan

    2016-02-01

    Full Text Available Objectives: This study was undertaken to assess the degree of agreement amongst obstetricians regarding decisions to perform emergency Caesarean section (CS procedures at a university hospital. Methods: This retrospective clinical audit was carried out on 50 consecutive emergency CS procedures performed between November 2012 and March 2013 on women with singleton pregnancies at the Sultan Qaboos University Hospital in Muscat, Oman. Data on each procedure were collected from electronic patient records and independently reviewed by six senior obstetricians to determine agreement with the decision. Results: Of the 50 women who underwent CS procedures, the mean age was 28.9 ± 5.1 years and 48% were primigravidae. A total of 65% of the CS procedures were category I. The most common indications for a CS was a non-reassuring fetal heart trace (40% and dystocia (32%. There was complete agreement on the decision to perform 62% of the CS procedures. Five and four obstetricians agreed on 80% and 95% of the procedures, respectively. The range of disagreement was 4–20%. Disagreement occurred primarily with category II and III procedures compared to category I. Additionally, disagreement occurred in cases where the fetal heart trace pattern was interpreted as an indication for a category II CS. Conclusion: The majority of obstetricians agreed on the decisions to perform 94% of the emergency CS procedures. Obstetric decision-making could be improved with the implementation of fetal scalp pH testing facilities, fetal heart trace interpretation training and cardiotocography review meetings.

  6. Spinal anaesthesia for caesarean section in pregnant women with fetal distress: time for reappraisal.

    Science.gov (United States)

    Afolayan, J M; Olajumoke, T O; Esangbedo, S E; Edomwonyi, N P

    2014-06-01

    Residents' competency-based training and multidisciplinary cooperation are needed for rapid sequence spinal anaesthesia for fetal distress. Multiple standard but 'crash' spinal anaesthesia for non-obstetric procedures is imperative for acquisition of experienced hands. The purpose of this review is to share our modest experiences in the use of rapid spinal anaesthesia for emergency Caesarean delivery in pregnant women complicated with fetal distress. Fetal distress diagnosis is made promtly, intravenous line put in place in labour ward. Pre-loading or not, one-touch, non-touch spinal technique prevents unnecessary delay and further fetal hypoxic injury. Spinal pack is on stand by in the operating room at all time. Preloading is possible during the waiting period for other care providers otherwise coloading is used. A single wipe of the back with chlorhexidine lotion is frequently used for scrubbing. Lidocaine infiltration or spay is essential and does not waste time but opioid as adjuvant to bupivacaine wastes a lot of time to constitute and measure. So, opioid should be avoided. Average of 2.5 ml of 0.5% hyperbaric bupivacaine is frequently used in our centres. Surgery starts almost immediately after cleaning and drapping of the patient by the obstetrician. Ephedrine is made handy and constituted in case there is hypotension which fluid alone cannot treat.

  7. The risk of caesarean section in obese women analysed by parity.

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2012-02-01

    OBJECTIVE: This study looked at the association between caesarean section (CS) and Body Mass Index (BMI) in primigravidas compared with multigravidas. STUDY DESIGN: We enrolled women at their convenience, in the first trimester after an ultrasound examination confirmed an ongoing pregnancy. Weight and height were measured digitally and BMI calculated. After delivery, clinical details were again collected from the Hospital\\'s computerised database. RESULTS: Of the 2000 women enrolled, there were 50.4% (n=1008) primigravidas and 49.6% (n=992) multigravidas. Of the 2000 8.5% were delivered by elective CS and 13.4% were delivered by emergency CS giving an overall rate of 21.9%. The overall CS rate was 30.1% in obese women compared with 19.2% in the normal BMI category (p<0.001). In primigravidas the increase in CS rate in obese women was due to an increase in emergency CS (p<0.005) and in multigravidas the increase was due to an increase in elective CS (p<0.01). In obese primigravidas 20.6% had an emergency section for fetal distress. In obese multigravidas 17.2% had a repeat elective CS. CONCLUSION: The influence of maternal obesity on the increase in CS rates is different in primigravidas compared with multigravidas.

  8. Clonidine versus tramadol for post spinal shivering during caesarean section: A randomized double blind clinical study

    Directory of Open Access Journals (Sweden)

    Velayudha S Reddy

    2011-01-01

    Full Text Available Background : Control of post spinal shivering is essential for optimal perioperative care, which can be achieved either by oral or parental medications. The present study is designed to evaluate the efficacy and safety of intravenous low-dose clonidine and tramadol in the treatment of post spinal shivering. Materials and Methods : In this prospective, a double blind, randomized study, 90 ASA grade I or II, parturients aged 18 - 35 years, undergoing caesarean section under spinal anaesthesia, who subsequently developed shivering grade 3 or 4, were randomized into two groups, to receive either clonidine or tramadol. The efficacy and response rate of the study drugs were evaluated and recorded. Side effects like, nausea, vomiting, hypotension, bradycardia, dry mouth, sedation, skin rash and headache, if present, were recorded. All data were analyzed by using the Chi square test and the Z-test. Results : There were significant differences in the response rate between the drugs (P < 0.05. Time taken from the starting of treatment to cessation of shivering was significantly less with the tramadol group (P < 0.05, however, the frequency of nausea, vomiting, sedation and headache were also significantly more in the tramadol group Conclusion : In our study we concluded that both clonidine and tramadol control shivering. However, the response rate was higher and time taken to control shivering was lesser with tramadol, but the response rate and the side effects were lesser with clonidine.

  9. Anesthetic management of caesarean section in a patient with double outlet right ventricle

    Directory of Open Access Journals (Sweden)

    Rohith Krishna

    2012-01-01

    Full Text Available Double outlet right ventricle (DORV is a rare congenital heart defect involving the great arteries. In DORV, both aorta and pulmonary artery arise from the right ventricle resulting in admixture of blood. We report a 22-year-old parturient with DORV and severe pulmonary stenosis who underwent caesarean delivery at 36 weeks gestation with low dose combined spinal-epidural anesthesia. This lady was assessed by echocardiogram to have situs inversus, dextrocardia, severe pulmonary artery stenosis (gradient = 146 mm Hg, DORV with subarterial VSD (1 cm. She had 95% room air saturation and her blood investigations were within normal limits. We established a peripheral venous access and radial arterial line for continuous blood pressure monitoring. Combined spinal epidural anesthesia was considered a better option. Epidural catheter was secured at L 2 -L 3 space and fixed after giving test dose 3 mL 2% lignocaine. Subarachnoid block administered at L 3 -L 4 level using 1.2 mL of 0.5% heavy bupivacaine. A sensory block of T 10 was obtained which was supplemented with 4 mL 0.75% ropivacaine to obtain a level of T 6 . Patient tolerated the procedure well. She was shifted to post-operative ICU. Post-operative pain was managed with epidural 0.2% ropivacaine at 4 mL/h. Patient remained hemodynamically stable throughout the procedure and in the postoperative period while she was being followed up for subsequent 48 h.

  10. Impact single versus double layer uterine closure in caesarean section to uterine rupture

    Directory of Open Access Journals (Sweden)

    Budi Iman Santoso

    2016-07-01

    Full Text Available Caesarean section (CS is one of the most frequent delivery methods in the world whereas the rates of CS were varied according to developing (from 3.5 to 29.2% and developed countries (21.1%. The study aims to known the impact of single versus double layer uterine closure to uterine rupture in the history of cesarean section (CS. In this case report, the clinical question is single versus double-layer uterine closure on the previous CS, gives better outcome to reduce the risk of uterine rupture. To answer this question, we search the evidence from Pub Med and Cochrane database with the keywords: and ldquo;cesarean section" and "uterine rupture" and and ldquo;uterine closure and rdquo;. The inclusion criteria are written in English and focused comparing single and double layer uterine closure to uterine rupture in the previous CS. From the searching literature, we found 3 systematic reviews and 23 articles which were relevant to the topic. After screening the abstract and language, we got 2 systematic reviews and 4 articles. At the end, only 4 articles consisting of 1 systematic review and 3 articles were included to be appraised. Based on evidences, single layer uterine closure did not increase the risk of uterine rupture. Apart from that, shorter operative times and lower estimated blood loss became the superiority of single-layer uterine closure. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2074-2078

  11. Surgical site infection after caesarean section: space for post-discharge surveillance improvements and reliable comparisons.

    Science.gov (United States)

    Ferraro, Federica; Piselli, Pierluca; Pittalis, Silvia; Ruscitti, Luca E; Cimaglia, Claudia; Ippolito, Giuseppe; Puro, Vincenzo

    2016-04-01

    Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive.

  12. A COMPARISON OF SPINAL ANAESTHESIA WITH LEVOBUPIVACAINE AND HYPERBARIC BUPIVACAINE COMBINED WITH FENTANYL IN CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Kurmanadh Kalepalli

    2016-10-01

    Full Text Available BACKGROUND Recent trends in obstetric anaesthesia show increased popularity of regional anaesthesia among obstetric anaesthetists. General anaesthesia in caesarean section is associated with high morbidity and mortality rate when compared with regional anaesthesia. Regional anaesthesia has its own demerits which are primarily related to excessively high spinal blocks and toxicity of local anaesthetics. Reduction in doses and improvement in technique to avoid high level blocks and increased awareness of toxicity of local anaesthetics have contributed to reduction in complications related to regional anaesthesia. The challenges presented by a parturient requiring anaesthesia or analgesia, or both, make the role of obstetric anaesthesiologist both challenging and rewarding. Spinal anesthesia is a popular technique for caesarean delivery. Hyperbaric Bupivacaine in 8% glucose is often used. Plain or glucose-free, Bupivacaine has been frequently referred to as “Isobaric” in the literature, even after Blomqvist and Nilsson demonstrated its hypobaricity. More recently, several studies have confirmed that plain Bupivacaine is indeed hypobaric in comparison with human CSF. Although hyperbaric local anesthetic solutions have a remarkable record of safety, their use is not totally without risk. To prevent unilateral or saddle blocks, patients should move from the lateral or sitting position rapidly to supine position. Hyperbaric solutions may cause sudden cardiac arrest after spinal anesthesia because of the extension of the sympathetic block. The use of truly isobaric solutions may prove less sensitive to position issues. Hyperbaric solutions may cause hypotension or bradycardia after mobilization. Isobaric solutions are favored with respect to their less sensitivity to postural changes. MATERIALS AND METHODS 60 full term parturients of ASA Grade 1 and 2 posted for elective caesarean section under spinal anaesthesia were divided in to two groups. GROUP

  13. The Effect of Musical Therapy on Postoperative Pain after Caesarean Section

    Directory of Open Access Journals (Sweden)

    Ali Sizlan

    2009-04-01

    Full Text Available AIM: We reasoned that addition of musicotherapy -a simple and convenient method with no adverse effects- in the preoperative period would have favorable effects pertaining to postoperative pain. METHODS: One hundred patients, between the ages of 20-40 years, who were undergoing elective caesarean delivery under general anaesthesia, were enrolled. The patients were randomly allocated into two groups (with 50 patients in each and in group 1, patients listened to music through a headphone for one hour immediately before surgery whereas in group 2, patients did not listen to any music during the same period. The anaesthetic technique was standardized. All neonates were also assessed and Apgar scores were recorded. In the postanaesthesia care unit, patients were connected to i.v.-PCA device when they were able to respond to commands. The patient’s level of satisfaction with perioperative care was assessed by a 10-cm visual analogue scale and the severity of postoperative pain was assessed with VAS. RESULTS: Postoperative tramadol consumption, total amount of tramadol consumption, additional analgesic use and all VAS values were lower in group 1 (p<0.05. Apgar scores were significantly greater in group 1. CONCLUSION: We imply that music therapy given before surgery decreases postoperative pain and analgesic requirement. [TAF Prev Med Bull 2009; 8(2.000: 107-112

  14. Why do niches develop in Caesarean uterine scars? Hypotheses on the aetiology of niche development.

    Science.gov (United States)

    Vervoort, A J M W; Uittenbogaard, L B; Hehenkamp, W J K; Brölmann, H A M; Mol, B W J; Huirne, J A F

    2015-12-01

    Caesarean section (CS) results in the occurrence of the phenomenon 'niche'. A 'niche' describes the presence of a hypoechoic area within the myometrium of the lower uterine segment, reflecting a discontinuation of the myometrium at the site of a previous CS. Using gel or saline instillation sonohysterography, a niche is identified in the scar in more than half of the women who had had a CS, most with the uterus closed in one single layer, without closure of the peritoneum. An incompletely healed scar is a long-term complication of the CS and is associated with more gynaecological symptoms than is commonly acknowledged. Approximately 30% of women with a niche report spotting at 6-12 months after their CS. Other reported symptoms in women with a niche are dysmenorrhoea, chronic pelvic pain and dyspareunia. Given the association between a niche and gynaecological symptoms, obstetric complications and potentially with subfertility, it is important to elucidate the aetiology of niche development after CS in order to develop preventive strategies. Based on current published data and our observations during sonographic, hysteroscopic and laparoscopic evaluations of niches we postulate some hypotheses on niche development. Possible factors that could play a role in niche development include a very low incision through cervical tissue, inadequate suturing technique during closure of the uterine scar, surgical interventions that increase adhesion formation or patient-related factors that impair wound healing or increase inflammation or adhesion formation.

  15. User cost of Caesarean section: case study of Bunia, Democratic Republic of Congo.

    Science.gov (United States)

    Deboutte, Danielle; O'Dempsey, Tim; Mann, Gillian; Faragher, Brian

    2015-01-01

    The study estimated the user cost of Caesarean section (CS), a major component of emergency obstetric care (EmOC), in a post conflict situation in Bunia, DR Congo, 2008. A case control study used a structured questionnaire to compare women who had a CS (cases) with women who had a vaginal delivery (controls). Service information was recorded in 20 facilities providing obstetric care. Maternal and perinatal deaths, including those outside health facilities, were recorded and verified. The user cost of CS was estimated at four hospitals, one of them managed by an international non-governmental organization offering EmOC free of charge, compared to the user cost of women who had a vaginal delivery. Among paying users, the mean healthcare cost was $US68.0 for CS and $US12.1 for vaginal delivery; mean transport cost to and from the hospital was $US11.7 for cases and $US3.2 for controls. The mean monthly family income was $US75.5. The user cost of CS placed an important financial burden on patients and their families. During transition from humanitarian to developmental assistance, donors and the State should shore up the EmOC budget to avoid an increase in maternal and perinatal mortality.

  16. TRAMADOL AS A PRE-INDUCTION AGENT FOR CAESAREAN SECTION UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Rakesh

    2016-05-01

    Full Text Available AIM To evaluate the efficacy and safety of Tramadol for the mother and the foetus when used as part of balanced anaesthesia without the possibility of using potent anaesthetics. METHODS Forty parturients undergoing caesarean section irrespective of their American Society of Anaesthesiologists physical status classification or associated medical conditions were included in randomised single blind study. The patients were randomly allocated to receive Tramadol 1 mg/kg (n=20 and Tramadol 2 mg/kg (n=20 intravenously 15 minutes before induction with Thiopentone. Anaesthesia was maintained only on nitrous-oxide and oxygen mixture with controlled ventilation. RESULTS A total of 70% of patients in group I and 90% in group II showed acceptable haemodynamic changes. There was no significant difference in the uterine tone between the two groups. The Apgar scores at one and five minutes were not significantly different between the two groups. CONCLUSION It was found that the Tramadol at 2 mg/kg intravenous dose could avoid use of inhalation agents in 90% of patients and the dose was safe for even compromised babies.

  17. A Customizable Text Classifier for Text Mining

    Directory of Open Access Journals (Sweden)

    Yun-liang Zhang

    2007-12-01

    Full Text Available Text mining deals with complex and unstructured texts. Usually a particular collection of texts that is specified to one or more domains is necessary. We have developed a customizable text classifier for users to mine the collection automatically. It derives from the sentence category of the HNC theory and corresponding techniques. It can start with a few texts, and it can adjust automatically or be adjusted by user. The user can also control the number of domains chosen and decide the standard with which to choose the texts based on demand and abundance of materials. The performance of the classifier varies with the user's choice.

  18. A survey of decision tree classifier methodology

    Science.gov (United States)

    Safavian, S. R.; Landgrebe, David

    1991-01-01

    Decision tree classifiers (DTCs) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps the most important feature of DTCs is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issues. After considering potential advantages of DTCs over single-state classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

  19. Progress in diagnosis and treatment of caesarean scars pregnancy%剖宫产术后子宫瘢痕妊娠的诊治进展

    Institute of Scientific and Technical Information of China (English)

    李静玲(综述); 胡晓霞(审校)

    2014-01-01

    Caesarean scar pregnancy(CSP)is one of the rare ectopic pregnancy.With the increasing of cae-sarean section rates ,the incidence of caesarean scar pregnancy tends to rise .The pathogenesis of caesarean scar preg-nancy is unknown ,diagnosis has no unified standard ,and the misdiagnosis rate is high .Clinical treatment also remains controversial .This review focused on the research progress in diagnosis and treatment of caesarean scar pregnancy .%剖宫产术后子宫瘢痕妊娠是一种罕见的异位妊娠,近年来随着剖宫产率的增加,发病率也呈逐年增长的趋势,该病发病机制迄今尚未阐明,诊断方面尚无统一标准,误诊率高,临床治疗也尚存争议。现就其诊断与治疗的研究进展作一综述。

  20. Visual Classifier Training for Text Document Retrieval.

    Science.gov (United States)

    Heimerl, F; Koch, S; Bosch, H; Ertl, T

    2012-12-01

    Performing exhaustive searches over a large number of text documents can be tedious, since it is very hard to formulate search queries or define filter criteria that capture an analyst's information need adequately. Classification through machine learning has the potential to improve search and filter tasks encompassing either complex or very specific information needs, individually. Unfortunately, analysts who are knowledgeable in their field are typically not machine learning specialists. Most classification methods, however, require a certain expertise regarding their parametrization to achieve good results. Supervised machine learning algorithms, in contrast, rely on labeled data, which can be provided by analysts. However, the effort for labeling can be very high, which shifts the problem from composing complex queries or defining accurate filters to another laborious task, in addition to the need for judging the trained classifier's quality. We therefore compare three approaches for interactive classifier training in a user study. All of the approaches are potential candidates for the integration into a larger retrieval system. They incorporate active learning to various degrees in order to reduce the labeling effort as well as to increase effectiveness. Two of them encompass interactive visualization for letting users explore the status of the classifier in context of the labeled documents, as well as for judging the quality of the classifier in iterative feedback loops. We see our work as a step towards introducing user controlled classification methods in addition to text search and filtering for increasing recall in analytics scenarios involving large corpora.

  1. Classifying Finitely Generated Indecomposable RA Loops

    CERN Document Server

    Cornelissen, Mariana

    2012-01-01

    In 1995, E. Jespers, G. Leal and C. Polcino Milies classified all finite ring alternative loops (RA loops for short) which are not direct products of proper subloops. In this paper we extend this result to finitely generated RA loops and provide an explicit description of all such loops.

  2. Classifying web pages with visual features

    NARCIS (Netherlands)

    de Boer, V.; van Someren, M.; Lupascu, T.; Filipe, J.; Cordeiro, J.

    2010-01-01

    To automatically classify and process web pages, current systems use the textual content of those pages, including both the displayed content and the underlying (HTML) code. However, a very important feature of a web page is its visual appearance. In this paper, we show that using generic visual fea

  3. Neural Classifier Construction using Regularization, Pruning

    DEFF Research Database (Denmark)

    Hintz-Madsen, Mads; Hansen, Lars Kai; Larsen, Jan;

    1998-01-01

    In this paper we propose a method for construction of feed-forward neural classifiers based on regularization and adaptive architectures. Using a penalized maximum likelihood scheme, we derive a modified form of the entropic error measure and an algebraic estimate of the test error. In conjunction...

  4. Large margin classifier-based ensemble tracking

    Science.gov (United States)

    Wang, Yuru; Liu, Qiaoyuan; Yin, Minghao; Wang, ShengSheng

    2016-07-01

    In recent years, many studies consider visual tracking as a two-class classification problem. The key problem is to construct a classifier with sufficient accuracy in distinguishing the target from its background and sufficient generalize ability in handling new frames. However, the variable tracking conditions challenges the existing methods. The difficulty mainly comes from the confused boundary between the foreground and background. This paper handles this difficulty by generalizing the classifier's learning step. By introducing the distribution data of samples, the classifier learns more essential characteristics in discriminating the two classes. Specifically, the samples are represented in a multiscale visual model. For features with different scales, several large margin distribution machine (LDMs) with adaptive kernels are combined in a Baysian way as a strong classifier. Where, in order to improve the accuracy and generalization ability, not only the margin distance but also the sample distribution is optimized in the learning step. Comprehensive experiments are performed on several challenging video sequences, through parameter analysis and field comparison, the proposed LDM combined ensemble tracker is demonstrated to perform with sufficient accuracy and generalize ability in handling various typical tracking difficulties.

  5. Design and evaluation of neural classifiers

    DEFF Research Database (Denmark)

    Hintz-Madsen, Mads; Pedersen, Morten With; Hansen, Lars Kai;

    1996-01-01

    In this paper we propose a method for the design of feedforward neural classifiers based on regularization and adaptive architectures. Using a penalized maximum likelihood scheme we derive a modified form of the entropy error measure and an algebraic estimate of the test error. In conjunction...

  6. Adaptively robust filtering with classified adaptive factors

    Institute of Scientific and Technical Information of China (English)

    CUI Xianqiang; YANG Yuanxi

    2006-01-01

    The key problems in applying the adaptively robust filtering to navigation are to establish an equivalent weight matrix for the measurements and a suitable adaptive factor for balancing the contributions of the measurements and the predicted state information to the state parameter estimates. In this paper, an adaptively robust filtering with classified adaptive factors was proposed, based on the principles of the adaptively robust filtering and bi-factor robust estimation for correlated observations. According to the constant velocity model of Kalman filtering, the state parameter vector was divided into two groups, namely position and velocity. The estimator of the adaptively robust filtering with classified adaptive factors was derived, and the calculation expressions of the classified adaptive factors were presented. Test results show that the adaptively robust filtering with classified adaptive factors is not only robust in controlling the measurement outliers and the kinematic state disturbing but also reasonable in balancing the contributions of the predicted position and velocity, respectively, and its filtering accuracy is superior to the adaptively robust filter with single adaptive factor based on the discrepancy of the predicted position or the predicted velocity.

  7. Face detection by aggregated Bayesian network classifiers

    NARCIS (Netherlands)

    Pham, T.V.; Worring, M.; Smeulders, A.W.M.

    2002-01-01

    A face detection system is presented. A new classification method using forest-structured Bayesian networks is used. The method is used in an aggregated classifier to discriminate face from non-face patterns. The process of generating non-face patterns is integrated with the construction of the aggr

  8. MScanner: a classifier for retrieving Medline citations

    Directory of Open Access Journals (Sweden)

    Altman Russ B

    2008-02-01

    Full Text Available Abstract Background Keyword searching through PubMed and other systems is the standard means of retrieving information from Medline. However, ad-hoc retrieval systems do not meet all of the needs of databases that curate information from literature, or of text miners developing a corpus on a topic that has many terms indicative of relevance. Several databases have developed supervised learning methods that operate on a filtered subset of Medline, to classify Medline records so that fewer articles have to be manually reviewed for relevance. A few studies have considered generalisation of Medline classification to operate on the entire Medline database in a non-domain-specific manner, but existing applications lack speed, available implementations, or a means to measure performance in new domains. Results MScanner is an implementation of a Bayesian classifier that provides a simple web interface for submitting a corpus of relevant training examples in the form of PubMed IDs and returning results ranked by decreasing probability of relevance. For maximum speed it uses the Medical Subject Headings (MeSH and journal of publication as a concise document representation, and takes roughly 90 seconds to return results against the 16 million records in Medline. The web interface provides interactive exploration of the results, and cross validated performance evaluation on the relevant input against a random subset of Medline. We describe the classifier implementation, cross validate it on three domain-specific topics, and compare its performance to that of an expert PubMed query for a complex topic. In cross validation on the three sample topics against 100,000 random articles, the classifier achieved excellent separation of relevant and irrelevant article score distributions, ROC areas between 0.97 and 0.99, and averaged precision between 0.69 and 0.92. Conclusion MScanner is an effective non-domain-specific classifier that operates on the entire Medline

  9. 剖宫产疤痕处妊娠超声诊断及解决方案探讨%Ultrasonic diagnosis of caesarean scar pregnancy and solutions

    Institute of Scientific and Technical Information of China (English)

    胡永铭; 葛菲; 陈燕娥; 莫妃; 叶婷婷; 王昌忠

    2015-01-01

    Objective To discuss the value of ultrasonic diagnosis in caesarean scar pregnancy,and to evaluate the value of the image features in providing reference for clinical solutions.Methods Ultrasound was used to diagnose and classify cesarean scar pregnancy.According to the relationship between lesions and uterine cavity,muscular layer,and the protruding levels of serous and blood supply situation,different clinical solutions were taken.Results Thirty cases of caesarean scar pregnancy were diagnosed,including 10 cases of simple gestational sac (type Ⅰ),6 cases of mixed mass (typeⅡ),and 14 cases with gestational sac in uterine cavity (typeⅢ).Among the 30 cases,14 received medical abortion combined with local drug administration,laparoscopic abortion,scar repair,and 3 received transvaginal cesarean scar pregnancy debridement surgery combined with scar repair,with 10 cases undergoing medical abortion com-bined with debridement surgery under ultrasound monitoring and 3 cases continuing pregnancy.Conclusion Ultra-sound can diagnose cesarean scar pregnancy early,and provide a valuable reference for clinical solutions.%目的 探讨超声诊断剖宫产疤痕处妊娠,并根据其图像特征为临床提供参考解决方案的价值.方法 运用超声对剖宫产疤痕处妊娠诊断并分型,依据病灶与宫腔、肌层的关系,以及突出浆膜程度和血供情况,采取不同的临床解决方案.结果 超声诊断疤痕处妊娠30例,其中单纯妊娠囊型(Ⅰ型) 10例,混合包块型(Ⅱ型) 6例,孕囊部分位于宫腔型(Ⅲ型) 14例.30例疤痕处妊娠孕妇中药流+局部用药+腹腔镜妊娠物清除+疤痕修补术14例,阴式疤痕妊娠物清除+疤痕修补术3例,药流+超声监测下清宫10例,继续妊娠3例.继续妊娠孕妇除伴有前置胎盘及轻度胎盘植入外,均无不良结局发生.结论 超声能早期明确诊断剖宫产疤痕处妊娠,并可为临床提供较有价值的参考解决方案.

  10. America in the Eyes of America Watchers:

    DEFF Research Database (Denmark)

    Feng, Huiyun; He, Kai

    2015-01-01

    that almost half of the survey participants thought that America would remain the global hegemon in the next ten years. Meanwhile, a large majority was also optimistic that China is a rising great power, especially in the economic sense, in the world. More than half of the respondents saw Asian military......Based on an original survey conducted in the summer of 2012 in Beijing, we examine how China's America watchers—IR scholars who work on US-China relations—have viewed China's power status in the international system, US-China relations and some specific US policies in Asia. Our survey shows...... issues, such as the South China Sea issue, as the most difficult problem between China and the US....

  11. Lupus Foundation of America

    Science.gov (United States)

    ... and Testing New Treatments Learn More About the Lupus Foundation of America We are devoted to solving ... Spam Control Text: Please leave this field empty Lupus FAQ What is lupus? What are the common ...

  12. Prevent Child Abuse America

    Science.gov (United States)

    ... call the police . Crisis and support contacts For Child Abuse Reporting Numbers in your State please visit: Child ... suspected child abuse and neglect. Parent Resources Prevent Child Abuse America (800) CHILDREN A resource for tips, referrals, ...

  13. Neonatal clinical evaluation, blood gas and radiographic assessment after normal birth, vaginal dystocia or caesarean section in dogs.

    Science.gov (United States)

    Silva, L C G; Lúcio, C F; Veiga, G A L; Rodrigues, J A; Vannucchi, C I

    2009-07-01

    This study aimed to standardize signs and diagnostic criteria of respiratory function in newborn puppies delivered normally or after dystocia and caesarean operation. A total of 48 neonates were allocated into groups: eutocia (n = 20), dystocia (n = 8), caesarean (c)-section (n = 20). Neonatal health was assessed using the Apgar score and body temperature was determined at 0, 5 and 60 min after delivery. Venous blood gases (pO(2) and SO(2)) was measured immediately and 60 min after delivery, and a thoracic radiograph was made between 0 and 5 min of life. The c-section group had significantly lower Apgar scores at birth and 5 min. Hypothermia was present at 5 min in the eutocia and c-section groups, and at 60 min in all groups. The eutocia group had an irregular respiratory pattern in 78% of puppies at birth, 27.7% at 5 min and 21% at 60 min compared with 87.5%, 62.5% and 12.5% of the pups in the dystocia group where there was irregular respiratory rhythm, moderate to intense respiratory sounds with agonic episodes. The c-section group had respiratory alterations in 70%, 45% and 16% of puppies at 0, 5 and 60 min, respectively. Radiographic abnormalities were present in 17% of the pups in the eutocia group, 25% of the pups in the dystocia group and 30% of the pups in the c-section group, respectively. The c-section group had significantly lower SO(2) values at 60 min than at birth. All puppies had hypoxaemia, but a significant decrease was observed in the c-section group. Newborn puppies had tissue hypoxia and irregular respiratory pattern at birth. Caesarean-section puppies had lower vitality; however, all developed satisfactory Apgar scores at 5 min of life, regardless of the obstetric condition.

  14. Incidence of surgical site infection following caesarean section: a systematic review and meta-analysis protocol

    Science.gov (United States)

    Greene, Richard A; Corcoran, Paul; O'Neill, Sinéad M

    2017-01-01

    Introduction Caesarean section (CS) rates have increased globally during the past three decades. Surgical site infection (SSI) following CS is a common cause of morbidity with reported rates of 3–15%. SSI represents a substantial burden to the health system including increased length of hospitalisation and costs of postdischarge care. The definition of SSI varies with the postoperative follow-up period among different health systems, resulting in differences in the reporting of SSI incidence. We propose to conduct the first systematic review and meta-analysis to determine the pooled estimate for the overall incidence of SSI following CS. Methods and analysis We will perform a comprehensive search to identify all potentially relevant published studies on the incidence of SSI following CS reported from 1992 in the English language. Electronic databases including PubMed, CINAHL, EMBASE and Scopus will be searched using a detailed search strategy. Following study selection, full-text paper retrieval, data extraction and synthesis, we will appraise study quality and risk of bias and assess heterogeneity. Incidence data will be combined where feasible in a meta-analysis using Stata software and fixed-effects or random-effects models as appropriate. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethics and dissemination Ethical approval is not required as this review will use published data. The review will evaluate the overall incidence of SSI following CS and will provide the first quantitative estimate of the magnitude of SSI. It will serve as a benchmark for future studies, identify research gaps and remaining challenges, and emphasise the need for appropriate prevention and control measures for SSI post-CS. A manuscript reporting the results of the systematic review and meta-analysis will be submitted to a peer-reviewed journal and presented at scientific conferences

  15. Fears related to pregnancy and childbirth among primigravidae who requested caesarean versus vaginal delivery in Iran.

    Science.gov (United States)

    Matinnia, Nasrin; Faisal, Ibrahim; Hanafiah Juni, Muhamad; Herjar, Abdul Rahman; Moeini, Babak; Osman, Zubaidah Jamil

    2015-05-01

    Pregnancy- and childbirth-related fears are common psychological concerns and the primary reasons for requesting caesarean section (CS). We aimed to examine the content of maternal fear and the associated demographic factors in a sample of Iranian primigravidae. A randomly selected sample of primigravidae (n = 342) was recruited in four health care centres in Iran. Data were collected using a 30-item questionnaire. Principal components factor analysis was applied to identify the main factors of pregnancy- and childbirth-related fears. All primigravidae reported some degree of fear, 48.2 % presented severe fear, and 62.6 % requested a CS because of childbirth-related fear. Most of the employed primigravidae with higher education level, higher family income, and unplanned pregnancy requested CS. The items constructed to measure maternal fear were subjected to exploratory factor analysis. Six categories were identified, including 'process of labour and childbirth', 'life and well-being of the baby', 'competence and behaviour of maternity ward personnel', 'own capabilities and reactions', 'becoming a parent and family life after delivery' and 'general fear in pregnancy' that cumulatively explained 55.3 % of the variance. The most common factor was 'life and well-being of the baby'. Severe fear was found in 70.6 % of those who chose CS, while 10.9 % of those who chose vaginal delivery reported severe fear. The between-group differences for mean scores and levels of fear were statistically significant. Pregnancy- and childbirth-related fears were frequently experienced by all low-risk primigravidae. Better strategies to address women's psychological needs during pregnancy are necessary.

  16. Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

    Science.gov (United States)

    Dunn, Clare Newton; Zhang, Qianpian; Sia, Josh Tjunrong; Assam, Pryseley Nkouibert; Tagore, Shephali; Sng, Ban Leong

    2016-01-01

    Background and Aims: A decision-to-delivery interval (DDI) of 30 min for category-one caesarean section (CS) deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one (‘crash’) CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS. Methods: This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre. We analysed the factors associated with DDI, mode of anaesthesia and perinatal outcomes. Summary statistics were performed for the outcomes. The association factors were considered significant at P < 0.05. Results: The mean (standard deviation) DDI was 9.4 (3.2) min with all deliveries achieved within 30 min. The longest factor in the DDI was time taken to transfer patients. A shorter DDI was not significantly associated with improved perinatal outcomes. The majority (88.9%) of women had general anaesthesia (GA) for category-one CS. Of those who had an epidural catheter already in situ (34.4%), 25.6% had successful epidural extension. GA was associated with shorter DDI, but worse perinatal outcomes than regional anaesthesia (RA). Conclusions: Our ‘crash’ CS protocol achieved 100% of deliveries within 30 min. The majority (88.9%) of the patients had GA for category-one CS. GA was found to be associated with shorter anaesthesia and operation times, but poorer perinatal outcomes compared to RA. PMID:27601736

  17. Evaluation of timings and outcomes in category-one caesarean sections: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Clare Newton Dunn

    2016-01-01

    Full Text Available Background and Aims: A decision-to-delivery interval (DDI of 30 min for category-one caesarean section (CS deliveries is the standard of practice recommended by clinical guidelines. Our institution established a protocol for category-one (′crash′ CS to expedite deliveries. The aim of this study is to evaluate DDI, factors that affect DDI and the mode of anaesthesia for category-one CS. Methods: This retrospective cohort study evaluated 390 women who underwent category-one CS in a tertiary obstetric centre. We analysed the factors associated with DDI, mode of anaesthesia and perinatal outcomes. Summary statistics were performed for the outcomes. The association factors were considered significant at P < 0.05. Results: The mean (standard deviation DDI was 9.4 (3.2 min with all deliveries achieved within 30 min. The longest factor in the DDI was time taken to transfer patients. A shorter DDI was not significantly associated with improved perinatal outcomes. The majority (88.9% of women had general anaesthesia (GA for category-one CS. Of those who had an epidural catheter already in situ (34.4%, 25.6% had successful epidural extension. GA was associated with shorter DDI, but worse perinatal outcomes than regional anaesthesia (RA. Conclusions: Our ′crash′ CS protocol achieved 100% of deliveries within 30 min. The majority (88.9% of the patients had GA for category-one CS. GA was found to be associated with shorter anaesthesia and operation times, but poorer perinatal outcomes compared to RA.

  18. National Variation in Caesarean Section Rates: A Cross Sectional Study in Ireland

    Science.gov (United States)

    Sinnott, Sarah-Jo; Brick, Aoife; Layte, Richard; Cunningham, Nathan; Turner, Michael J.

    2016-01-01

    Objective Internationally, caesarean section (CS) rates are rising. However, mean rates of CS across providers obscure extremes of CS provision. We aimed to quantify variation between all maternity units in Ireland. Methods Two national databases, the National Perinatal Reporting System and the Hospital Inpatient Enquiry Scheme, were used to analyse data for all women delivering singleton births weighing ≥500g. We used multilevel models to examine variation between hospitals in Ireland for elective and emergency CS, adjusted for individual level sociodemographic, clinical and organisational variables. Analyses were subsequently stratified for nullipara and multipara with and without prior CS. Results The national CS rate was 25.6% (range 18.2% ─ 35.1%). This was highest in multipara with prior CS at 86.1% (range 6.9% ─ 100%). The proportion of variation in CS that was attributable to the hospital of birth was 11.1% (95% CI, 6.0 ─ 19.4) for elective CS and 2.9% (95% CI, 1.4 ─ 5.6) for emergency CS, after adjustment. Stratifying across parity group, variation between hospitals was greatest for multipara with prior CS. Both types of CS were predicted by increasing age, prior history of miscarriage or stillbirth, prior CS, antenatal complications and private model of care. Conclusion The proportion of variation attributable to the hospital was higher for elective CS than emergency CS suggesting that variation is more likely influenced by antenatal decision making than intrapartum decision making. Multipara with prior CS were particularly subject to variability, highlighting a need for consensus on appropriate care in this group. PMID:27280848

  19. Birth by caesarean section and prevalence of risk factors for non-communicable diseases in young adults: a birth cohort study.

    Directory of Open Access Journals (Sweden)

    Bernardo L Horta

    Full Text Available BACKGROUND: Conflicting findings on the risk of obesity among subjects born by caesarean section have been published. Caesarean section should also increase the risk of obesity related cardiovascular risk factors if type of delivery is associated with obesity later in life. This study was aimed at assessing the effect of type of delivery on metabolic cardiovascular risk factors in early adulthood. METHODOLOGY AND PRINCIPAL FINDINGS: In 1982, maternity hospitals in Pelotas, southern Brazil, were visited and those livebirths whose family lived in the urban area of the city have been followed. In 2000, when male subjects undertook the Army entrance examination (n=2200, fat mass and fat free mass were estimated through bioimpedance. In 2004-2005, we attempted to follow the whole cohort (n=4297, and the following outcomes were studied: blood pressure; HDL cholesterol; triglycerides; random blood glucose, C-reactive protein, waist circumference and body mass index. The estimates were adjusted for the following confounders: family income at birth; maternal schooling; household assets index in childhood; maternal skin color; birth order; maternal age; maternal prepregnancy weight; maternal height; maternal smoking during pregnancy; birthweight and family income at early adulthood. RESULTS: In the crude analyses, blood pressure (systolic, diastolic and mean arterial pressure and body mass index were higher among subjects who were delivered through caesarean section. After controlling for confounders, systolic blood pressure was 1.15 mmHg (95% confidence interval: 0.05; 2.25 higher among subjects delivered by caesarean section, and BMI 0.40 kg/m(2 (95% confidence interval: 0.08; 0.71. After controlling for BMI the effect on systolic blood pressure dropped to 0.60 mmHg (95% confidence interval: -0.47; 1.67. Fat mass at 18 years of age was also higher among subjects born by caesarean section. CONCLUSION: Caesarean section was associated with a small

  20. Improving 2D Boosted Classifiers Using Depth LDA Classifier for Robust Face Detection

    Directory of Open Access Journals (Sweden)

    Mahmood Rahat

    2012-05-01

    Full Text Available Face detection plays an important role in Human Robot Interaction. Many of services provided by robots depend on face detection. This paper presents a novel face detection algorithm which uses depth data to improve the efficiency of a boosted classifier on 2D data for reduction of false positive alarms. The proposed method uses two levels of cascade classifiers. The classifiers of the first level deal with 2D data and classifiers of the second level use depth data captured by a stereo camera. The first level employs conventional cascade of boosted classifiers which eliminates many of nonface sub windows. The remaining sub windows are used as input to the second level. After calculating the corresponding depth model of the sub windows, a heuristic classifier along with a Linear Discriminant analysis (LDA classifier is applied on the depth data to reject remaining non face sub windows. The experimental results of the proposed method using a Bumblebee-2 stereo vision system on a mobile platform for real time detection of human faces in natural cluttered environments reveal significantly reduction of false positive alarms of 2D face detector.

  1. Occult Spinal Dysraphism in Obstetrics: A Case Report of Caesarean Section with Subarachnoid Anaesthesia after Remifentanil Intravenous Analgesia for Labour

    Science.gov (United States)

    Valente, A.; Frassanito, L.; Natale, L.; Draisci, G.

    2012-01-01

    Neuraxial techniques of anaesthesia and analgesia are the current choice in obstetrics for efficacy and general low risk of major complications. Concern exists about neuraxial anaesthesia in patients with occult neural tube defects, regarding both labour analgesia and anaesthesia for Caesarean section. Recently, remifentanil infusion has been proposed as an analgesic technique alternative to lumbar epidural, especially when epidural analgesia appears to be contraindicated. Here, we discuss the case of a pregnant woman attending at our institution with occult, symptomatic spinal dysraphism who requested labour analgesia. She was selected for remifentanil intravenous infusion for labour pain and then underwent urgent operative delivery with spinal anaesthesia with no complications. PMID:22844625

  2. A quality improvement tool - driver diagram: a model of driver diagram to reduce primary caesarean section rates

    Directory of Open Access Journals (Sweden)

    Naima Fathima

    2016-05-01

    Results: Various quality improvement tools can be used in the clinical context. Among them, driver diagram is most widely used at the start of an improvement initiative. The driver diagram in this article shows its applicability in one of the clinical aspects of obstetrics, to reduce primary caesarean section rates. Conclusions: Driver diagram is an easy and a simple tool widely used in quality improvement activities. It is essential to use at the beginning of improvement initiatives. [Int J Res Med Sci 2016; 4(5.000: 1339-1342

  3. Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations

    Directory of Open Access Journals (Sweden)

    Sukhen Samanta

    2014-01-01

    Full Text Available Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block, intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa and the role of plasmapheresis in leptospira related jaundice with renal failure.

  4. Successful use of a Bakri Tamponade Balloon in the treatment of puerperal uterine inversion during caesarean section.

    Science.gov (United States)

    Vivanti, A J; Furet, E; Nizard, J

    2016-04-23

    Acute puerperal inversion of the uterus is a rare life-threatening obstetric emergency, especially during caesarean section. We present the case of a 30-year-old patient with acute puerperal inversion of the uterus that occurred during placental removal. After a quick reversion of the uterus, an immediate postpartum haemorrhage (PPH) due to massive uterine atony was observed. This atony impacted the whole uterus, with a very thin uterine myometrium. The use of a Bakri Tamponade Balloon use allowed treating extreme uterine atony, immediately stop haemorrhage, and prevent a possible risk of immediate recurrence.

  5. Anesthesia Management of an Emergent Caesarean Section Case with the History of Central Core Myopathy: Case Report

    Directory of Open Access Journals (Sweden)

    Cagla Bali

    2013-08-01

    Full Text Available Central core myopatyhy is a rarely seen hereditary neuromuscular disorder that is involved in congenitally myopathies group. The disease is characterized by muscular weakness, skeleton system deformities, increased malign hyperthermia sensitivity and anesthesia management is critically important. In these patients, prolonged muscular weakness and malign hyperthermia that can complicate the perioperative management are the most critical risks. In this case report, anesthesia management of an electively planned caesarean section patient, taken into emergency surgery that is also previously known to have central core myopathy diagnosis will be shared. [Cukurova Med J 2013; 38(4.000: 770-773

  6. Occult Spinal Dysraphism in Obstetrics: A Case Report of Caesarean Section with Subarachnoid Anaesthesia after Remifentanil Intravenous Analgesia for Labour

    Directory of Open Access Journals (Sweden)

    A. Valente

    2012-01-01

    Full Text Available Neuraxial techniques of anaesthesia and analgesia are the current choice in obstetrics for efficacy and general low risk of major complications. Concern exists about neuraxial anaesthesia in patients with occult neural tube defects, regarding both labour analgesia and anaesthesia for Caesarean section. Recently, remifentanil infusion has been proposed as an analgesic technique alternative to lumbar epidural, especially when epidural analgesia appears to be contraindicated. Here, we discuss the case of a pregnant woman attending at our institution with occult, symptomatic spinal dysraphism who requested labour analgesia. She was selected for remifentanil intravenous infusion for labour pain and then underwent urgent operative delivery with spinal anaesthesia with no complications.

  7. Caesarean section in a patient with Myasthenia Gravis: A bigger challenge for the anesthesiologist than the obstetrician

    Directory of Open Access Journals (Sweden)

    Manoj K Sanwal

    2012-01-01

    Full Text Available Myasthenia Gravis (MG is an acquired, autoimmune disorder affecting neuromuscular junction presenting with easy fatigability, progressive weakness, diplopia, difficulty in speaking and swallowing and even ventilatory failure in severe cases. During pregnancy the disease may go into remission or may exacerbate at any time during first, second and third trimesters or postpartum period. We are reporting the case of a 28 year old primigravida, known case of MG, who underwent caesarean section and developed muscular weakness on third postoperative day. Her neonate also had tachypnoea and hypotonia, Both, the mother and the baby were managed aggressively and responded well to therapy.

  8. Comparison of low doses of intrathecal bupivacaine in combined spinal epidural anaesthesia with epidural volume extension for caesarean delivery

    OpenAIRE

    Jain, Gaurav; Dinesh K. Singh; Bansal, Pranav; Ahmed, Bashir; Dhama, Satyavir S.

    2012-01-01

    Aims and Objectives: This study aims to compare relative efficacy of three different doses of intrathecal bupivacaine in combined spinal epidural anaesthesia (CSEA) for caesarean delivery. Materials and Methods: In a double blinded manner, 204 cases were randomized into three groups: I, II, and III to receive a dose of 4, 5.5, and 7 mg of hyperbaric bupivacaine with a fixed dose of 25 μg fentanyl intrathecally, and Dextran 40 w/v 10 mL given for epidural volume extension (EVE), in CSEA. Our p...

  9. Semantic Features for Classifying Referring Search Terms

    Energy Technology Data Exchange (ETDEWEB)

    May, Chandler J.; Henry, Michael J.; McGrath, Liam R.; Bell, Eric B.; Marshall, Eric J.; Gregory, Michelle L.

    2012-05-11

    When an internet user clicks on a result in a search engine, a request is submitted to the destination web server that includes a referrer field containing the search terms given by the user. Using this information, website owners can analyze the search terms leading to their websites to better understand their visitors needs. This work explores some of the features that can be used for classification-based analysis of such referring search terms. We present initial results for the example task of classifying HTTP requests countries of origin. A system that can accurately predict the country of origin from query text may be a valuable complement to IP lookup methods which are susceptible to the obfuscation of dereferrers or proxies. We suggest that the addition of semantic features improves classifier performance in this example application. We begin by looking at related work and presenting our approach. After describing initial experiments and results, we discuss paths forward for this work.

  10. Max-margin based Bayesian classifier

    Institute of Scientific and Technical Information of China (English)

    Tao-cheng HU‡; Jin-hui YU

    2016-01-01

    There is a tradeoff between generalization capability and computational overhead in multi-class learning. We propose a generative probabilistic multi-class classifi er, considering both the generalization capability and the learning/prediction rate. We show that the classifi er has a max-margin property. Thus, prediction on future unseen data can nearly achieve the same performance as in the training stage. In addition, local variables are eliminated, which greatly simplifi es the optimization problem. By convex and probabilistic analysis, an efficient online learning algorithm is developed. The algorithm aggregates rather than averages dualities, which is different from the classical situations. Empirical results indicate that our method has a good generalization capability and coverage rate.

  11. Classifying bed inclination using pressure images.

    Science.gov (United States)

    Baran Pouyan, M; Ostadabbas, S; Nourani, M; Pompeo, M

    2014-01-01

    Pressure ulcer is one of the most prevalent problems for bed-bound patients in hospitals and nursing homes. Pressure ulcers are painful for patients and costly for healthcare systems. Accurate in-bed posture analysis can significantly help in preventing pressure ulcers. Specifically, bed inclination (back angle) is a factor contributing to pressure ulcer development. In this paper, an efficient methodology is proposed to classify bed inclination. Our approach uses pressure values collected from a commercial pressure mat system. Then, by applying a number of image processing and machine learning techniques, the approximate degree of bed is estimated and classified. The proposed algorithm was tested on 15 subjects with various sizes and weights. The experimental results indicate that our method predicts bed inclination in three classes with 80.3% average accuracy.

  12. Classifying sows' activity types from acceleration patterns

    DEFF Research Database (Denmark)

    Cornou, Cecile; Lundbye-Christensen, Søren

    2008-01-01

    -dimensional axes, plus the length of the acceleration vector) are selected for each activity. Each time series is modeled using a Dynamic Linear Model with cyclic components. The classification method, based on a Multi-Process Kalman Filter (MPKF), is applied to a total of 15 times series of 120 observations......An automated method of classifying sow activity using acceleration measurements would allow the individual sow's behavior to be monitored throughout the reproductive cycle; applications for detecting behaviors characteristic of estrus and farrowing or to monitor illness and welfare can be foreseen....... This article suggests a method of classifying five types of activity exhibited by group-housed sows. The method involves the measurement of acceleration in three dimensions. The five activities are: feeding, walking, rooting, lying laterally and lying sternally. Four time series of acceleration (the three...

  13. Combining supervised classifiers with unlabeled data

    Institute of Scientific and Technical Information of China (English)

    刘雪艳; 张雪英; 李凤莲; 黄丽霞

    2016-01-01

    Ensemble learning is a wildly concerned issue. Traditional ensemble techniques are always adopted to seek better results with labeled data and base classifiers. They fail to address the ensemble task where only unlabeled data are available. A label propagation based ensemble (LPBE) approach is proposed to further combine base classification results with unlabeled data. First, a graph is constructed by taking unlabeled data as vertexes, and the weights in the graph are calculated by correntropy function. Average prediction results are gained from base classifiers, and then propagated under a regularization framework and adaptively enhanced over the graph. The proposed approach is further enriched when small labeled data are available. The proposed algorithms are evaluated on several UCI benchmark data sets. Results of simulations show that the proposed algorithms achieve satisfactory performance compared with existing ensemble methods.

  14. Classifying objects in LWIR imagery via CNNs

    Science.gov (United States)

    Rodger, Iain; Connor, Barry; Robertson, Neil M.

    2016-10-01

    The aim of the presented work is to demonstrate enhanced target recognition and improved false alarm rates for a mid to long range detection system, utilising a Long Wave Infrared (LWIR) sensor. By exploiting high quality thermal image data and recent techniques in machine learning, the system can provide automatic target recognition capabilities. A Convolutional Neural Network (CNN) is trained and the classifier achieves an overall accuracy of > 95% for 6 object classes related to land defence. While the highly accurate CNN struggles to recognise long range target classes, due to low signal quality, robust target discrimination is achieved for challenging candidates. The overall performance of the methodology presented is assessed using human ground truth information, generating classifier evaluation metrics for thermal image sequences.

  15. Letter identification and the neural image classifier.

    Science.gov (United States)

    Watson, Andrew B; Ahumada, Albert J

    2015-02-12

    Letter identification is an important visual task for both practical and theoretical reasons. To extend and test existing models, we have reviewed published data for contrast sensitivity for letter identification as a function of size and have also collected new data. Contrast sensitivity increases rapidly from the acuity limit but slows and asymptotes at a symbol size of about 1 degree. We recast these data in terms of contrast difference energy: the average of the squared distances between the letter images and the average letter image. In terms of sensitivity to contrast difference energy, and thus visual efficiency, there is a peak around ¼ degree, followed by a marked decline at larger sizes. These results are explained by a Neural Image Classifier model that includes optical filtering and retinal neural filtering, sampling, and noise, followed by an optimal classifier. As letters are enlarged, sensitivity declines because of the increasing size and spacing of the midget retinal ganglion cell receptive fields in the periphery.

  16. Classification Studies in an Advanced Air Classifier

    Science.gov (United States)

    Routray, Sunita; Bhima Rao, R.

    2016-10-01

    In the present paper, experiments are carried out using VSK separator which is an advanced air classifier to recover heavy minerals from beach sand. In classification experiments the cage wheel speed and the feed rate are set and the material is fed to the air cyclone and split into fine and coarse particles which are collected in separate bags. The size distribution of each fraction was measured by sieve analysis. A model is developed to predict the performance of the air classifier. The objective of the present model is to predict the grade efficiency curve for a given set of operating parameters such as cage wheel speed and feed rate. The overall experimental data with all variables studied in this investigation is fitted to several models. It is found that the present model is fitting good to the logistic model.

  17. Comparing cosmic web classifiers using information theory

    Science.gov (United States)

    Leclercq, Florent; Lavaux, Guilhem; Jasche, Jens; Wandelt, Benjamin

    2016-08-01

    We introduce a decision scheme for optimally choosing a classifier, which segments the cosmic web into different structure types (voids, sheets, filaments, and clusters). Our framework, based on information theory, accounts for the design aims of different classes of possible applications: (i) parameter inference, (ii) model selection, and (iii) prediction of new observations. As an illustration, we use cosmographic maps of web-types in the Sloan Digital Sky Survey to assess the relative performance of the classifiers T-WEB, DIVA and ORIGAMI for: (i) analyzing the morphology of the cosmic web, (ii) discriminating dark energy models, and (iii) predicting galaxy colors. Our study substantiates a data-supported connection between cosmic web analysis and information theory, and paves the path towards principled design of analysis procedures for the next generation of galaxy surveys. We have made the cosmic web maps, galaxy catalog, and analysis scripts used in this work publicly available.

  18. Comparing cosmic web classifiers using information theory

    CERN Document Server

    Leclercq, Florent; Jasche, Jens; Wandelt, Benjamin

    2016-01-01

    We introduce a decision scheme for optimally choosing a classifier, which segments the cosmic web into different structure types (voids, sheets, filaments, and clusters). Our framework, based on information theory, accounts for the design aims of different classes of possible applications: (i) parameter inference, (ii) model selection, and (iii) prediction of new observations. As an illustration, we use cosmographic maps of web-types in the Sloan Digital Sky Survey to assess the relative performance of the classifiers T-web, DIVA and ORIGAMI for: (i) analyzing the morphology of the cosmic web, (ii) discriminating dark energy models, and (iii) predicting galaxy colors. Our study substantiates a data-supported connection between cosmic web analysis and information theory, and paves the path towards principled design of analysis procedures for the next generation of galaxy surveys. We have made the cosmic web maps, galaxy catalog, and analysis scripts used in this work publicly available.

  19. Design of Robust Neural Network Classifiers

    DEFF Research Database (Denmark)

    Larsen, Jan; Andersen, Lars Nonboe; Hintz-Madsen, Mads

    1998-01-01

    a modified likelihood function which incorporates the potential risk of outliers in the data. This leads to the introduction of a new parameter, the outlier probability. Designing the neural classifier involves optimization of network weights as well as outlier probability and regularization parameters. We...... suggest to adapt the outlier probability and regularisation parameters by minimizing the error on a validation set, and a simple gradient descent scheme is derived. In addition, the framework allows for constructing a simple outlier detector. Experiments with artificial data demonstrate the potential......This paper addresses a new framework for designing robust neural network classifiers. The network is optimized using the maximum a posteriori technique, i.e., the cost function is the sum of the log-likelihood and a regularization term (prior). In order to perform robust classification, we present...

  20. Statistical Mechanics of Soft Margin Classifiers

    OpenAIRE

    Risau-Gusman, Sebastian; Gordon, Mirta B.

    2001-01-01

    We study the typical learning properties of the recently introduced Soft Margin Classifiers (SMCs), learning realizable and unrealizable tasks, with the tools of Statistical Mechanics. We derive analytically the behaviour of the learning curves in the regime of very large training sets. We obtain exponential and power laws for the decay of the generalization error towards the asymptotic value, depending on the task and on general characteristics of the distribution of stabilities of the patte...

  1. Deterministic Pattern Classifier Based on Genetic Programming

    Institute of Scientific and Technical Information of China (English)

    LI Jian-wu; LI Min-qiang; KOU Ji-song

    2001-01-01

    This paper proposes a supervised training-test method with Genetic Programming (GP) for pattern classification. Compared and contrasted with traditional methods with regard to deterministic pattern classifiers, this method is true for both linear separable problems and linear non-separable problems. For specific training samples, it can formulate the expression of discriminate function well without any prior knowledge. At last, an experiment is conducted, and the result reveals that this system is effective and practical.

  2. Reconfiguration-based implementation of SVM classifier on FPGA for Classifying Microarray data.

    Science.gov (United States)

    Hussain, Hanaa M; Benkrid, Khaled; Seker, Huseyin

    2013-01-01

    Classifying Microarray data, which are of high dimensional nature, requires high computational power. Support Vector Machines-based classifier (SVM) is among the most common and successful classifiers used in the analysis of Microarray data but also requires high computational power due to its complex mathematical architecture. Implementing SVM on hardware exploits the parallelism available within the algorithm kernels to accelerate the classification of Microarray data. In this work, a flexible, dynamically and partially reconfigurable implementation of the SVM classifier on Field Programmable Gate Array (FPGA) is presented. The SVM architecture achieved up to 85× speed-up over equivalent general purpose processor (GPP) showing the capability of FPGAs in enhancing the performance of SVM-based analysis of Microarray data as well as future bioinformatics applications.

  3. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT.

    Science.gov (United States)

    Chaboyer, Wendy; Anderson, Vinah; Webster, Joan; Sneddon, Anne; Thalib, Lukman; Gillespie, Brigid M

    2014-09-30

    Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a definitive trial. Ninety-two obese women undergoing elective CS were randomized in theatre via a central web based system using a parallel 1:1 process to two groups i.e., 46 women received the intervention (NPWT PICO™ dressing) and 46 women received standard care (Comfeel Plus(®) dressing). All women received the intended dressing following wound closure. The relative risk of SSI in the intervention group was 0.81 (95% CI 0.38-1.68); for the number of complications excluding SSI it was 0.98 (95% CI 0.34-2.79). A sample size of 784 (392 per group) would be required to find a statistically significant difference in SSI between the two groups with 90% power. These results demonstrate that a larger definitive trial is feasible and that careful planning and site selection is critical to the success of the overall study.

  4. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT

    Directory of Open Access Journals (Sweden)

    Wendy Chaboyer

    2014-09-01

    Full Text Available Obese women undergoing caesarean section (CS are at increased risk of surgical site infection (SSI. Negative Pressure Wound Therapy (NPWT is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS and also the feasibility of conducting a definitive trial. Ninety-two obese women undergoing elective CS were randomized in theatre via a central web based system using a parallel 1:1 process to two groups i.e., 46 women received the intervention (NPWT PICO™ dressing and 46 women received standard care (Comfeel Plus® dressing. All women received the intended dressing following wound closure. The relative risk of SSI in the intervention group was 0.81 (95% CI 0.38–1.68; for the number of complications excluding SSI it was 0.98 (95% CI 0.34–2.79. A sample size of 784 (392 per group would be required to find a statistically significant difference in SSI between the two groups with 90% power. These results demonstrate that a larger definitive trial is feasible and that careful planning and site selection is critical to the success of the overall study.

  5. Labour and Childbirth After Previous Caesarean Section: Recommendations of the Austrian Society of Obstetrics and Gynaecology (OEGGG).

    Science.gov (United States)

    Reif, P; Brezinka, C; Fischer, T; Husslein, P; Lang, U; Ramoni, A; Zeisler, H; Klaritsch, P

    2016-12-01

    The new expert recommendation from the Austrian Society of Obstetrics and Gynaecology (OEGGG) comprises an interpretation and summary of guidelines from the leading specialist organisations worldwide (RCOG, ACOG, SOGC, CNGOF, WHO, NIH, NICE, UpToDate). In essence it outlines alternatives to the direct pathway to elective repeat caesarean section (ERCS). In so doing it aligns with international trends, according to which a differentiated, individualised clinical approach is recommended that considers benefits and risks to both mother and child, provides detailed counselling and takes the patient's wishes into account. In view of good success rates (60-85 %) for vaginal birth after caesarean section (VBAC) the consideration of predictive factors during antenatal birth planning has become increasingly important. This publication provides a compact management recommendation for the majority of standard clinical situations. However it cannot and does not claim to cover all possible scenarios. The consideration of all relevant factors in each individual case, and thus the ultimate decision on mode of delivery, remains the discretion and responsibility of the treating obstetrician.

  6. Intelligent neural network classifier for automatic testing

    Science.gov (United States)

    Bai, Baoxing; Yu, Heping

    1996-10-01

    This paper is concerned with an application of a multilayer feedforward neural network for the vision detection of industrial pictures, and introduces a high characteristics image processing and recognizing system which can be used for real-time testing blemishes, streaks and cracks, etc. on the inner walls of high-accuracy pipes. To take full advantage of the functions of the artificial neural network, such as the information distributed memory, large scale self-adapting parallel processing, high fault-tolerance ability, this system uses a multilayer perceptron as a regular detector to extract features of the images to be inspected and classify them.

  7. Classifying spaces of degenerating polarized Hodge structures

    CERN Document Server

    Kato, Kazuya

    2009-01-01

    In 1970, Phillip Griffiths envisioned that points at infinity could be added to the classifying space D of polarized Hodge structures. In this book, Kazuya Kato and Sampei Usui realize this dream by creating a logarithmic Hodge theory. They use the logarithmic structures begun by Fontaine-Illusie to revive nilpotent orbits as a logarithmic Hodge structure. The book focuses on two principal topics. First, Kato and Usui construct the fine moduli space of polarized logarithmic Hodge structures with additional structures. Even for a Hermitian symmetric domain D, the present theory is a refinem

  8. Learning Rates for -Regularized Kernel Classifiers

    Directory of Open Access Journals (Sweden)

    Hongzhi Tong

    2013-01-01

    Full Text Available We consider a family of classification algorithms generated from a regularization kernel scheme associated with -regularizer and convex loss function. Our main purpose is to provide an explicit convergence rate for the excess misclassification error of the produced classifiers. The error decomposition includes approximation error, hypothesis error, and sample error. We apply some novel techniques to estimate the hypothesis error and sample error. Learning rates are eventually derived under some assumptions on the kernel, the input space, the marginal distribution, and the approximation error.

  9. Gearbox Condition Monitoring Using Advanced Classifiers

    Directory of Open Access Journals (Sweden)

    P. Večeř

    2010-01-01

    Full Text Available New efficient and reliable methods for gearbox diagnostics are needed in automotive industry because of growing demand for production quality. This paper presents the application of two different classifiers for gearbox diagnostics – Kohonen Neural Networks and the Adaptive-Network-based Fuzzy Interface System (ANFIS. Two different practical applications are presented. In the first application, the tested gearboxes are separated into two classes according to their condition indicators. In the second example, ANFIS is applied to label the tested gearboxes with a Quality Index according to the condition indicators. In both applications, the condition indicators were computed from the vibration of the gearbox housing. 

  10. Cubical sets as a classifying topos

    DEFF Research Database (Denmark)

    Spitters, Bas

    Coquand’s cubical set model for homotopy type theory provides the basis for a computational interpretation of the univalence axiom and some higher inductive types, as implemented in the cubical proof assistant. We show that the underlying cube category is the opposite of the Lawvere theory of De...... Morgan algebras. The topos of cubical sets itself classifies the theory of ‘free De Morgan algebras’. This provides us with a topos with an internal ‘interval’. Using this interval we construct a model of type theory following van den Berg and Garner. We are currently investigating the precise relation...

  11. 5 CFR 1312.23 - Access to classified information.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Access to classified information. 1312.23... Classified Information § 1312.23 Access to classified information. Classified information may be made... “need to know” and the access is essential to the accomplishment of official government duties....

  12. Are caesarean sections, induced labor and oxytocin regulation linked to Autism Spectrum Disorders?

    Science.gov (United States)

    Gialloreti, Leonardo Emberti; Benvenuto, Arianna; Benassi, Francesca; Curatolo, Paolo

    2014-06-01

    The etiology of Autism Spectrum Disorders (ASDs) continues to be elusive. While ASDs have been shown to be heritable, several environmental co-factors, such as, e.g. pre- or perinatal adverse events, could play a role in the pathogenesis of the disorder as well. Prevalence of ASDs appears to have increased in the last three decades, but the causes of this surge are not fully understood. As perinatal adverse events have increased as well, they have been regarded as logical contributors to the risen prevalence of ASDs. Over the last three decades there has been also a considerable increase in the rates of induced labor and caesarean sections (CS). However, even if a causal association between CS and ASDs increase has been suggested, it has not yet been proven. Nevertheless, we hypothesize here that such an association is actual and that it might help to explain a part of the increase in ASD diagnoses. Our assumption is based on the wider epidemiological picture of ASDs and CS, as well as on the possible biological plausibility of this correlation, by postulating potential epigenetic and neurobiological mechanisms underpinning this relationship. Today, several observations point toward the existence of epigenetic dysregulation in ASDs and this raises the issue of the role of environmental factors in bringing about epigenetic modifications. Epigenetic dysregulations in some brain neuropeptide systems could play a role in the behavioral dysfunctions of ASDs. Particularly, some evidence suggests a dysregulation of the oxytocinergic system in autistic brains. Perinatal alterations of oxytocin (OT) can also have life-long lasting effects on the development of social behaviors. Within the perinatal period, various processes, like pitocin infusion or CS, can alter the OT balance in the newborn; OT dysregulation could then interact with genetic factors, leading ultimately to the development of ASDs. Large long-term prospective studies are needed to identify causal pathways

  13. Caesarean sections and for-profit status of hospitals: systematic review and meta-analysis

    Science.gov (United States)

    Syrogiannouli, Lamprini; Luta, Xhyljeta; Tal, Kali; Goodman, David C; da Costa, Bruno R; Jüni, Peter

    2017-01-01

    Objective Financial incentives may encourage private for-profit providers to perform more caesarean section (CS) than non-profit hospitals. We therefore sought to determine the association of for-profit status of hospital and odds of CS. Design Systematic review and meta-analysis. Data sources MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews from the first year of records through February 2016. Eligibility criteria To be eligible, studies had to report data to allow the calculation of ORs of CS comparing private for-profit hospitals with public or private non-profit hospitals in a specific geographic area. Outcomes The prespecified primary outcome was the adjusted OR of births delivered by CS in private for-profit hospitals as compared with public or private non-profit hospitals; the prespecified secondary outcome was the crude OR of CS in private for-profit hospitals as compared with public or private non-profit hospitals. Results 15 articles describing 17 separate studies in 4.1 million women were included. In a meta-analysis of 11 studies, the adjusted odds of delivery by CS was 1.41 higher in for-profit hospitals as compared with non-profit hospitals (95% CI 1.24 to 1.60) with no relevant heterogeneity between studies (τ2≤0.037). Findings were robust across subgroups of studies in stratified analyses. The meta-analysis of crude estimates from 16 studies revealed a somewhat more pronounced association (pooled OR 1.84, 95% CI 1.49 to 2.27) with moderate-to-high heterogeneity between studies (τ2≥0.179). Conclusions CS are more likely to be performed by for-profit hospitals as compared with non-profit hospitals. This holds true regardless of women's risk and contextual factors such as country, year or study design. Since financial incentives are likely to play an important role, we recommend examination of incentive structures of for-profit hospitals to identify strategies that encourage appropriate provision of CS. PMID:28213600

  14. Rotational Study of Ambiguous Taxonomic Classified Asteroids

    Science.gov (United States)

    Linder, Tyler R.; Sanchez, Rick; Wuerker, Wolfgang; Clayson, Timothy; Giles, Tucker

    2017-01-01

    The Sloan Digital Sky Survey (SDSS) moving object catalog (MOC4) provided the largest ever catalog of asteroid spectrophotometry observations. Carvano et al. (2010), while analyzing MOC4, discovered that individual observations of asteroids which were observed multiple times did not classify into the same photometric-based taxonomic class. A small subset of those asteroids were classified as having both the presence and absence of a 1um silicate absorption feature. If these variations are linked to differences in surface mineralogy, the prevailing assumption that an asteroid’s surface composition is predominantly homogenous would need to be reexamined. Furthermore, our understanding of the evolution of the asteroid belt, as well as the linkage between certain asteroids and meteorite types may need to be modified.This research is an investigation to determine the rotational rates of these taxonomically ambiguous asteroids. Initial questions to be answered:Do these asteroids have unique or nonstandard rotational rates?Is there any evidence in their light curve to suggest an abnormality?Observations were taken using PROMPT6 a 0.41-m telescope apart of the SKYNET network at Cerro Tololo Inter-American Observatory (CTIO). Observations were calibrated and analyzed using Canopus software. Initial results will be presented at AAS.

  15. Objectively classifying Southern Hemisphere extratropical cyclones

    Science.gov (United States)

    Catto, Jennifer

    2016-04-01

    There has been a long tradition in attempting to separate extratropical cyclones into different classes depending on their cloud signatures, airflows, synoptic precursors, or upper-level flow features. Depending on these features, the cyclones may have different impacts, for example in their precipitation intensity. It is important, therefore, to understand how the distribution of different cyclone classes may change in the future. Many of the previous classifications have been performed manually. In order to be able to evaluate climate models and understand how extratropical cyclones might change in the future, we need to be able to use an automated method to classify cyclones. Extratropical cyclones have been identified in the Southern Hemisphere from the ERA-Interim reanalysis dataset with a commonly used identification and tracking algorithm that employs 850 hPa relative vorticity. A clustering method applied to large-scale fields from ERA-Interim at the time of cyclone genesis (when the cyclone is first detected), has been used to objectively classify identified cyclones. The results are compared to the manual classification of Sinclair and Revell (2000) and the four objectively identified classes shown in this presentation are found to match well. The relative importance of diabatic heating in the clusters is investigated, as well as the differing precipitation characteristics. The success of the objective classification shows its utility in climate model evaluation and climate change studies.

  16. Adaptive classifier for steel strip surface defects

    Science.gov (United States)

    Jiang, Mingming; Li, Guangyao; Xie, Li; Xiao, Mang; Yi, Li

    2017-01-01

    Surface defects detection system has been receiving increased attention as its precision, speed and less cost. One of the most challenges is reacting to accuracy deterioration with time as aged equipment and changed processes. These variables will make a tiny change to the real world model but a big impact on the classification result. In this paper, we propose a new adaptive classifier with a Bayes kernel (BYEC) which update the model with small sample to it adaptive for accuracy deterioration. Firstly, abundant features were introduced to cover lots of information about the defects. Secondly, we constructed a series of SVMs with the random subspace of the features. Then, a Bayes classifier was trained as an evolutionary kernel to fuse the results from base SVMs. Finally, we proposed the method to update the Bayes evolutionary kernel. The proposed algorithm is experimentally compared with different algorithms, experimental results demonstrate that the proposed method can be updated with small sample and fit the changed model well. Robustness, low requirement for samples and adaptive is presented in the experiment.

  17. Classifying Coding DNA with Nucleotide Statistics

    Directory of Open Access Journals (Sweden)

    Nicolas Carels

    2009-10-01

    Full Text Available In this report, we compared the success rate of classification of coding sequences (CDS vs. introns by Codon Structure Factor (CSF and by a method that we called Universal Feature Method (UFM. UFM is based on the scoring of purine bias (Rrr and stop codon frequency. We show that the success rate of CDS/intron classification by UFM is higher than by CSF. UFM classifies ORFs as coding or non-coding through a score based on (i the stop codon distribution, (ii the product of purine probabilities in the three positions of nucleotide triplets, (iii the product of Cytosine (C, Guanine (G, and Adenine (A probabilities in the 1st, 2nd, and 3rd positions of triplets, respectively, (iv the probabilities of G in 1st and 2nd position of triplets and (v the distance of their GC3 vs. GC2 levels to the regression line of the universal correlation. More than 80% of CDSs (true positives of Homo sapiens (>250 bp, Drosophila melanogaster (>250 bp and Arabidopsis thaliana (>200 bp are successfully classified with a false positive rate lower or equal to 5%. The method releases coding sequences in their coding strand and coding frame, which allows their automatic translation into protein sequences with 95% confidence. The method is a natural consequence of the compositional bias of nucleotides in coding sequences.

  18. Classifying anatomical subtypes of subjective memory impairment.

    Science.gov (United States)

    Jung, Na-Yeon; Seo, Sang Won; Yoo, Heejin; Yang, Jin-Ju; Park, Seongbeom; Kim, Yeo Jin; Lee, Juyoun; Lee, Jin San; Jang, Young Kyoung; Lee, Jong Min; Kim, Sung Tae; Kim, Seonwoo; Kim, Eun-Joo; Na, Duk L; Kim, Hee Jin

    2016-12-01

    We aimed to categorize subjective memory impairment (SMI) individuals based on their patterns of cortical thickness and to propose simple models that can classify each subtype. We recruited 613 SMI individuals and 613 age- and gender-matched normal controls. Using hierarchical agglomerative cluster analysis, SMI individuals were divided into 3 subtypes: temporal atrophy (12.9%), minimal atrophy (52.4%), and diffuse atrophy (34.6%). Individuals in the temporal atrophy (Alzheimer's disease-like atrophy) subtype were older, had more vascular risk factors, and scored the lowest on neuropsychological tests. Combination of these factors classified the temporal atrophy subtype with 73.2% accuracy. On the other hand, individuals with the minimal atrophy (non-neurodegenerative) subtype were younger, were more likely to be female, and had depression. Combination of these factors discriminated the minimal atrophy subtype with 76.0% accuracy. We suggest that SMI can be largely categorized into 3 anatomical subtypes that have distinct clinical features. Our models may help physicians decide next steps when encountering SMI patients and may also be used in clinical trials.

  19. Comparison of Current Frame-Based Phoneme Classifiers

    Directory of Open Access Journals (Sweden)

    Vaclav Pfeifer

    2011-01-01

    Full Text Available This paper compares today’s most common frame-based classifiers. These classifiers can be divided into the two main groups – generic classifiers which creates the most probable model based on the training data (for example GMM and discriminative classifiers which focues on creating decision hyperplane. A lot of research has been done with the GMM classifiers and therefore this paper will be mainly focused on the frame-based classifiers. Two discriminative classifiers will be presented. These classifiers implements a hieararchical tree root structure over the input phoneme group which shown to be an effective. Based on these classifiers, two efficient training algorithms will be presented. We demonstrate advantages of our training algorithms by evaluating all classifiers over the TIMIT speech corpus.

  20. 关于择期剖宫产与急诊剖宫产的临床特征的对比研究%Comparison of Clinical Features between Elective Caesarean Section and E-mergency Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    危秀蓉; 杨成芬; 张久娣

    2015-01-01

    目的:回顾性分析择期剖宫产与急诊剖宫产的临床资料,解析急诊剖宫产的危险性。方法收集2010年1月-2014年1月在该院剖宫产的产妇资料共2135例,按开始手术与分娩发动和破膜的关系分为择期剖宫产与急诊剖宫产两组,其中择期剖宫产642例为A组,急诊剖宫产1493例为B组,进行回顾性分析。结果A组、B组手术时间分别为(45.2±15.1)min、(60.7±13.5)min;A组、B组手术中出血量分别为(305.1±107.4)mL、(425.4±218.2)mL;A组、B组术后肛门排气时间分别为(23.5±10.2)h、(29.0±13.6)h;以上数据两组相比差异有统计学意义(P<0.05)。 A组、B组取头困难率分别为6.72%、10.41%;A组、B组子宫切口撕裂率分别为1.68%、5.15%;A组、B组新生儿窒息率分别为2.45%、6.73%;A组、B组术后早期切口感染率分别为3.90%、7.61%;A组、B组术后发热率分别为30.17%、41.31%,以上数据两组相比差异有统计学意义(P<0.01)。结论急诊剖宫产比择期剖宫产具有更高的安全隐患和手术风险,在降低手术风险的同时也应尽量减少急诊剖宫产。%Objective To retrospectively analyze the the clinical data of elective caesarean section and emergency caesarean sec-tion, and the danger of emergency caesarean section. Methods 2135 cases in our hospital From January 2010 to January 2014 , according to the relation between the start operation and the onset of labor and rupture of membranes, were divided into elective caesarean section group (Group A,n=642) and emergency caesarean section (Group B, n=1493). The data of all the patients were retrospectively analyzed. Results Group A, group B, operation time were (45.2±15.1)min, (60.7±13.5)min;A group, B group, amount of bleeding during operation were (305.1±107.4)mL, (425.4±218.2)mL; Anal exhaust time of A group, B group after op-eration were (23.5±10.2)h, (29.0±13.6)h;there was statistical

  1. Research on the Effect of Different Operation Type of Pet Canine Caesarean%犬剖腹产不同术式的效果研究

    Institute of Scientific and Technical Information of China (English)

    张苗苗; 黎瑞

    2012-01-01

    为探讨宠物犬剖腹产的最佳术式,提高临床治疗效果,将68例宠物犬难产病例分为3组,第1组27例,用脐后腹正中线切口治疗;第2组29例,用腹侧壁切口治疗;第3组12例,用腹白线旁切口治疗。结果表明:第1组治愈率88.9%;第2组治愈率89.7%;第3组治愈率83.3%。试验结果表明,腹侧壁切口效果最好。%In order to investigate the best caesarean section methods of pet canines and to improve clinical therapeutic efficacy, 86 dystocia cases of pet canines were divided into 3 groups randomly in the experiment. The first group 27 cases were taken caesarean section through the mid-incision afer the navel. The second 29 eases were used caesarean section through the cut of flank. Caesarean section through near-mid-incision cut taken in the third group 12 cases. The cure rate in the three groups were 88.9% ,89.7% ,83.3% respectively. The results showed that the effect of ventral incision treatment was the best.

  2. Carbetocin in comparison with oxytocin in several dosing regimens for the prevention of uterine atony after elective caesarean section in the Netherlands

    NARCIS (Netherlands)

    Holleboom, C. A. G.; van Eyck, J.; Koenen, S. V.; Kreuwel, I. A. M.; Bergwerff, F.; Creutzberg, E. C.; Bruinse, H. W.

    2013-01-01

    Purpose The aim of the study was to compare the prophylactic effects of carbetocin with those of oxytocin for the prevention of uterine atony in patients undergoing elective caesarean section (CS) in the Netherlands. The primary endpoint was the need for additional uterotonic medication. Methods Eac

  3. Evaluation of intrathecal bupivacaine alone, bupivacaine with butorphanol and bupivacaine with dexmedetomidine for lower segment caesarean section: a randomized control trial

    Directory of Open Access Journals (Sweden)

    Ashem Jack Meitei

    2016-12-01

    Conclusions: Addition of dexmedetomidine to spinal bupivacaine block in caesarean section increase the duration of analgesia and motor block with minimal side effect and no adverse effects on the babies. [Int J Basic Clin Pharmacol 2016; 5(6.000: 2675-2682

  4. Vaginal birth after a caesarean section : the development of a Western European population-based prediction model for deliveries at term

    NARCIS (Netherlands)

    Schoorel, E. N. C.; van Kuijk, S. M. J.; Melman, S.; Nijhuis, J. G.; Smits, L. J. M.; Aardenburg, R.; de Boer, K.; Delemarre, F. M. C.; van Dooren, I. M.; Franssen, M. T. M.; Kaplan, M.; Kleiverda, G.; Kuppens, S. M. I.; Kwee, A.; Lim, F. T. H.; Mol, B. W. J.; Roumen, F. J. M. E.; Sikkema, J. M.; Smid-Koopman, E.; Visser, H.; Woiski, M.; Hermens, R. P. M. G.; Scheepers, H. C. J.

    2014-01-01

    ObjectiveTo develop and internally validate a model that predicts the outcome of an intended vaginal birth after caesarean (VBAC) for a Western European population that can be used to personalise counselling for deliveries at term. DesignRegistration-based retrospective cohort study. SettingFive uni

  5. The HysNiche trial: Hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

    NARCIS (Netherlands)

    A.J.M.W. Vervoort; L.F. Van der Voet; M. Witmer; A.L. Thurkow; C.M. Radder; P.J.M. van Kesteren; H.W.P. Quartero; W.K.H. Kuchenbecker (Walter); M.Y. Bongers; P.M.A.J. Geomini; L.H.M. de Vleeschouwer; M.H.A. van Hooff (Marcel); H.A. van Vliet; S. Veersema (S.); W.B. Renes; H.S. van Meurs (Hannah); B. Bosmans; K.O. Rengerink (Katrien Oude); H.A.M. Brölmann (H. A M); B.W.J. Mol (Ben W.J.); J.A.F. Huirne (Judith)

    2015-01-01

    textabstractBackground: A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is

  6. The HysNiche trial : hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial

    NARCIS (Netherlands)

    Vervoort, A J M W; Van der Voet, L F; Witmer, M; Thurkow, A L; Radder, C M; van Kesteren, P J M; Quartero, H W P; Kuchenbecker, W K H; Bongers, M Y; Geomini, P M A J; de Vleeschouwer, L H M; van Hooff, M H A; van Vliet, H A A M; Veersema, S; Renes, W B; van Meurs, H S; Bosmans, J; Oude Rengerink, K; Brölmann, H A M; Mol, B W J; Huirne, J A F

    2015-01-01

    BACKGROUND: A caesarean section (CS) can cause a defect or disruption of the myometrium at the site of the uterine scar, called a niche. In recent years, an association between a niche and postmenstrual spotting after a CS has been demonstrated. Hysteroscopic resection of these niches is thought to

  7. Science in Latin America.

    Science.gov (United States)

    Ayala, Francisco J.

    1995-01-01

    A brief history of science and technology in Latin America that begins with the Mayan civilization and progresses through the colonial period to the present. Compares increased scientific productivity in the Latin American and Caribbean regions to productivity in the United States and European Union. (LZ)

  8. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  9. Literacy in South America.

    Science.gov (United States)

    Hornberger, Nancy H.

    1991-01-01

    Literacy in South America must be understood in terms of the linguistic diversity there, where only 2 of 14 nations and territories are monolingual. Oral traditions, standardization of indigenous languages, nonstandard varieties of colonial languages, bilingual education and mother tongue literacy, literacy teaching, and politics are discussed.…

  10. Americas at Odds

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Despite lingering disputes,the United States keeps a firm grip on Latin America During his presidential campaign,Evo Morales said his election would be a "nightmare" for the United States.The Bolivian president honored his words. On September 10, Morales declared U.S.

  11. Ecodesign in Central America

    NARCIS (Netherlands)

    Crul, M.R.M.

    2003-01-01

    This PhD thesis describes and analyses the change process started by the Ecodesign project in Central America, executed between 1998 and 2002. The project started using the concept and praxis developed in Europe. Nine ecodesign projects were performed in industry, and ecodesign was introduced to cou

  12. Sarcoma Foundation of America

    Science.gov (United States)

    ... Google+ Twitter LinkedIn YouTube © 2017 Sarcoma Foundation of America | All Rights Reserved. | Terms of Use | Privacy Policy Website Design & Hosting by 270net Technologies, Inc. X - Enter Your Location - - or - Get your current location Home About Us History People Public Filings News & Media SFA in the ...

  13. An Idea Called America

    Science.gov (United States)

    Hartoonian, Michael; Van Scotter, Richard; White, William E.

    2007-01-01

    America evolved out of the principles of the eighteenth-century Enlightenment, suggesting that individuals could govern themselves and that people were "endowed" with "unalienable rights" such as life, liberty, and the pursuit of happiness. To secure these principles, Americans would continue to work on forming a more perfect Union, by…

  14. Lateinamerika oder -amerikas? Latin America or Americas?

    Directory of Open Access Journals (Sweden)

    Ana Belén García Timón

    2008-07-01

    Full Text Available Anhand interdisziplinärer und empirischer Studien wird Lateinamerika als Bühne für die Entwicklung transkultureller Phänomene präsentiert. Geschlechterverhältnisse in unterschiedlichen Kontexten stehen im Mittelpunkt der Untersuchung. Begriffe wie Macht, Rasse oder Raum werden mit dem Ziel, weg von der bisherigen Vorstellung von homogenen kulturellen Einheiten zu kommen, revidiert.Latin America is presented as a stage for the development of transcultural phenomena through the use of interdisciplinary and empirical studies. Gender relations in different contexts lie at the heart of this study. Terms such as power, race, or space are revised with the goal of moving away from current perceptions of homogenous cultural unities.

  15. Classifying prion and prion-like phenomena.

    Science.gov (United States)

    Harbi, Djamel; Harrison, Paul M

    2014-01-01

    The universe of prion and prion-like phenomena has expanded significantly in the past several years. Here, we overview the challenges in classifying this data informatically, given that terms such as "prion-like", "prion-related" or "prion-forming" do not have a stable meaning in the scientific literature. We examine the spectrum of proteins that have been described in the literature as forming prions, and discuss how "prion" can have a range of meaning, with a strict definition being for demonstration of infection with in vitro-derived recombinant prions. We suggest that although prion/prion-like phenomena can largely be apportioned into a small number of broad groups dependent on the type of transmissibility evidence for them, as new phenomena are discovered in the coming years, a detailed ontological approach might be necessary that allows for subtle definition of different "flavors" of prion / prion-like phenomena.

  16. Learning Vector Quantization for Classifying Astronomical Objects

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    The sizes of astronomical surveys in different wavebands are increas-ing rapidly. Therefore, automatic classification of objects is becoming ever moreimportant. We explore the performance of learning vector quantization (LVQ) inclassifying multi-wavelength data. Our analysis concentrates on separating activesources from non-active ones. Different classes of X-ray emitters populate distinctregions of a multidimensional parameter space. In order to explore the distributionof various objects in a multidimensional parameter space, we positionally cross-correlate the data of quasars, BL Lacs, active galaxies, stars and normal galaxiesin the optical, X-ray and infrared bands. We then apply LVQ to classify them withthe obtained data. Our results show that LVQ is an effective method for separatingAGNs from stars and normal galaxies with multi-wavelength data.

  17. A cognitive approach to classifying perceived behaviors

    Science.gov (United States)

    Benjamin, Dale Paul; Lyons, Damian

    2010-04-01

    This paper describes our work on integrating distributed, concurrent control in a cognitive architecture, and using it to classify perceived behaviors. We are implementing the Robot Schemas (RS) language in Soar. RS is a CSP-type programming language for robotics that controls a hierarchy of concurrently executing schemas. The behavior of every RS schema is defined using port automata. This provides precision to the semantics and also a constructive means of reasoning about the behavior and meaning of schemas. Our implementation uses Soar operators to build, instantiate and connect port automata as needed. Our approach is to use comprehension through generation (similar to NLSoar) to search for ways to construct port automata that model perceived behaviors. The generality of RS permits us to model dynamic, concurrent behaviors. A virtual world (Ogre) is used to test the accuracy of these automata. Soar's chunking mechanism is used to generalize and save these automata. In this way, the robot learns to recognize new behaviors.

  18. Speech Emotion Recognition Using Fuzzy Logic Classifier

    Directory of Open Access Journals (Sweden)

    Daniar aghsanavard

    2016-01-01

    Full Text Available Over the last two decades, emotions, speech recognition and signal processing have been one of the most significant issues in the adoption of techniques to detect them. Each method has advantages and disadvantages. This paper tries to suggest fuzzy speech emotion recognition based on the classification of speech's signals in order to better recognition along with a higher speed. In this system, the use of fuzzy logic system with 5 layers, which is the combination of neural progressive network and algorithm optimization of firefly, first, speech samples have been given to input of fuzzy orbit and then, signals will be investigated and primary classified in a fuzzy framework. In this model, a pattern of signals will be created for each class of signals, which results in reduction of signal data dimension as well as easier speech recognition. The obtained experimental results show that our proposed method (categorized by firefly, improves recognition of utterances.

  19. Classifying and ranking DMUs in interval DEA

    Institute of Scientific and Technical Information of China (English)

    GUO Jun-peng; WU Yu-hua; LI Wen-hua

    2005-01-01

    During efficiency evaluating by DEA, the inputs and outputs of DMUs may be intervals because of insufficient information or measure error. For this reason, interval DEA is proposed. To make the efficiency scores more discriminative, this paper builds an Interval Modified DEA (IMDEA) model based on MDEA.Furthermore, models of obtaining upper and lower bounds of the efficiency scores for each DMU are set up.Based on this, the DMUs are classified into three types. Next, a new order relation between intervals which can express the DM' s preference to the three types is proposed. As a result, a full and more eonvietive ranking is made on all the DMUs. Finally an example is given.

  20. CLASSIFYING MEDICAL IMAGES USING MORPHOLOGICAL APPEARANCE MANIFOLDS.

    Science.gov (United States)

    Varol, Erdem; Gaonkar, Bilwaj; Davatzikos, Christos

    2013-12-31

    Input features for medical image classification algorithms are extracted from raw images using a series of pre processing steps. One common preprocessing step in computational neuroanatomy and functional brain mapping is the nonlinear registration of raw images to a common template space. Typically, the registration methods used are parametric and their output varies greatly with changes in parameters. Most results reported previously perform registration using a fixed parameter setting and use the results as input to the subsequent classification step. The variation in registration results due to choice of parameters thus translates to variation of performance of the classifiers that depend on the registration step for input. Analogous issues have been investigated in the computer vision literature, where image appearance varies with pose and illumination, thereby making classification vulnerable to these confounding parameters. The proposed methodology addresses this issue by sampling image appearances as registration parameters vary, and shows that better classification accuracies can be obtained this way, compared to the conventional approach.

  1. Classifying antiarrhythmic actions: by facts or speculation.

    Science.gov (United States)

    Vaughan Williams, E M

    1992-11-01

    Classification of antiarrhythmic actions is reviewed in the context of the results of the Cardiac Arrhythmia Suppression Trials, CAST 1 and 2. Six criticisms of the classification recently published (The Sicilian Gambit) are discussed in detail. The alternative classification, when stripped of speculative elements, is shown to be similar to the original classification. Claims that the classification failed to predict the efficacy of antiarrhythmic drugs for the selection of appropriate therapy have been tested by an example. The antiarrhythmic actions of cibenzoline were classified in 1980. A detailed review of confirmatory experiments and clinical trials during the past decade shows that predictions made at the time agree with subsequent results. Classification of the effects drugs actually have on functioning cardiac tissues provides a rational basis for finding the preferred treatment for a particular arrhythmia in accordance with the diagnosis.

  2. A Spiking Neural Learning Classifier System

    CERN Document Server

    Howard, Gerard; Lanzi, Pier-Luca

    2012-01-01

    Learning Classifier Systems (LCS) are population-based reinforcement learners used in a wide variety of applications. This paper presents a LCS where each traditional rule is represented by a spiking neural network, a type of network with dynamic internal state. We employ a constructivist model of growth of both neurons and dendrites that realise flexible learning by evolving structures of sufficient complexity to solve a well-known problem involving continuous, real-valued inputs. Additionally, we extend the system to enable temporal state decomposition. By allowing our LCS to chain together sequences of heterogeneous actions into macro-actions, it is shown to perform optimally in a problem where traditional methods can fail to find a solution in a reasonable amount of time. Our final system is tested on a simulated robotics platform.

  3. Segmentation of Fingerprint Images Using Linear Classifier

    Directory of Open Access Journals (Sweden)

    Xinjian Chen

    2004-04-01

    Full Text Available An algorithm for the segmentation of fingerprints and a criterion for evaluating the block feature are presented. The segmentation uses three block features: the block clusters degree, the block mean information, and the block variance. An optimal linear classifier has been trained for the classification per block and the criteria of minimal number of misclassified samples are used. Morphology has been applied as postprocessing to reduce the number of classification errors. The algorithm is tested on FVC2002 database, only 2.45% of the blocks are misclassified, while the postprocessing further reduces this ratio. Experiments have shown that the proposed segmentation method performs very well in rejecting false fingerprint features from the noisy background.

  4. Classifying supernovae using only galaxy data

    Energy Technology Data Exchange (ETDEWEB)

    Foley, Ryan J. [Astronomy Department, University of Illinois at Urbana-Champaign, 1002 West Green Street, Urbana, IL 61801 (United States); Mandel, Kaisey [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States)

    2013-12-01

    We present a new method for probabilistically classifying supernovae (SNe) without using SN spectral or photometric data. Unlike all previous studies to classify SNe without spectra, this technique does not use any SN photometry. Instead, the method relies on host-galaxy data. We build upon the well-known correlations between SN classes and host-galaxy properties, specifically that core-collapse SNe rarely occur in red, luminous, or early-type galaxies. Using the nearly spectroscopically complete Lick Observatory Supernova Search sample of SNe, we determine SN fractions as a function of host-galaxy properties. Using these data as inputs, we construct a Bayesian method for determining the probability that an SN is of a particular class. This method improves a common classification figure of merit by a factor of >2, comparable to the best light-curve classification techniques. Of the galaxy properties examined, morphology provides the most discriminating information. We further validate this method using SN samples from the Sloan Digital Sky Survey and the Palomar Transient Factory. We demonstrate that this method has wide-ranging applications, including separating different subclasses of SNe and determining the probability that an SN is of a particular class before photometry or even spectra can. Since this method uses completely independent data from light-curve techniques, there is potential to further improve the overall purity and completeness of SN samples and to test systematic biases of the light-curve techniques. Further enhancements to the host-galaxy method, including additional host-galaxy properties, combination with light-curve methods, and hybrid methods, should further improve the quality of SN samples from past, current, and future transient surveys.

  5. A COMPARATIVE STUDY OF ANALGESIC EFFICACY OF INTRATHECAL CLONIDINE WITH BUPIVACAINE & BUPIVACAINE ALONE IN ELECTIVE CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Chethanananda

    2014-03-01

    Full Text Available : Spinal anaesthesia in caesarean section has many advantages in that it is simpler to perform, provides a more certain endpoint& has a higher degree of success than epidural anaesthesia as it provides more profound block than epidural anaesthesia. As the dose of local anaesthetics used with spinal anaesthesia is small, there is little chance of maternal toxicity & placental transfer of drugs. Bupivacaine 0.5% is the most popular drug used for spinal anaesthesia in caesarean section. Many adjuvant drugs are added intrathecally along with Bupivacaine to increase the duration and intensity of analgesia. Intrathecal Clonidine (an α2 agonist is being extensively evaluated as an alternative to neuraxial opioid along with local anaesthetic agents. We evaluated the efficacy of clonidine added to 0.5% bupivacaine in prolonging the analgesia produced by intrathecal bupivacaine in parturients undergoing elective lower segment caesarean section (LSCS. 60 parturients between 20-30 years of age weighing 50-70 Kgs belonging to ASA (American Society of Anaesthesiologists grading I & II were prospectively randomised to two groups. 30 parturients of Group B (control group received 2.0 ml of 0.5% hyperbaric bupivacaine intrathecally alone and 30 parturients of Group BC received 1.75 ml of 0.5% hyperbaric bupivacaine +0.25 ml (37.5mcg of preservative free clonidine. The time taken for onset of sensory and motor blockade duration of postoperative analgesia and the duration of motor blockade were noted. The mean time of onset of sensory blockade in Group B was 57.16±9.9 seconds and Group BC was 62.8±6.80 seconds (p < 0.05. The meantime taken for onset motor block was 66.00±5.15 seconds in Group B and 81.33±8.89 seconds in Group BC (p = 0.000 with the grade of motor blockade was similar in both groups. The mean duration of analgesia was 152.77±11.79 minutes in B group and 288.16±16.73 in BC group (p = 0.000. The mean duration of motor blockade was 93.33±8

  6. Influence of Very Early Exposure of Cefuroxime on Gut Microbiota Composition of Infants Born by Caesarean Section

    DEFF Research Database (Denmark)

    Krogfelt, Karen Angeliki; Bin Shamzir Kamal, Shamrulazhar; Hyldig, Nana

    2016-01-01

    Background: Cefuroxime is a broad-spectrum cephalosporin antibiotic. It is standard caesarean section (CS) procedure at many hospitals to administer the mother a single prophylactic dose (1500mg) before skin incision and hence before the umbilical cord is cut, indirectly exposing the foetus...... born by CS. Methods: 42 pregnant women (BMImothers were randomly assigned to either receiving cefuroxime before skin incision or immediately after the umbilical cord were cut. Faecal samples were collected from...... all infants at 10 days. GM composition were determined by MiSeq-based tag-encoded 16S rRNA gene targeted high throughput amplicon sequencing. Bacteria were cultured on selective and non-selective agar plates (aerobically and anaerobically) from the faecal samples and the bacterial strains were...

  7. A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital

    LENUS (Irish Health Repository)

    O’ Hanlon, M

    2016-09-01

    Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.

  8. Electricity in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    Breeze, P.

    1998-12-01

    The report provides an overview of the Latin American power market; analyses the power generation, transmission and distribution capabilities of 20 countries in central and south America; includes detailed comparative data on current capacity, shortfall and growth; investigates the existing network infrastructures and projected demand; examines the opportunities for independent power producers resulting from deregulation; assesses indigenous and imported fuel resources; and discusses the broad financial opportunities and restraints.

  9. Latin America Report.

    Science.gov (United States)

    1986-11-05

    8217Americas Watch’ Charges (THE DAILY GLEANER, 26 Sep 86) 92 - c - Briefs World Bank Loans 94 MEXICO 1985 Key Parastate Enterprise Losses Near...year later in the DIARIO DE CENTROAMERICA , on 27 December 1985. The previous pact, which had been in effect for 25 years, was the Central American... Mexico , including a sizable reduction in spreads (risk rates) collected from that country, will be the point of departure for the new round of

  10. Elective caesarean section versus vaginal delivery for preventing mother to child transmission of hepatitis B virus – a systematic review

    Directory of Open Access Journals (Sweden)

    Yang Jin

    2008-08-01

    Full Text Available Abstract Background Caesarean section before labor or before ruptured membranes ("elective caesarean section", or ECS has been introduced as an intervention for preventing mother-to-child transmission (MTCT of hepatitis B virus (HBV. Currently, no evidence that ECS versus vaginal delivery reduces the rate of MTCT of HBV has been generally provided. The aim of this review is to assess, from randomized control trails (RCTs, the efficacy and safety of ECS versus vaginal delivery in preventing mother-to-child HBV transmission. Results We searched Cochrane Pregnancy and Childbirth Group's Trials Register (January, 2008, the Cochrane Central Register of Controlled Trials (the Cochrane Library 2008, issue 1, PubMed (1950 to 2008, EMBASE (1974 to 2008, Chinese Biomedical Literature Database (CBM (1975 to 2008, China National Knowledge Infrastructure (CNKI (1979 to 2008, VIP database (1989 to 2008, as well as reference lists of relevant studies. Finally, four randomized trails involving 789 people were included. Based on meta-analysis, There was strong evidence that ECS versus vaginal delivery could effectively reduce the rate of MTCT of HBV (ECS: 10.5%; vaginal delivery: 28.0%. The difference between the two groups (ECS versus vaginal delivery had statistical significance (RR 0.41, 95% CI 0.28 to 0.60, P Conclusion ECS appears to be effective in preventing MTCT of HBV and no postpartum morbidity (PPM was reported. However, the conclusions of this review must be considered with great caution due to high risk of bias in each included study (graded C.

  11. EFFICACY OF TRANEXAMIC ACID IN DECREASING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION: A RANDOMIZED CASE CONTROL PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Tullika

    2014-03-01

    Full Text Available : INTRODUCTION: To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the amount of bleeding during and after lower segment caesarean section (LSCS. Tranexamic acid helps to reduce bleeding during and after LSCS. OBJECTIVES: To study the efficacy and safety of Tranexamic acid in reducing blood loss during and after Lower segment Caesarean Section (LSCS. METHODS: A randomized case controlled prospective study was conducted on 200 women undergoing lower segment cesarean section. Hundreds of them that were given tranexamic acid immediately before LSCS were compared to hundred others to whom tranexamic acid was not given. Blood loss was collected and measured during the two periods, from plancental delivery to end of LSCS and second from end of LSCS to two hours postpartum. RESULTS: Tranexamic acid significantly reduced the quantity of blood loss from placental delivery to end of LSCS, 202.25ml in the study group vs392.20 ml in the control group (p<0.001; from the end of LSCS, to 2 hours postpartum 3.80ml in the study group versus 112.25ml in the control group (p<0.001; In totality, it significantly reduced the quantity of blood loss from placental delivery to two hours postpartum i.e. 27.05ml in the study group versus 510.45ml in the control group (p < 0.001. No complications or side effects were noted. CONCLUSION: Tranexamic acid significantly reduced the amount of blood loss during and after LSCS. Tranexamic acid can be used prophylactically; moreover it is safer and effective in women undergoing LSCS.

  12. Knowledge, attitude and acceptance of antenatal women toward labor analgesia and caesarean section in a medical college hospital in India

    Directory of Open Access Journals (Sweden)

    Udita Naithani

    2011-01-01

    Full Text Available Background : The present audit was initiated to evaluate the knowledge, attitude, perception and acceptance of women toward labor analgesia and caesarean section, in a Medical College Hospital in Udaipur, India. Materials and Methods : A semi-structured interview of 200 antenatal women was conducted, to assess the knowledge, attitude and perception regarding labor analgesia and caesarean section (CS and to estimate the correlation of awareness and acceptability with demographic variables. The data were analyzed using Epi Info 6 and the Likert type scale (0 - 10, as also the chi square test, to calculate the statistical significance. Results : Most of the patients (n = 181, 90.50% were unaware of labor analgesia. When the option of labor analgesia was offered, only 23% (n = 46 accepted it and the most significant reason for refusal was to experience natural child birth (n = 114 / 154, 74.03%. An educational status of the graduate level had a positive impact on knowledge about labor analgesia (P = 0.0001. When the option for CS was offered, 73.50% women (n = 147; P = 0.008 refused and the most common reasons for refusal were fear of operation (53.06%, n = 78 and delay in resuming household work (46.26%, n = 68. Educational status up to the graduate level and previous surgical experience of CS had a positive correlation with preference for CS (P = 0.0092 and P = 0.0001, respectively. Conclusions : Awareness and acceptance for labor analgesia was relatively low among the prospective parturients. A higher level of education had a significant impact on their decisions regarding delivery.

  13. A comparative study of infusions of phenylephrine, ephedrine and phenylephrine plus ephedrine on maternal haemodynamics in elective caesarean section

    Directory of Open Access Journals (Sweden)

    Sabyasachi Das

    2011-01-01

    Full Text Available Introduction: This randomized double blind study was started with an objective of management of spinal anaesthesia-induced hypotension in elective caesarean section by combining two commonly used vasopressors - ephedrine and phenylephrine in half of their usual doses with an expectation of reducing their foetomaternal side effects. Methods: One hundred and thirty two patients were randomized into three groups to receive either 100 mg/ml phenylephrine (group-P, n=31 or 3 mg/ml ephedrine (group-E, n=33 or 50 mg phenylephrine plus 1.5 mg ephedrine/ml (group-PE, n=29. Immediately after spinal injection the study solution was started prophylactically in every patient at the rate of 40 ml/h. A predefined algorithm was used to adjust the infusion rate according to the systolic blood pressure (SBP. Results: Mean fall of SBP was significantly more in group-E than group-P (P=0.009 and group-PE (P=0.013. This was not significantly different when compared between group-P and group-PE (P=0.9. Episodes of hypotension and tachycardia were more in group-E than the other two groups. Statistically significant tachycardia was seen in Group-E than that in other two groups. Incidence of bradycardia and hypertension did not differ significantly among the groups. Maternal nausea and Apgar score were also comparable in three groups. Conclusion: Current study claims that prophylactic phenylephrine 100 mg/ml is a better choice than ephedrine (3 mg/ml or 50 mcg phenylephrine plus 1.5 mg ephedrine/ml in prevention of spinal anaesthesia-induced hypotension in elective caesarean section. Combination of two drugs in half the usual dose has no added advantage over phenylephrine, but this is better than ephedrine alone.

  14. Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Fyfe Elaine M

    2012-10-01

    Full Text Available Abstract Background Increasing rates of postpartum haemorrhage in developed countries over the past two decades are not explained by corresponding changes in risk factors and conjecture has been raised that maternal obesity may be responsible. Few studies investigating risk factors for PPH have included BMI or investigated PPH risk among nulliparous women. The aim of this study was to determine in a cohort of nulliparous women delivering at term whether overweight and obesity are independent risk factors for major postpartum haemorrhage (PPH ≥1000ml after vaginal and caesarean section delivery. Methods The study population was nulliparous singleton pregnancies delivered at term at National Women’s Hospital, Auckland, New Zealand from 2006 to 2009 (N=11,363. Multivariable logistic regression was adjusted for risk factors for major PPH. Results There were 7238 (63.7% women of normal BMI, 2631 (23.2% overweight and 1494 (13.1% obese. Overall, PPH rates were increased in overweight and obese compared with normal-weight women (n=255 [9.7%], n=233 [15.6%], n=524 [7.2%], p Conclusion Nulliparous obese women have a twofold increase in risk of major PPH compared to women with normal BMI regardless of mode of delivery. Higher rates of PPH among obese women are not attributable to their higher rates of caesarean delivery. Obesity is an important high risk factor for PPH, and the risk following vaginal delivery is emphasised. We recommend in addition to standard practice of active management of third stage of labour, there should be increased vigilance and preparation for PPH management in obese women.

  15. Fuzzy Wavenet (FWN classifier for medical images

    Directory of Open Access Journals (Sweden)

    Entather Mahos

    2005-01-01

    Full Text Available The combination of wavelet theory and neural networks has lead to the development of wavelet networks. Wavelet networks are feed-forward neural networks using wavelets as activation function. Wavelets networks have been used in classification and identification problems with some success. In this work we proposed a fuzzy wavenet network (FWN, which learns by common back-propagation algorithm to classify medical images. The library of medical image has been analyzed, first. Second, Two experimental tables’ rules provide an excellent opportunity to test the ability of fuzzy wavenet network due to the high level of information variability often experienced with this type of images. We have known that the wavelet transformation is more accurate in small dimension problem. But image processing is large dimension problem then we used neural network. Results are presented on the application on the three layer fuzzy wavenet to vision system. They demonstrate a considerable improvement in performance by proposed two table’s rule for fuzzy and deterministic dilation and translation in wavelet transformation techniques.

  16. Colorization by classifying the prior knowledge

    Institute of Scientific and Technical Information of China (English)

    DU Weiwei

    2011-01-01

    When a one-dimensional luminance scalar is replaced by a vector of a colorful multi-dimension for every pixel of a monochrome image,the process is called colorization.However,colorization is under-constrained.Therefore,the prior knowledge is considered and given to the monochrome image.Colorization using optimization algorithm is an effective algorithm for the above problem.However,it cannot effectively do with some images well without repeating experiments for confirming the place of scribbles.In this paper,a colorization algorithm is proposed,which can automatically generate the prior knowledge.The idea is that firstly,the prior knowledge crystallizes into some points of the prior knowledge which is automatically extracted by downsampling and upsampling method.And then some points of the prior knowledge are classified and given with corresponding colors.Lastly,the color image can be obtained by the color points of the prior knowledge.It is demonstrated that the proposal can not only effectively generate the prior knowledge but also colorize the monochrome image according to requirements of user with some experiments.

  17. A Neural Network Classifier of Volume Datasets

    CERN Document Server

    Zukić, Dženan; Kolb, Andreas

    2009-01-01

    Many state-of-the art visualization techniques must be tailored to the specific type of dataset, its modality (CT, MRI, etc.), the recorded object or anatomical region (head, spine, abdomen, etc.) and other parameters related to the data acquisition process. While parts of the information (imaging modality and acquisition sequence) may be obtained from the meta-data stored with the volume scan, there is important information which is not stored explicitly (anatomical region, tracing compound). Also, meta-data might be incomplete, inappropriate or simply missing. This paper presents a novel and simple method of determining the type of dataset from previously defined categories. 2D histograms based on intensity and gradient magnitude of datasets are used as input to a neural network, which classifies it into one of several categories it was trained with. The proposed method is an important building block for visualization systems to be used autonomously by non-experts. The method has been tested on 80 datasets,...

  18. Combining classifiers for robust PICO element detection

    Directory of Open Access Journals (Sweden)

    Grad Roland

    2010-05-01

    Full Text Available Abstract Background Formulating a clinical information need in terms of the four atomic parts which are Population/Problem, Intervention, Comparison and Outcome (known as PICO elements facilitates searching for a precise answer within a large medical citation database. However, using PICO defined items in the information retrieval process requires a search engine to be able to detect and index PICO elements in the collection in order for the system to retrieve relevant documents. Methods In this study, we tested multiple supervised classification algorithms and their combinations for detecting PICO elements within medical abstracts. Using the structural descriptors that are embedded in some medical abstracts, we have automatically gathered large training/testing data sets for each PICO element. Results Combining multiple classifiers using a weighted linear combination of their prediction scores achieves promising results with an f-measure score of 86.3% for P, 67% for I and 56.6% for O. Conclusions Our experiments on the identification of PICO elements showed that the task is very challenging. Nevertheless, the performance achieved by our identification method is competitive with previously published results and shows that this task can be achieved with a high accuracy for the P element but lower ones for I and O elements.

  19. Fault diagnosis with the Aladdin transient classifier

    Science.gov (United States)

    Roverso, Davide

    2003-08-01

    The purpose of Aladdin is to assist plant operators in the early detection and diagnosis of faults and anomalies in the plant that either have an impact on the plant performance, or that could lead to a plant shutdown or component damage if allowed to go unnoticed. The kind of early fault detection and diagnosis performed by Aladdin is aimed at allowing more time for decision making, increasing the operator awareness, reducing component damage, and supporting improved plant availability and reliability. In this paper we describe in broad lines the Aladdin transient classifier, which combines techniques such as recurrent neural network ensembles, Wavelet On-Line Pre-processing (WOLP), and Autonomous Recursive Task Decomposition (ARTD), in an attempt to improve the practical applicability and scalability of this type of systems to real processes and machinery. The paper focuses then on describing an application of Aladdin to a Nuclear Power Plant (NPP) through the use of the HAMBO experimental simulator of the Forsmark 3 boiling water reactor NPP in Sweden. It should be pointed out that Aladdin is not necessarily restricted to applications in NPPs. Other types of power plants, or even other types of processes, can also benefit from the diagnostic capabilities of Aladdin.

  20. Is it important to classify ischaemic stroke?

    LENUS (Irish Health Repository)

    Iqbal, M

    2012-02-01

    Thirty-five percent of all ischemic events remain classified as cryptogenic. This study was conducted to ascertain the accuracy of diagnosis of ischaemic stroke based on information given in the medical notes. It was tested by applying the clinical information to the (TOAST) criteria. Hundred and five patients presented with acute stroke between Jan-Jun 2007. Data was collected on 90 patients. Male to female ratio was 39:51 with age range of 47-93 years. Sixty (67%) patients had total\\/partial anterior circulation stroke; 5 (5.6%) had a lacunar stroke and in 25 (28%) the mechanism of stroke could not be identified. Four (4.4%) patients with small vessel disease were anticoagulated; 5 (5.6%) with atrial fibrillation received antiplatelet therapy and 2 (2.2%) patients with atrial fibrillation underwent CEA. This study revealed deficiencies in the clinical assessment of patients and treatment was not tailored to the mechanism of stroke in some patients.

  1. Classifying Unidentified Gamma-ray Sources

    CERN Document Server

    Salvetti, David

    2016-01-01

    During its first 2 years of mission the Fermi-LAT instrument discovered more than 1,800 gamma-ray sources in the 100 MeV to 100 GeV range. Despite the application of advanced techniques to identify and associate the Fermi-LAT sources with counterparts at other wavelengths, about 40% of the LAT sources have no a clear identification remaining "unassociated". The purpose of my Ph.D. work has been to pursue a statistical approach to identify the nature of each Fermi-LAT unassociated source. To this aim, we implemented advanced machine learning techniques, such as logistic regression and artificial neural networks, to classify these sources on the basis of all the available gamma-ray information about location, energy spectrum and time variability. These analyses have been used for selecting targets for AGN and pulsar searches and planning multi-wavelength follow-up observations. In particular, we have focused our attention on the search of possible radio-quiet millisecond pulsar (MSP) candidates in the sample of...

  2. Optimized Radial Basis Function Classifier for Multi Modal Biometrics

    Directory of Open Access Journals (Sweden)

    Anand Viswanathan

    2014-07-01

    Full Text Available Biometric systems can be used for the identification or verification of humans based on their physiological or behavioral features. In these systems the biometric characteristics such as fingerprints, palm-print, iris or speech can be recorded and are compared with the samples for the identification or verification. Multimodal biometrics is more accurate and solves spoof attacks than the single modal bio metrics systems. In this study, a multimodal biometric system using fingerprint images and finger-vein patterns is proposed and also an optimized Radial Basis Function (RBF kernel classifier is proposed to identify the authorized users. The extracted features from these modalities are selected by PCA and kernel PCA and combined to classify by RBF classifier. The parameters of RBF classifier is optimized by using BAT algorithm with local search. The performance of the proposed classifier is compared with the KNN classifier, Naïve Bayesian classifier and non-optimized RBF classifier.

  3. MISR Level 2 TOA/Cloud Classifier parameters V003

    Data.gov (United States)

    National Aeronautics and Space Administration — This is the Level 2 TOA/Cloud Classifiers Product. It contains the Angular Signature Cloud Mask (ASCM), Regional Cloud Classifiers, Cloud Shadow Mask, and...

  4. Method of generating features optimal to a dataset and classifier

    Energy Technology Data Exchange (ETDEWEB)

    Bruillard, Paul J.; Gosink, Luke J.; Jarman, Kenneth D.

    2016-10-18

    A method of generating features optimal to a particular dataset and classifier is disclosed. A dataset of messages is inputted and a classifier is selected. An algebra of features is encoded. Computable features that are capable of describing the dataset from the algebra of features are selected. Irredundant features that are optimal for the classifier and the dataset are selected.

  5. Recognition of pornographic web pages by classifying texts and images.

    Science.gov (United States)

    Hu, Weiming; Wu, Ou; Chen, Zhouyao; Fu, Zhouyu; Maybank, Steve

    2007-06-01

    With the rapid development of the World Wide Web, people benefit more and more from the sharing of information. However, Web pages with obscene, harmful, or illegal content can be easily accessed. It is important to recognize such unsuitable, offensive, or pornographic Web pages. In this paper, a novel framework for recognizing pornographic Web pages is described. A C4.5 decision tree is used to divide Web pages, according to content representations, into continuous text pages, discrete text pages, and image pages. These three categories of Web pages are handled, respectively, by a continuous text classifier, a discrete text classifier, and an algorithm that fuses the results from the image classifier and the discrete text classifier. In the continuous text classifier, statistical and semantic features are used to recognize pornographic texts. In the discrete text classifier, the naive Bayes rule is used to calculate the probability that a discrete text is pornographic. In the image classifier, the object's contour-based features are extracted to recognize pornographic images. In the text and image fusion algorithm, the Bayes theory is used to combine the recognition results from images and texts. Experimental results demonstrate that the continuous text classifier outperforms the traditional keyword-statistics-based classifier, the contour-based image classifier outperforms the traditional skin-region-based image classifier, the results obtained by our fusion algorithm outperform those by either of the individual classifiers, and our framework can be adapted to different categories of Web pages.

  6. Development of a combined GIS, neural network and Bayesian classifier methodology for classifying remotely sensed data

    Science.gov (United States)

    Schneider, Claudio Albert

    This research is aimed at the solution of two common but still largely unsolved problems in the classification of remotely sensed data: (1) Classification accuracy of remotely sensed data decreases significantly in mountainous terrain, where topography strongly influences the spectral response of the features on the ground; and (2) when attempting to obtain more detailed classifications, e.g. forest cover types or species, rather than just broad categories of forest such as coniferous or deciduous, the accuracy of the classification generally decreases significantly. The main objective of the study was to develop a widely applicable and efficient classification procedure for mapping forest and other cover types in mountainous terrain, using an integrated GIS/neural network/Bayesian classification approach. The performance of this new technique was compared to a standard supervised Maximum Likelihood classification technique, a "conventional" Bayesian/Maximum Likelihood classification, and to a "conventional" neural network classifier. Results indicate a considerable improvement of the new technique over the standard Maximum Likelihood classification technique, as well as a better accuracy than the "conventional" Bayesian/Maximum Likelihood classifier (13.08 percent improvement in overall accuracy), but the "conventional" neural network classifiers outperformed all the techniques compared in this study, with an overall accuracy improvement of 15.94 percent as compared to the standard Maximum Likelihood classifier (from 46.77 percent to 62.71 percent). However, the overall accuracies of all the classification techniques compared in this study were relative low. It is believed that this was caused by problems related to the inadequacy of the reference data. On the other hand, the results also indicate the need to develop a different sampling design to more effectively cover the variability across all the parameters needed by the neural network classification technique

  7. Counting, Measuring And The Semantics Of Classifiers

    Directory of Open Access Journals (Sweden)

    Susan Rothstein

    2010-12-01

    Full Text Available This paper makes two central claims. The first is that there is an intimate and non-trivial relation between the mass/count distinction on the one hand and the measure/individuation distinction on the other: a (if not the defining property of mass nouns is that they denote sets of entities which can be measured, while count nouns denote sets of entities which can be counted. Crucially, this is a difference in grammatical perspective and not in ontological status. The second claim is that the mass/count distinction between two types of nominals has its direct correlate at the level of classifier phrases: classifier phrases like two bottles of wine are ambiguous between a counting, or individuating, reading and a measure reading. On the counting reading, this phrase has count semantics, on the measure reading it has mass semantics.ReferencesBorer, H. 1999. ‘Deconstructing the construct’. In K. Johnson & I. Roberts (eds. ‘Beyond Principles and Parameters’, 43–89. Dordrecht: Kluwer publications.Borer, H. 2008. ‘Compounds: the view from Hebrew’. In R. Lieber & P. Stekauer (eds. ‘The Oxford Handbook of Compounds’, 491–511. Oxford: Oxford University Press.Carlson, G. 1977b. Reference to Kinds in English. Ph.D. thesis, University of Massachusetts at Amherst.Carlson, G. 1997. Quantifiers and Selection. Ph.D. thesis, University of Leiden.Carslon, G. 1977a. ‘Amount relatives’. Language 53: 520–542.Chierchia, G. 2008. ‘Plurality of mass nouns and the notion of ‘semantic parameter”. In S. Rothstein (ed. ‘Events and Grammar’, 53–103. Dordrecht: Kluwer.Danon, G. 2008. ‘Definiteness spreading in the Hebrew construct state’. Lingua 118: 872–906.http://dx.doi.org/10.1016/j.lingua.2007.05.012Gillon, B. 1992. ‘Toward a common semantics for English count and mass nouns’. Linguistics and Philosophy 15: 597–640.http://dx.doi.org/10.1007/BF00628112Grosu, A. & Landman, F. 1998. ‘Strange relatives of the third kind

  8. A new approach to classifier fusion based on upper integral.

    Science.gov (United States)

    Wang, Xi-Zhao; Wang, Ran; Feng, Hui-Min; Wang, Hua-Chao

    2014-05-01

    Fusing a number of classifiers can generally improve the performance of individual classifiers, and the fuzzy integral, which can clearly express the interaction among the individual classifiers, has been acknowledged as an effective tool of fusion. In order to make the best use of the individual classifiers and their combinations, we propose in this paper a new scheme of classifier fusion based on upper integrals, which differs from all the existing models. Instead of being a fusion operator, the upper integral is used to reasonably arrange the finite resources, and thus to maximize the classification efficiency. By solving an optimization problem of upper integrals, we obtain a scheme for assigning proportions of examples to different individual classifiers and their combinations. According to these proportions, new examples could be classified by different individual classifiers and their combinations, and the combination of classifiers that specific examples should be submitted to depends on their performance. The definition of upper integral guarantees such a conclusion that the classification efficiency of the fused classifier is not less than that of any individual classifier theoretically. Furthermore, numerical simulations demonstrate that most existing fusion methodologies, such as bagging and boosting, can be improved by our upper integral model.

  9. O neoliberalismo na America Latina

    OpenAIRE

    David Ibarra

    2011-01-01

    Neoliberalism in Latin America. Neoliberalism and globalization had decisive influence in shaping public policies both internal and foreign in Latin America. Less state, trade and market freedoms, social goals subordinated to economic criteria, are part and parcel of the neoliberal utopia. Price stability was erected as the main social objective; import substitution resulted replaced by exports as the main source of growth. The neoliberal net results as applied to Latin America are: less grow...

  10. An America unknown

    OpenAIRE

    2010-01-01

    If we consider that the Spanish chroniclers had gradually invented what eventually became America, as O'Gorman proposed, the Portuguese chroniclers of the first half of the 16th century were even more cautious in building an identity for the overseas territories visited by Columbus and Cabral. These sixteenth century chroniclers, focusing on Asia, only later ceased to think of this "almost other world" as a place of passage, to think of it as a place to stop. Disregarding the surprised tone o...

  11. Pensamento da America

    OpenAIRE

    2013-01-01

    Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas, Programa de Pós-Graduação em História, Florianópolis, 2013. Esta dissertação objetivou investigar a atividade editorial de Rui Ribeiro Couto e Renato Costa Almeida enquanto estes intelectuais estiveram à frente do Pensamento da America, uma publicação mensal vinculada ao A Manhã, jornal porta voz do Estado Novo. Este suplemento panamericano veio a público entre 1941 e 1949, no entanto a...

  12. Mosques in North America

    Directory of Open Access Journals (Sweden)

    Omar Khalidi

    2008-12-01

    Full Text Available The following article derived from an exhibit catalogue put together by Public Affairs Germany in the U.S. Embassy in Berlin and the U.S. Consulates in Frankfurt and Düsseldorf and accompanied Dr. Omar Khalidi’s photo exhibit “Mosques in America.” There are over 2,000 mosques in the United States, mostly housed in buildings originally built for other purposes. American mosques built in the last few decades, however, in the period in which Islam has begun to feel at home in the United States, are almost universally architect-designed.

  13. Eating in America

    Institute of Scientific and Technical Information of China (English)

    康海燕

    2007-01-01

    Americans are too busy to cook at home.They often eat outside.Eating culture is one of the important parts in America.There are many kinds of restaurants.Some are open for breakfast. Others are open twenty-four hours a day. A number of restaurants call themselves"family restaurants".They serve no alcohol~* and have fairly restricted~* menus.They serve steaks,hamburgers and sandwiches.Besides these,there are some special restaurants.They serve only or mainly steaks,seafood,etc.

  14. Let's Go to America!

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

      The United States and China have signed an agreement to facilitate Chinese group leisure travel to the United States. This agreement provides the necessary framework to permit group leisure travel from China to the United States. U.S. companies can now enter into business relationships with Chinese travel agencies to organize and market travel packages for group leisure travel to the United States. It also attracts more and more Chinese to go to America, as more and more convenience and comforts are coming up during the travel.……

  15. Let's Go to America!

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The United States and China have signed an agreement to facilitate Chinese group leisure travel to the United States. This agreement provides the necessary framework to permit group leisure travel from China to the United States. U.S. companies can now enter into business relationships with Chinese travel agencies to organize and market travel packages for group leisure travel to the United States. It also attracts more and more Chinese to go to America, as more and more convenience and comforts are coming up during the travel.

  16. BAT-BORNE RABIES IN LATIN AMERICA

    Directory of Open Access Journals (Sweden)

    Luis E. Escobar

    2015-02-01

    Full Text Available The situation of rabies in America is complex: rabies in dogs has decreased dramatically, but bats are increasingly recognized as natural reservoirs of other rabies variants. Here, bat species known to be rabies-positive with different antigenic variants, are summarized in relation to bat conservation status across Latin America. Rabies virus is widespread in Latin American bat species, 22.5%75 of bat species have been confirmed as rabies-positive. Most bat species found rabies positive are classified by the International Union for Conservation of Nature as “Least Concern”. According to diet type, insectivorous bats had the most species known as rabies reservoirs, while in proportion hematophagous bats were the most important. Research at coarse spatial scales must strive to understand rabies ecology; basic information on distribution and population dynamics of many Latin American and Caribbean bat species is needed; and detailed information on effects of landscape change in driving bat-borne rabies outbreaks remains unassessed. Finally, integrated approaches including public health, ecology, and conservation biology are needed to understand and prevent emergent diseases in bats.

  17. Intramuscular adrenaline does not reduce the incidence of respiratory distress and hypoglycaemia in neonates delivered by elective caesarean section at term

    DEFF Research Database (Denmark)

    Pedersen, Pernille; Avlund, O L; Pedersen, B L

    2008-01-01

    AIM: To test whether intramuscular injection of 30 microg adrenaline decreased the incidence of respiratory distress and hypoglycaemia in term infants delivered by elective caesarean section before active labour. METHOD: The study was randomised and double-blinded. A total of 270 neonates were...... assigned to intramuscular treatment with saline (0.30 ml) or 30 microg adrenaline (0.30 ml) immediately after birth. The primary endpoint was referral to the neonatal ward because of respiratory distress or a blood glucose level ... of respiratory distress and hypoglycaemia was 14% among infants treated with adrenaline compared with 7% in those who received saline injection (p = 0.048). CONCLUSION: Intramuscular injection of 30 microg adrenaline does not reduce the incidence of respiratory distress or hypoglycaemia after elective caesarean...

  18. A brief study on status and reason of caesarean section and its effect%浅谈剖宫产率增高的原因及对策

    Institute of Scientific and Technical Information of China (English)

    吴少平; 陈婉; 黄芳

    2010-01-01

    Objective To study the status and reason of caesarean section and its effect to obstetrics and gynecology department. Methods Caesarean section was the effective method to solve dystocia and some high risk pregnancy before 1980s. With the improving of anesthesia,caesarean section and newborn rescue technology, the cesarean rate was increased year after year. Results There were many reasons, the main one was the social factors, secondly, the diagnostic technique was improved and the reducing application of the vagina deliver technique, etc. ,There were man y complications after caesarean section, and the maternal mortality was higher than that of vaginal spontaneous labour. Conclusion Doctors are expected to correctly master the operative indication for caesare an section, increase vagina deliver technique, reduce cesarean section rate and improve obstetric quality.%20世纪80年代之前剖宫产是解决难产及解决某些高危妊娠的有效方法.随着麻醉,削宫产及新生儿抢救技术的提高,剖宫产率逐年增高.原因很多,主要原因有社会因素,其次是诊疗技术的提高以及阴道助产技术的减少等,削官产术后的并发症较多,产妇死亡率较阴道分娩高,希望临床产科医生正确掌握削宫产的手术指征,提高阴道助产技术,降低剖宫产率,提高产科质量.

  19. 护理干预对基层医院剖宫产率的影响%Influence of nursing intervention on caesarean section rate in grassroots hospitals

    Institute of Scientific and Technical Information of China (English)

    张小绸; 钟小洁; 陈娇娇; 黄晓秋; 张小央

    2009-01-01

    Objective To observe the effect of nursing intervention on caesarean section rate in grass-roots hospitals. Methods 240 parturient women who were to infanticipate were divided into the experimental group and the control group with 120 patients in each group according to hospitalization sequence. Parturient women in the experimental group received nursing intervention with new nursing model during the delivery, while women in the control group just finished parturition using routine procedures. The caesarean section rate of the two groups were compared with χ2 test. Results The caesarean section rate of parturient women in the experimental group was significantly lower than that in the control group. Conclusions Nursing inter-vention has certain effect on decreasing the caesarean section rate in grassroots hospitals.%目的 观察护理干预对基层医院剖宫产率的影响.方法 选择240例待分娩产妇,按住院顺序随机分成实验组和对照组各120例.实验组产妇在整个分娩过程中,采用护理新模式给予护理干预.对照组产妇只按常规程序分娩.比较2组产妇的剖官产率,进行χ2检验.结果 实验组产妇剖官产率明显低于对照组.结论 护理干预对降低基层医院剖宫产率有一定的影响.

  20. Image Classifying Registration and Dynamic Region Merging

    Directory of Open Access Journals (Sweden)

    Himadri Nath Moulick

    2013-07-01

    Full Text Available In this paper, we address a complex image registration issue arising when the dependencies between intensities of images to be registered are not spatially homogeneous. Such a situation is frequentlyencountered in medical imaging when a pathology present in one of the images modifies locally intensity dependencies observed on normal tissues. Usual image registration models, which are based on a single global intensity similarity criterion, fail to register such images, as they are blind to local deviations of intensity dependencies. Such a limitation is also encountered in contrast enhanced images where there exist multiple pixel classes having different properties of contrast agent absorption. In this paper, we propose a new model in which the similarity criterion is adapted locally to images by classification of image intensity dependencies. Defined in a Bayesian framework, the similarity criterion is a mixture of probability distributions describing dependencies on two classes. The model also includes a class map which locates pixels of the two classes and weights the two mixture components. The registration problem is formulated both as an energy minimization problem and as a Maximum A Posteriori (MAP estimation problem. It is solved using a gradient descent algorithm. In the problem formulation and resolution, the image deformation and the class map are estimated at the same time, leading to an original combination of registration and classification that we call image classifying registration. Whenever sufficient information about class location is available in applications, the registration can also be performed on its own by fixing a given class map. Finally, we illustrate the interest of our model on two real applications from medical imaging: template-based segmentation of contrast-enhanced images and lesion detection in mammograms. We also conduct an evaluation of our model on simulated medical data and show its ability to take into

  1. Pulse contour analysis calibrated by Trans-pulmonar thermodilution (Picco Plus ® for the perioperative management of a caesarean section in a patient with severe cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Nicolas Brogly

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND: The delivery of cardiac patients is a challenge for the anaesthesiologist, to whom the welfare of both the mother and the foetus is a main issue. In case of caesarean section, advanced monitoring allows to optimize haemodynamic condition and to improve morbidity and mortality. OBJECTIVE: To describe the use of pulse contour analysis calibrated by Trans-pulmonar thermodilution (Picco Plus® for the perioperative management of a caesarean section in a patient with severe cardiomyopathy. CASE REPORT: We describe the case of a 28-year-old woman with a congenital heart disease who was submitted to a caesarean section under general anaesthesia for maternal pathology and foetal breech presentation. Intra- and post-operative management was optimized by advanced haemodynamic monitorization obtained by pulse contour wave analysis and thermodilution calibration (Picco Plus® monitor. The information about preload, myocardial contractility and postcharge was useful in guiding the fluid therapy and the use of vasoactive drugs. CONCLUSION: This case report illustrates the importance of advanced haemodynamic monitoring with an acceptably invasive device in obstetric patients with high cardiac risk. The increasing experience in advanced haemodynamic management will probably permit to decrease morbidity and mortality of obstetric patients in the future.

  2. Rule Based Ensembles Using Pair Wise Neural Network Classifiers

    Directory of Open Access Journals (Sweden)

    Moslem Mohammadi Jenghara

    2015-03-01

    Full Text Available In value estimation, the inexperienced people's estimation average is good approximation to true value, provided that the answer of these individual are independent. Classifier ensemble is the implementation of mentioned principle in classification tasks that are investigated in two aspects. In the first aspect, feature space is divided into several local regions and each region is assigned with a highly competent classifier and in the second, the base classifiers are applied in parallel and equally experienced in some ways to achieve a group consensus. In this paper combination of two methods are used. An important consideration in classifier combination is that much better results can be achieved if diverse classifiers, rather than similar classifiers, are combined. To achieve diversity in classifiers output, the symmetric pairwise weighted feature space is used and the outputs of trained classifiers over the weighted feature space are combined to inference final result. In this paper MLP classifiers are used as the base classifiers. The Experimental results show that the applied method is promising.

  3. Anaglyph, South America

    Science.gov (United States)

    2003-01-01

    This anaglyph (stereoscopic view) of South America was generated with data from the Shuttle Radar Topography Mission (SRTM). It is best viewed at or near full resolution with anaglyph glasses. For this broad view the resolution of the data was first reduced to 30 arcseconds (about 928 meters north-south but variable east-west), matching the best previously existing global digital topographic data set called GTOPO30. The data were then resampled to a Mercator projection with approximately square pixels (about one kilometer, or 0.6 miles, on each side). Even at this decreased resolution the variety of landforms comprising the South American continent is readily apparent.Topographic relief in South America is dominated by the Andes Mountains, which extend all along the Pacific Coast. These mountains are created primarily by the convergence of the Nazca and South American tectonic plates. The Nazca Plate, which underlies the eastern Pacific Ocean, slides under western South America resulting in crustal thickening, uplift, and volcanism. Another zone of plate convergence occurs along the northwestern coast of South America where the Caribbean Plate also slides under the South American Plate and forms the northeastern extension of the Andes Mountains.East of the Andes, much of northern South America drains into the Amazon River, the world's largest river in terms of both watershed area and flow volume. Topographic relief is very low in much of the Amazon Basin but SRTM data provide an excellent detailed look at the basin's three-dimensional drainage pattern, including the geologic structural trough (syncline) that hosts the eastern river channel.North of the Amazon, the Guiana Highlands commonly stand in sharp contrast to the surrounding lowlands, indeed hosting the world's tallest waterfall, Angel Falls (979 meters or 3212 feet). Folded and fractured bedrock structures are distinctive in the topographic pattern.South of the Amazon, the Brazilian Highlands show a mix of

  4. Locking in on Latin America

    Institute of Scientific and Technical Information of China (English)

    MICHAEL; RICE

    2006-01-01

    China cautious as it sets up generous investment in Latin America The United States is keeping a watchful eye as China bolsters political and economic ties with Latin America. The situation has U.S. political analysts trying to determine just how China s emerging influence

  5. Bayesian classifiers applied to the Tennessee Eastman process.

    Science.gov (United States)

    Dos Santos, Edimilson Batista; Ebecken, Nelson F F; Hruschka, Estevam R; Elkamel, Ali; Madhuranthakam, Chandra M R

    2014-03-01

    Fault diagnosis includes the main task of classification. Bayesian networks (BNs) present several advantages in the classification task, and previous works have suggested their use as classifiers. Because a classifier is often only one part of a larger decision process, this article proposes, for industrial process diagnosis, the use of a Bayesian method called dynamic Markov blanket classifier that has as its main goal the induction of accurate Bayesian classifiers having dependable probability estimates and revealing actual relationships among the most relevant variables. In addition, a new method, named variable ordering multiple offspring sampling capable of inducing a BN to be used as a classifier, is presented. The performance of these methods is assessed on the data of a benchmark problem known as the Tennessee Eastman process. The obtained results are compared with naive Bayes and tree augmented network classifiers, and confirm that both proposed algorithms can provide good classification accuracies as well as knowledge about relevant variables.

  6. Stochastic margin-based structure learning of Bayesian network classifiers.

    Science.gov (United States)

    Pernkopf, Franz; Wohlmayr, Michael

    2013-02-01

    The margin criterion for parameter learning in graphical models gained significant impact over the last years. We use the maximum margin score for discriminatively optimizing the structure of Bayesian network classifiers. Furthermore, greedy hill-climbing and simulated annealing search heuristics are applied to determine the classifier structures. In the experiments, we demonstrate the advantages of maximum margin optimized Bayesian network structures in terms of classification performance compared to traditionally used discriminative structure learning methods. Stochastic simulated annealing requires less score evaluations than greedy heuristics. Additionally, we compare generative and discriminative parameter learning on both generatively and discriminatively structured Bayesian network classifiers. Margin-optimized Bayesian network classifiers achieve similar classification performance as support vector machines. Moreover, missing feature values during classification can be handled by discriminatively optimized Bayesian network classifiers, a case where purely discriminative classifiers usually require mechanisms to complete unknown feature values in the data first.

  7. Utilization of antenatal ultrasound scan and implications for caesarean section: a cross-sectional study in rural Eastern China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-04-01

    Full Text Available Abstract Background Antenatal ultrasound scan is a widely accepted component of antenatal care. Studies have looked at the relationship between ultrasound scanning and caesarean section (CS in certain groups of women in China. However, there are limited data on the utilization of antenatal ultrasound scanning in the general population, including its association with CS. The purpose of this study is to describe the utilization of antenatal ultrasound screening in rural Eastern China and to explore the association between antenatal ultrasound scan and uptake of CS. Methods Based on a cluster randomized sample, a total of 2326 women with childbirth participated in the study. A household survey was conducted to collect socio-economic information, obstetric history and utilization of maternal health services. Results Coverage of antenatal care was 96.8% (2251/2326. During antenatal care, 96.1% (2164/2251 women received ultrasound screening and the reported average number was 2.55. 46.8% women received at least 3 ultrasound scans and the maximum number reached 11. The CS rate was found to be 54.8% (1275/2326. After adjusting for socio-demographic and clinical variables, it showed a statistically significant association between antenatal ultrasound scans and uptake of CS by multivariate logistic regression model. High husband education level, high maternal age, having previous adverse pregnant outcome and pregnancy complications during the index pregnancy were also found to be risk factors of choosing a CS. Conclusions A high use of antenatal ultrasound scan in rural Eastern China is found and is influenced by socio-demographic and clinical factors. Evidence-based guidelines for antenatal ultrasound scans need to be developed and disseminated to clinicians including physicians, nurses and sonographers. Guidance about the appropriate use of ultrasound scans should also be shared with women in order to discourage unreasonable expectations and demands. It

  8. South America Geologic Map (geo6ag)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — South America is part of Region 6 (Central and South America) for the World Energy Assessment. The geologic map of South America was digitized so that we could use...

  9. Recognition of Arabic Sign Language Alphabet Using Polynomial Classifiers

    OpenAIRE

    2005-01-01

    Building an accurate automatic sign language recognition system is of great importance in facilitating efficient communication with deaf people. In this paper, we propose the use of polynomial classifiers as a classification engine for the recognition of Arabic sign language (ArSL) alphabet. Polynomial classifiers have several advantages over other classifiers in that they do not require iterative training, and that they are highly computationally scalable with the number of classes. Based on...

  10. Fermilab and Latin America

    Science.gov (United States)

    Lederman, Leon M.

    2006-09-01

    As Director of Fermilab, starting in 1979, I began a series of meetings with scientists in Latin America. The motivation was to stir collaboration in the field of high energy particle physics, the central focus of Fermilab. In the next 13 years, these Pan American Symposia stirred much discussion of the use of modern physics, created several groups to do collaborative research at Fermilab, and often centralized facilities and, today, still provides the possibility for much more productive North-South collaboration in research and education. In 1992, I handed these activities over to the AAAS, as President. This would, I hoped, broaden areas of collaboration. Such collaboration is unfortunately very sensitive to political events. In a rational world, it would be the rewards, cultural and economic, of collaboration that would modulate political relations. We are not there yet.

  11. 剖宫产术后高危妊娠药物流产临床分析%Clinical analysis of high risk medical abortion after caesarean section

    Institute of Scientific and Technical Information of China (English)

    胡乔飞; 方瑞娟; 陈素文; 李长东; 孟凡; 李军; 陈雁鸣

    2014-01-01

    Objective To analyze the high risk induced abortion inpatients after caesarean section in Beijing Ob-stetrics and Gynecology Hospital, and understand the status in order to put forward the countermeasures and effective con-traception measures. Methods One hundred and fifty cases of re-pregnant women who were treated by induced abortion associated with curettages (uterine aspiration) guided by B mode ultrasound were analyzed retrospectively from Jan-uary, 2012 to December, 2013. Results The success rate of abortion using Mifepristone and Carboprost methylate was 98.0%, the average vaginal bleeding was (36.5±10.3)ml, the average days in hospital were (4.3±1.2)d without evident com-plications. No significant differences were observed among the number of caesarean sections and educational levels and contraception conditions (P>0.05), but there was significant differences between the number of caesarean sections and the interval from the last caesarean section (P0.05), but there was significant differences between the number of caesarean sections and hemorrhage volume during abortion (P0.05);但不同剖宫产次数患者本次妊娠距离末次剖宫产时间的差异有统计学意义(P0.05);但不同剖宫产次数患者再次妊娠流产中出血量的差异有统计学意义(P<0.05),≥2次剖宫产术后再次妊娠患者流产中出血量明显增加。结论米非司酮配合卡前列甲酯结合B超下清宫术是终止剖宫产术后高危妊娠的有效方法;呼吁医疗机构大力宣传剖宫产术后避孕知识,落实科学有效的避孕方法。

  12. Elective caesarean section and neonatal respiratory diseases%择期剖宫分娩与新生儿呼吸系统疾病

    Institute of Scientific and Technical Information of China (English)

    岳少杰

    2011-01-01

    As an effective solution to high-risk pregnancy, dystocia and other obstetric critical diseases, the caesarean section plays an important role in reducing the perinatal morbidity and mortality. In spite of the effect of the eaesarean section on reducing the incidence of neonatal asphyxia, trauma and meeonium aspiration syndrome,however, recent studies found that it cannot reduce the neonatal mortality. Meanwhile, the elective caesarean can increase the probability of the occurrence of neonatal respiratory distress and of the admission to neonatal intensive care unit significantly. Based on the main types of respiratory diseases in term newborn infants caused by elective caesarean section, this paper briefly discusses the potential mechanisms and the principles of management for the respiratory diseases. The aims of this paper are lo increase the knowledge of adverse effects on the respiratory system caused by elective caesarean, and to reduce the occurrence of neonatal respiratory disease due to elective caesarean section, and to improve the prognosis.%剖宫分娩作为解决高危妊娠、难产等产科危重症的有效途径,在降低围产期母婴发病率和病死率中起着非常重要的作用.但近期研究发现剖宫分娩并未降低新生儿的死亡率,同时发现虽然剖宫分娩使新生儿窒息、创伤和胎粪吸入发生率降低,但择期剖宫分娩的新生儿发生呼吸窘迫和入住新生儿重症监护病房的概率明显增高.文章在简要介绍择期剖宫分娩足月儿出现呼吸系统疾病主要类型的基础上进一步讨论择期剖宫分娩的新生儿出现严重呼吸系统疾病的可能机制以及处理原则,以提高对择期剖宫分娩新生儿呼吸系统疾病的认识,减少择期剖宫分娩所致新生儿呼吸系统疾病的发生及改善预后.

  13. Construction of unsupervised sentiment classifier on idioms resources

    Institute of Scientific and Technical Information of China (English)

    谢松县; 王挺

    2014-01-01

    Sentiment analysis is the computational study of how opinions, attitudes, emotions, and perspectives are expressed in language, and has been the important task of natural language processing. Sentiment analysis is highly valuable for both research and practical applications. The focuses were put on the difficulties in the construction of sentiment classifiers which normally need tremendous labeled domain training data, and a novel unsupervised framework was proposed to make use of the Chinese idiom resources to develop a general sentiment classifier. Furthermore, the domain adaption of general sentiment classifier was improved by taking the general classifier as the base of a self-training procedure to get a domain self-training sentiment classifier. To validate the effect of the unsupervised framework, several experiments were carried out on publicly available Chinese online reviews dataset. The experiments show that the proposed framework is effective and achieves encouraging results. Specifically, the general classifier outperforms two baselines (a Naïve 50% baseline and a cross-domain classifier), and the bootstrapping self-training classifier approximates the upper bound domain-specific classifier with the lowest accuracy of 81.5%, but the performance is more stable and the framework needs no labeled training dataset.

  14. 6 CFR 7.23 - Emergency release of classified information.

    Science.gov (United States)

    2010-01-01

    ... Classified Information Non-disclosure Form. In emergency situations requiring immediate verbal release of... information through approved communication channels by the most secure and expeditious method possible, or...

  15. Wind Powering America Podcasts, Wind Powering America (WPA)

    Energy Technology Data Exchange (ETDEWEB)

    2012-04-01

    Wind Powering America and the National Association of Farm Broadcasters produce a series of radio interviews featuring experts discussing wind energy topics. The interviews are aimed at a rural stakeholder audience and are available as podcasts. On the Wind Powering America website, you can access past interviews on topics such as: Keys to Local Wind Energy Development Success, What to Know about Installing a Wind Energy System on Your Farm, and Wind Energy Development Can Revitalize Rural America. This postcard is a marketing piece that stakeholders can provide to interested parties; it will guide them to this online resource for podcast episodes.

  16. Multi-input distributed classifiers for synthetic genetic circuits.

    Directory of Open Access Journals (Sweden)

    Oleg Kanakov

    Full Text Available For practical construction of complex synthetic genetic networks able to perform elaborate functions it is important to have a pool of relatively simple modules with different functionality which can be compounded together. To complement engineering of very different existing synthetic genetic devices such as switches, oscillators or logical gates, we propose and develop here a design of synthetic multi-input classifier based on a recently introduced distributed classifier concept. A heterogeneous population of cells acts as a single classifier, whose output is obtained by summarizing the outputs of individual cells. The learning ability is achieved by pruning the population, instead of tuning parameters of an individual cell. The present paper is focused on evaluating two possible schemes of multi-input gene classifier circuits. We demonstrate their suitability for implementing a multi-input distributed classifier capable of separating data which are inseparable for single-input classifiers, and characterize performance of the classifiers by analytical and numerical results. The simpler scheme implements a linear classifier in a single cell and is targeted at separable classification problems with simple class borders. A hard learning strategy is used to train a distributed classifier by removing from the population any cell answering incorrectly to at least one training example. The other scheme implements a circuit with a bell-shaped response in a single cell to allow potentially arbitrary shape of the classification border in the input space of a distributed classifier. Inseparable classification problems are addressed using soft learning strategy, characterized by probabilistic decision to keep or discard a cell at each training iteration. We expect that our classifier design contributes to the development of robust and predictable synthetic biosensors, which have the potential to affect applications in a lot of fields, including that of

  17. Multi-input distributed classifiers for synthetic genetic circuits.

    Science.gov (United States)

    Kanakov, Oleg; Kotelnikov, Roman; Alsaedi, Ahmed; Tsimring, Lev; Huerta, Ramón; Zaikin, Alexey; Ivanchenko, Mikhail

    2015-01-01

    For practical construction of complex synthetic genetic networks able to perform elaborate functions it is important to have a pool of relatively simple modules with different functionality which can be compounded together. To complement engineering of very different existing synthetic genetic devices such as switches, oscillators or logical gates, we propose and develop here a design of synthetic multi-input classifier based on a recently introduced distributed classifier concept. A heterogeneous population of cells acts as a single classifier, whose output is obtained by summarizing the outputs of individual cells. The learning ability is achieved by pruning the population, instead of tuning parameters of an individual cell. The present paper is focused on evaluating two possible schemes of multi-input gene classifier circuits. We demonstrate their suitability for implementing a multi-input distributed classifier capable of separating data which are inseparable for single-input classifiers, and characterize performance of the classifiers by analytical and numerical results. The simpler scheme implements a linear classifier in a single cell and is targeted at separable classification problems with simple class borders. A hard learning strategy is used to train a distributed classifier by removing from the population any cell answering incorrectly to at least one training example. The other scheme implements a circuit with a bell-shaped response in a single cell to allow potentially arbitrary shape of the classification border in the input space of a distributed classifier. Inseparable classification problems are addressed using soft learning strategy, characterized by probabilistic decision to keep or discard a cell at each training iteration. We expect that our classifier design contributes to the development of robust and predictable synthetic biosensors, which have the potential to affect applications in a lot of fields, including that of medicine and industry.

  18. The Ten-Group Robson Classification: A Single Centre Approach Identifying Strategies to Optimise Caesarean Section Rates

    Science.gov (United States)

    Tanaka, Keisuke

    2017-01-01

    Caesarean section (CS) rates have been increasing worldwide and have caused concerns. For meaningful comparisons to be made World Health Organization recommends the use of the Ten-Group Robson classification as the global standard for assessing CS rates. 2625 women who birthed over a 12-month period were analysed using this classification. Women with previous CS (group 5) comprised 10.9% of the overall 23.5% CS rate. Women with one previous CS who did not attempt VBAC contributed 5.3% of the overall 23.5% CS rate. Second largest contributor was singleton nulliparous women with cephalic presentation at term (5.1% of the total 23.5%). Induction of labour was associated with higher CS rate (groups 1 and 3) (24.5% versus 11.9% and 6.2% versus 2.6%, resp.). For postdates IOL we recommend a gatekeeper booking system to minimise these being performed <41 weeks. We suggest setting up dedicated VBAC clinic to support for women with one previous CS. Furthermore review of definition of failure to progress in labour not only may lower CS rates in groups 1 and 2a but also would reduce the size of group 5 in the future. PMID:28167965

  19. The Ten-Group Robson Classification: A Single Centre Approach Identifying Strategies to Optimise Caesarean Section Rates

    Directory of Open Access Journals (Sweden)

    Keisuke Tanaka

    2017-01-01

    Full Text Available Caesarean section (CS rates have been increasing worldwide and have caused concerns. For meaningful comparisons to be made World Health Organization recommends the use of the Ten-Group Robson classification as the global standard for assessing CS rates. 2625 women who birthed over a 12-month period were analysed using this classification. Women with previous CS (group 5 comprised 10.9% of the overall 23.5% CS rate. Women with one previous CS who did not attempt VBAC contributed 5.3% of the overall 23.5% CS rate. Second largest contributor was singleton nulliparous women with cephalic presentation at term (5.1% of the total 23.5%. Induction of labour was associated with higher CS rate (groups 1 and 3 (24.5% versus 11.9% and 6.2% versus 2.6%, resp.. For postdates IOL we recommend a gatekeeper booking system to minimise these being performed <41 weeks. We suggest setting up dedicated VBAC clinic to support for women with one previous CS. Furthermore review of definition of failure to progress in labour not only may lower CS rates in groups 1 and 2a but also would reduce the size of group 5 in the future.

  20. Trends in caesarean section and instrumental deliveries in relation to Body Mass Index: a clinical survey during 1978 - 2001

    Directory of Open Access Journals (Sweden)

    Josefsson Ann

    2010-07-01

    Full Text Available Abstract Background During the last 20 years the rate of CS has increased in Sweden as it has in many other countries. The proportion of pregnant women suffering from a high BMI has also increased rapidly during the same time period. It would therefore be of interest to study both how and if these two observations are related to each other. The aim was therefore to study trends in mode of caesarean section (CS and instrumental deliveries among women in three BMI groups over a time span of almost 25 years with special focus on the observed body weight of pregnant women. Method The design is a retrospective cohort study using medical records of consecutively delivered women at two delivery wards in South East Sweden during the years 1978, 1986, 1992, 1997 and 2001. Results No significant time-trends were found for CS and instrumental delivery within each BMI-group for the time period studied. The proportion of women with BMI ≥ 25 delivered by means of CS or instrumental delivery increased quite dramatically from 1978 to 2001 (χ2 test for trend; p Conclusion Overweight and obese pregnant women constitute a rapidly growing proportion of the total number of CS and instrumental deliveries. Planning and allocation of health resources must be adjusted to this fact and its implications.

  1. The Effect of Channa striatus (Haruan Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women

    Directory of Open Access Journals (Sweden)

    Siti Zubaidah Ab Wahab

    2015-01-01

    Full Text Available Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES, wound cosmetic appearance based on visual analogue scale (VAS scores and patient satisfaction score (PSS, and safety profiles between C. striatus group and placebo group after six weeks of lower segment caesarean section (LSCS delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either the C. striatus group (500 mg daily or placebo group (500 mg of maltodextrin daily. 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain p=0.814 and WES p=0.160 between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p=0.014 and p<0.001, resp.. The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient’s satisfaction and is safe for human consumption.

  2. Does caesarean section negatively influence the post-partum prognosis of low back pain and pelvic pain during pregnancy?

    Science.gov (United States)

    Mogren, Ingrid M

    2007-01-01

    Low back and pelvic pain (LBPP) is prevalent during pregnancy and also post-partum. The aetiology is poorly understood. The aim of this study was to investigate possible associations between epidural or spinal anaesthesia and caesarean section (CS) with persistent LBPP half a year after pregnancy. In a previous questionnaire study (n=891) altogether 639 (72%) women had reported LBPP during pregnancy. We sent these respondents a second questionnaire at approximately 6 months post-delivery. The response rate was 72.6% (n=464). The respondents were divided into three groups reporting 'no pain', 'recurrent pain' and 'continuous pain' in relation to LBPP 6 months after delivery. Pearson's chi-square test was used to test the difference between groups and logistic regression analysis was performed. Forty percent of the respondents had received epidural anaesthesia (EDA) or spinal anaesthesia during delivery and 18.5% of women had been delivered by CS. Epidural or spinal anaesthesia was not associated with persistent LBPP. There was no significant difference in CS rates between different sub-groups. The risk of persistent LBPP was increased three- to fourfold in women delivered by elective CS compared with women delivered by emergency CS. Epidural or spinal anaesthesia was not associated with risk of persistent LBPP. Elective CS was associated with an increased risk of persistent LBPP. However, the results must be interpreted with caution because of a relatively small study sample.

  3. Credit Rating and Capital Structure: Evidence from Latin America

    Directory of Open Access Journals (Sweden)

    Dany Rogers

    2013-09-01

    Full Text Available This paper aims to analyze the impact of reclassifications trends in credit rating decisions in capital structure of listed non-financial companies in Latin America. To verify both the existence of this association were employed data belonging to all non-financial companies listed in Latin America, possessing ratings issued by the three major international ratings agencies international (i.e. Standard & Poor's, Moody's and Fitch in January, 2010. When considering data for the period 2001-2010, through analysis of panel data, the main results suggest that the reclassifications of ratings seem have no informational content to the capital structure decisions of firms. However, some results indicate that companies classified in the worst levels of risk, and which are on the verge of the rating reclassifications, tend to use more debt than other companies, suggesting the existence of market timing.

  4. Quantum classifying spaces and universal quantum characteristic classes

    CERN Document Server

    Durdevic, M

    1996-01-01

    A construction of the noncommutative-geometric counterparts of classical classifying spaces is presented, for general compact matrix quantum structure groups. A quantum analogue of the classical concept of the classifying map is introduced and analyzed. Interrelations with the abstract algebraic theory of quantum characteristic classes are discussed. Various non-equivalent approaches to defining universal characteristic classes are outlined.

  5. Classifying queries submitted to a vertical search engine

    NARCIS (Netherlands)

    Berendsen, R.; Kovachev, B.; Meij, E.; de Rijke, M.; Weerkamp, W.

    2011-01-01

    We propose and motivate a scheme for classifying queries submitted to a people search engine. We specify a number of features for automatically classifying people queries into the proposed classes and examine the eectiveness of these features. Our main nding is that classication is feasible and that

  6. 16 CFR 1610.4 - Requirements for classifying textiles.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Requirements for classifying textiles. 1610... REGULATIONS STANDARD FOR THE FLAMMABILITY OF CLOTHING TEXTILES The Standard § 1610.4 Requirements for classifying textiles. (a) Class 1, Normal Flammability. Class 1 textiles exhibit normal flammability and...

  7. Classifying spaces with virtually cyclic stabilizers for linear groups

    DEFF Research Database (Denmark)

    Degrijse, Dieter Dries; Köhl, Ralf; Petrosyan, Nansen

    2015-01-01

    We show that every discrete subgroup of GL(n, ℝ) admits a finite-dimensional classifying space with virtually cyclic stabilizers. Applying our methods to SL(3, ℤ), we obtain a four-dimensional classifying space with virtually cyclic stabilizers and a decomposition of the algebraic K-theory of its...

  8. 21 CFR 1402.4 - Information classified by another agency.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Information classified by another agency. 1402.4 Section 1402.4 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY MANDATORY DECLASSIFICATION REVIEW § 1402.4 Information classified by another agency. When a request is received for information that...

  9. 25 CFR 304.3 - Classifying and marking of silver.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Classifying and marking of silver. 304.3 Section 304.3 Indians INDIAN ARTS AND CRAFTS BOARD, DEPARTMENT OF THE INTERIOR NAVAJO, PUEBLO, AND HOPI SILVER, USE OF GOVERNMENT MARK § 304.3 Classifying and marking of silver. For the present the Indian Arts and Crafts...

  10. O neoliberalismo na America Latina

    Directory of Open Access Journals (Sweden)

    David Ibarra

    2011-06-01

    Full Text Available Neoliberalism in Latin America. Neoliberalism and globalization had decisive influence in shaping public policies both internal and foreign in Latin America. Less state, trade and market freedoms, social goals subordinated to economic criteria, are part and parcel of the neoliberal utopia. Price stability was erected as the main social objective; import substitution resulted replaced by exports as the main source of growth. The neoliberal net results as applied to Latin America are: less growth, deindustrialization, income concentration and precarious employments. Therefore, countries public policies should try to gain autonomy to use jointly markets and public intervention in a constructive and innovative fashion.

  11. Analysis of Sequence Based Classifier Prediction for HIV Subtypes

    Directory of Open Access Journals (Sweden)

    S. Santhosh Kumar

    2012-10-01

    Full Text Available Human immunodeficiency virus (HIV is a lent virus that causes acquired immunodeficiency syndrome (AIDS. The main drawback in HIV treatment process is its sub type prediction. The sub type and group classification of HIV is based on its genetic variability and location. HIV can be divided into two major types, HIV type 1 (HIV-1 and HIV type 2 (HIV-2. Many classifier approaches have been used to classify HIV subtypes based on their group, but some of cases are having two groups in one; in such cases the classification becomes more complex. The methodology used is this paper based on the HIV sequences. For this work several classifier approaches are used to classify the HIV1 and HIV2. For implementation of the work a real time patient database is taken and the patient records are experimented and the final best classifier is identified with quick response time and least error rate.

  12. Helioclimatology of the Americas

    Science.gov (United States)

    Nurtaev, B. S.; Yakubov, M.; Shermatov, E.

    2013-05-01

    During the last 4 billion years, the Earth's climate has changed many times. There have been periods of warming and there have been ice ages. These large-scale climatic changes are shaped by factors like the tilt of the Earth's axis and tectonic plate movement. These major changes were driven by cyclical changes in the Earth's orbit, which altered the distribution of solar energy between the seasons and across the Earth. Milankovitch cycles explain well changes in climate over periods hundreds of thousands of years and are related to ice age cycles, but these cycles cannot explain the current rapid warming. The Sun is the most driving force for causing climate change. Much of the Sun energy evaporates water and causes atmospheric convection. Solar radiation, general circulation of atmosphere, geographical location of continents, oceans and the largest forms of a relief are the primary factors influencing on climate of lands. The purpose of this study is to identify contribution of the Sun on climate variability in the two continents, North and South America during instrumental records of air temperature. There were compared air temperatures of different weather stations in dependence from solar activity during the period 1878-1996. The high correlation between averaged temperature and solar activity was found for many weather stations of Americas. Air temperature in dependence from solar activity over the period 1878-1996 can be described by following equations: In Buenos Aires: T° = 0,04W+ 15,05, r-0,9; Caracas, Venezuela: T° = 0,03W + 18,88, r-0,73; Cordoba, Argentina: T° = 0,03W + 16,16, r-0,93; New York, Central Park: T° = 0,04W + 9,86, r-0,82; Toronto, T = 0,03W+ 6,66, r-0,81; Santiago Pudahuel, T= 0,019W + 13, 01, r - 0, 91; Rio de Janeiro:T°= 0,02W + 21,95, r= 0,88; Mexico over 1923-1986, T°= 0,021W+ 14,05, r-0,78; Miami over 1902-1996, T = 0,012W + 12,87 r-0,75; In our study, we used stations with reasonably long, consistently measured time records

  13. North America and South America (NA-SA) neuropathy project.

    Science.gov (United States)

    Pasnoor, Mamatha; Nascimento, Osvaldo J M; Trivedi, Jaya; Wolfe, Gil I; Nations, Sharon; Herbelin, Laura; de Freitas, M G; Quintanilha, Giseli; Khan, Saud; Dimachkie, Mazen; Barohn, Richard

    2013-08-01

    Peripheral neuropathy is a common neurological disorder. There may be important differences and similarities in the diagnosis of peripheral neuropathy between North America (NA) and South America (SA). Neuromuscular databases were searched for neuropathy diagnosis at two North American sites, University of Kansas Medical Center and University of Texas Southwestern Medical Center, and one South American site, Federal Fluminense University in Brazil. All patients were included into one of the six major categories: immune-mediated, diabetic, hereditary, infectious/inflammatory, systemic/metabolic/toxic (not diabetic) and cryptogenic. A comparison of the number of patients in each category was made between North America and South America databases. Total number of cases in North America was 1090 and in South America was 1034 [immune-mediated: NA 215 (19.7%), SA 191 (18%); diabetic: NA 148 (13.5%), SA 236 (23%); hereditary: NA 292 (26.7%), SA 103 (10%); infectious/inflammatory: NA 53 (4.8%), SA 141 (14%); systemic/metabolic/toxic: NA 71 (6.5%), SA 124 (12%); cryptogenic: NA 311 (28.5%), SA 239 (23%)]. Some specific neuropathy comparisons were hereditary neuropathies [Charcot-Marie-Tooth (CMT) cases] in NA 246/292 (84.2%) and SA 60/103 (58%); familial amyloid neuropathy in SA 31/103 (30%) and none in NA. Among infectious neuropathies, cases of human T-lymphotropic virus type 1 (HTLV-1) neuropathy in SA were 36/141(25%), Chagas disease in SA were 13/141(9%) and none for either in NA; cases of neuropathy due to leprosy in NA were 26/53 (49%) and in SA were 39/141(28%). South American tertiary care centers are more likely to see patients with infectious, diabetic and hereditary disorders such as familial amyloid neuropathies. North American tertiary centers are more likely to see patients with CMT. Immune neuropathies and cryptogenic neuropathies were seen equally in North America and South America.

  14. America's Electricity Future

    Science.gov (United States)

    Aubrecht, Gordon

    2006-03-01

    Where will America's future electricity supply come from? According to Vice President Cheney's energy task force, the U.S. needs to build about one 1 GW generating facilty a week in perpetuity.^(1) What sort of facilities will they be? Can the economy sustain such growth? Are there other possibilities? One possibility that strikes a chord with physicists is conservation as a source of energy. In this regard, Vice President Cheney famously said that conservation is``a sign of personal virtue, but it is not a sufficient basis---all by itself---for a sound, comprehensive energy policy,''^(2) echoing the Ayn Rand Instituite's view that ``Conservation is not a long- or short-term solution to the energy crisis. Conservation is the un-American idea of resigning oneself to doing with less.''^(3) This poster will explore the possible energy futures, their advantages and disadvantages, with and without conservation. 1. National Energy Policy Development Group (R. Cheney, C. L. Powell, P. O'Neill, G. Norton, A. M. Veneman, D. L. Evans, N. Y. Mineta, S. Abraham, J. M. Allbaugh, C. T. Whitman, J. B. Bolten, M. E. Daniels, L. B. Lindsey, and R. Barrales), National Energy Policy: Report of the National Energy Policy Development Group, (Washington, DC: Government Printing Office, 2001). 2. M. Allen, ``Bush energy plan will emphasize production,'' The Washington Post, 1 May 2001 3. R. Pool, ``Saving power deemed immoral,'' The Los Angeles Times, 12 May 2001.

  15. An America unknown

    Directory of Open Access Journals (Sweden)

    Susani Silveira Lemos França

    2010-01-01

    Full Text Available If we consider that the Spanish chroniclers had gradually invented what eventually became America, as O'Gorman proposed, the Portuguese chroniclers of the first half of the 16th century were even more cautious in building an identity for the overseas territories visited by Columbus and Cabral. These sixteenth century chroniclers, focusing on Asia, only later ceased to think of this "almost other world" as a place of passage, to think of it as a place to stop. Disregarding the surprised tone of the letters and reports used as sources, and showing concern in giving Cabral's travels a specific place in the construction of Portuguese history, the explorers' adventures highlight the peculiarities of the lands and peoples that would later come to deserve special attention from their congeners. It is the place that the Portuguese sixteenth century chronicler has given to these territories, and the place that was fixed in the memory of the 16th century Portuguese, which are the aspects covered in this text.

  16. ScaleUp America Communities

    Data.gov (United States)

    Small Business Administration — SBA’s new ScaleUp America Initiative is designed to help small firms with high potential “scale up” and grow their businesses so that they will provide more jobs and...

  17. Crohn's & Colitis Foundation of America

    Science.gov (United States)

    ... enabled to enjoy the full interactive experience. Crohn's & Colitis Foundation of America Find a Doctor Find a ... Local Chapters News Events Search: What are Crohn's & Colitis? What is Crohn's Disease What is Ulcerative Colitis ...

  18. African Ethnobotany in the Americas

    Directory of Open Access Journals (Sweden)

    Egleé L. Zent

    2013-10-01

    Full Text Available Review of African Ethnobotany in the Americas. Edited by Robert Voeks and John Rashford. 2013. Springer. Pp. 429, 105 illustrations, 69 color illustrations. $49.95 (paperback. ISBN 978‐1461408352.

  19. Domestic Terrorism: Is America Prepared?

    Science.gov (United States)

    2001-04-01

    Luther King , Jr. were attempts to push America from a path it has chosen. Painfully, the United States has stood firm in the face of terrorism and not...terrorism in America. Cowardly acts of terrorism such as the assassination of President John F. Kennedy, President Abraham Lincoln, and Dr. (Rev) Martin ...there are over 500 racist and neo-Nazi groups and over 400 active militia groups espousing extreme antigovernment views as of 1999. These hate groups

  20. Malignancy and Abnormality Detection of Mammograms using Classifier Ensembling

    Directory of Open Access Journals (Sweden)

    Nawazish Naveed

    2011-07-01

    Full Text Available The breast cancer detection and diagnosis is a critical and complex procedure that demands high degree of accuracy. In computer aided diagnostic systems, the breast cancer detection is a two stage procedure. First, to classify the malignant and benign mammograms, while in second stage, the type of abnormality is detected. In this paper, we have developed a novel architecture to enhance the classification of malignant and benign mammograms using multi-classification of malignant mammograms into six abnormality classes. DWT (Discrete Wavelet Transformation features are extracted from preprocessed images and passed through different classifiers. To improve accuracy, results generated by various classifiers are ensembled. The genetic algorithm is used to find optimal weights rather than assigning weights to the results of classifiers on the basis of heuristics. The mammograms declared as malignant by ensemble classifiers are divided into six classes. The ensemble classifiers are further used for multiclassification using one-against-all technique for classification. The output of all ensemble classifiers is combined by product, median and mean rule. It has been observed that the accuracy of classification of abnormalities is more than 97% in case of mean rule. The Mammographic Image Analysis Society dataset is used for experimentation.

  1. Faint spatial object classifier construction based on data mining technology

    Science.gov (United States)

    Lou, Xin; Zhao, Yang; Liao, Yurong; Nie, Yong-ming

    2016-11-01

    Data mining can effectively obtain the faint spatial object's patterns and characteristics, the universal relations and other implicated data characteristics, the key of which is classifier construction. Faint spatial object classifier construction with spatial data mining technology for faint spatial target detection is proposed based on theoretical analysis of design procedures and guidelines in detail. For the one-sidedness weakness during dealing with the fuzziness and randomness using this method, cloud modal classifier is proposed. Simulating analyzing results indicate that this method can realize classification quickly through feature combination and effectively resolve the one-sidedness weakness problem.

  2. Representation of classifier distributions in terms of hypergeometric functions

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    This paper derives alternative analytical expressions for classifier product distributions in terms of Gauss hypergeometric function, 2F1, by considering feed distribution defined in terms of Gates-Gaudin-Schumann function and efficiency curve defined in terms of a logistic function. It is shown that classifier distributions under dispersed conditions of classification pivot at a common size and the distributions are difference similar.The paper also addresses an inverse problem of classifier distributions wherein the feed distribution and efficiency curve are identified from the measured product distributions without needing to know the solid flow split of particles to any of the product streams.

  3. A RANDOMIZED CLINICAL STUDY TO EVALUATE THE EFFECT OF INTRAVENOUS MAGNESIUM SULPHATE FOR POSTOPERATIVE PAIN RELIEF IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Jitendra

    2015-09-01

    Full Text Available BACKGROUND : In this randomized, double - blind, prospective study, we have evaluated the effect of i.v. infusion of magnesium sulphate during spinal anaesthesia, for postoperative pain relief in patients undergoing lower segment caesarean section. AIM : A comparative evaluation of intravenous magnesium sulphate for prevention of postoperative pain relief in lower segment caesarean section under spinal anaesthesia” . METHODS AND MATERIAL S : 60 female patients of ASA grade I and II of the age group 20 - 40 yrs., posted for lower segment caesarean section under spinal anaesthesia were selected after pre anaesthetic fitness. Randomly patient were divided into two groups (n=30 patients each group NS, and group MS to receive 100ml of 0.9% Normal saline and Magnesium sulphate 50mg kg - 1 in 100ml of 0.9% Normal saline respectively to be given over 15 min, 60min after performing spinal anaesthesia. After surgery, rescue analgesia in form of inj. tramadol 100 mg i.v was provided for the patients. The Postoperative pain scores, Rescue analgesic consumption, and incidences of sedation, shivering, dysrhythmia, bradycardia, and hypotension evaluated immediately after surgery, and at 30 min, 1, 2, 3, hrs. After surgery. STATISTICAL ANALYSIS: Results were expressed as mean and standard deviation. P value of <0.05 was considered statistically significant. RESULTS: IV Magnesium sulphate 50 mg kg - 1 bolus significantly prolonged duration of analgesia, superior quality of analgesia ( L ower VAS and significant reduction in postoperative analgesic requirement than normal saline under spinal anaesthesia. No significant hemodynamic and respiratory instability occurred with Magnesium Sulphate use. CONCLUSION: I.V. magnesium sulphate administration during spinal anaesthesia improves postoperative analge sia without any notable complications.

  4. Clinical analysis of caesarean section scar pregnancy 42 cases%42例剖宫产子宫切口疤痕妊娠的临床分析

    Institute of Scientific and Technical Information of China (English)

    张娜

    2014-01-01

    OBJECTIVE: The clinical features of caesarean section scar pregnancy and treatment were analyzed and discussed. Methods: 42 patients in our hospital caesarean section scar pregnancy patients, for example, clinical characteristics of al patients were analyzed, the implementation of targeted therapy. Results: The patients had a history of menopause, more performance for vaginal bleeding. Under section B surreal anterior muscular presence blob, ultrasonography showed the presence of clumps of color flow signals around. Al patients were discharged after treatment. Conclusion: For patients with previous caesarean section scar pregnancy, need to be implemented in the clinical condition of the patient for targeted therapy, diagnostics and strengthen efforts to reduce the rate of misdiagnosis.%目的:对剖宫产子宫切口疤痕妊娠的临床特点以及治疗进行分析和探讨。方法:选取我院收治的42例剖宫产子宫切口疤痕妊娠患者为例,对所有患者的临床特点进行分析,实施针对性治疗。结果:患者均存在停经史,多表现为阴道出血。B超现实前壁下段肌层存在团状物,彩超显示团块周围存在彩色血流信号。患者经治疗均全部出院。结论:对于剖宫产子宫切口疤痕妊娠患者,在临床上需要针对患者的病情实施针对性治疗,并加强诊断力度,减少误诊率。

  5. The Effect of the Combined Use of Methylergonovine and Oxytocin during Caesarean Section in the Prevention of Post-partum Haemorrhage.

    Science.gov (United States)

    Şentürk, Şenol; Kağıtçı, Mehmet; Balık, Gülşah; Arslan, Halit; Kır Şahin, Figen

    2016-05-01

    We aimed to show to patients the benefit of post-partum haemorrhage prophylaxis treatment and the effectiveness as a uterotonic agent of the combined use of methylergonovine and oxytocin infusion in the prevention of haemorrhage during and after Caesarean section, by comparison with a control group which received oxytocin infusion only. Two groups of patients undergoing Caesarean section at the same clinic were included in the study. A combination of methylergonovine and oxytocin was administered to the first group during the intra-operative and post-operative periods. The second group did not receive methylergonovine and was administered only with oxytocin infusion in the intra-operative and post-operative periods. Pre-operative and post-operative haemogram readings were taken for all patients in each of the groups for comparison. No difference was found between the two groups with regard to mean ages and pre-operative haemogram values. The decrease in post-operative haemoglobin values for the group administered with methylergonovine maleate and oxytocin was found to be significantly greater than for the group administered with oxytocin only. Results indicated that prophylactic methylergonovine treatment was clearly successful for the patients and no adverse side effects were found. The routine use of methylergonovine and oxytocin infusion in combination during the intra-operative period of Caesarean section reduced the level of post-partum haemorrhage considerably. We believe that this procedure will also reduce the risk of uterine atony, but clearly, prospective studies will be necessary in future to confirm this assumption.

  6. [Apgar status, blood gases and acid base balance of neonates after caesarean sections, using either thiopentone or ketamine for induction of anaesthesia (author's transl)].

    Science.gov (United States)

    Traub, E; Knoche, E; Dick, W; Völschow, E

    1977-04-01

    Apgar status and acid base balance of 206 neonates, delivered by caesarean section under general anaesthesia, were investigated in order to compare the possible effects of either thiopentone- or ketamine-induction on the postpartum adaption. Several other criteria were recorded also, for instance, a possible neonatal asphyxia, the induction-delivery-interval, the maternal age, the administration of other than anaesthetic drugs etc. There were not correlations between the Apgar status and the induction-delivery interval in either groups. The number of neonates within the 3 Apgar-classes, and the asphyxiated neonates, were equally distributed in the thiopentone- and ketamine-groups. There was no correlation between maternal ages and either the thiopentone- or ketamin-babies, but a marked correlation with the number of depressed newborns. Those neonates, who were suspected to be hypoxic before anaesthesia showed a more depressed post-partum respiration after thiopentone- than after ketamine-induction. On the other hand it seems to be that neonatal respiration and total Apgar status was more depressed if the "ketamin mothers" were treated with sedatives, hypnotics and/or analgesics before caesarean section. The blood gas values and the acid base parameters did not show a statistically significant difference between the pH of the thiopentone- and the ketamine-neonates. These differences can be explained as the combination of the nonsignificant changes in PCO2 and standard-bicarbonate values. As far as can be judged from the above mentioned criteria it may be deduced that ketamine or thiopentone can equally well be used for inducation of anaesthesia for caesarean section.

  7. A randomised controlled trial of opioid only versus combined opioid and non-steroidal anti inflammatory analgesics for pain relief in the first 48 hours after Caesarean section

    Directory of Open Access Journals (Sweden)

    Natalia Adamou

    2014-01-01

    Full Text Available Background: Post-Caesarean section pain is complex in nature, requiring a combination of pharmacological and non-pharmacological methods. Effective management of postoperative pain will reduce postoperative morbidity, hospital stay and cost. The objective of this study was to compare the clinical effectiveness and adverse effects of a combination of non-selective cyclooxygenase (COX inhibitor (Diclofenac sodium 50 mg and opioid (Pentazocine 60 mg to opiod only (Pentazocine 60 mg for pain management after Caesarean section (CS at Aminu Kano Teaching Hospital (AKTH. Materials and Methods: This was a randomised double-blind controlled study conducted at AKTH, Kano, Nigeria. A total of 166 patients scheduled to undergo either emergency or elective Caesarean section were studied. Group I received a combination of COX inhibitor and opiod while Group II received opiod only for pain management after CS. Results: The average age of the patients was 28.35 years (SD ± 6.426 in the group I and 26.9(SD ± 6.133 in group II. The mean parity was 3.27(SD ± 2.67 and 2.75(SD ± 2.14 while the mean gestational age at admission was 37.68(SD ± 2.69 and 38.18(SD ± 2.63 weeks in the first and second groups, respectively. Comparison of the level of pain experienced and patients satisfaction during the first 48 hours postoperatively revealed that the level of pain was statistically significantly less and patient′s satisfaction significantly better in group I compared to group II (P-value 0.00001. Conclusion: The use of combined compared to single agent analgesia is safe, significantly reduced pain and improved patient satisfaction after a caesarian section (CS.

  8. A decade of inequality in maternity care: antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991–2004

    Directory of Open Access Journals (Sweden)

    Ronsmans Carine

    2007-08-01

    Full Text Available Abstract Background Bangladesh is committed to the fifth Millennium Development Goal (MDG-5 target of reducing its maternal mortality ratio by three-quarters between 1990 and 2015. Since the early 1990s, Bangladesh has followed a strategy of improving access to facilities equipped and staffed to provide emergency obstetric care (EmOC. Methods We used data from four Demographic and Health Surveys conducted between 1993 and 2004 to examine trends in the proportions of live births preceded by antenatal consultation, attended by a health professional, and delivered by caesarean section, according to key socio-demographic characteristics. Results Utilization of antenatal care increased substantially, from 24% in 1991 to 60% in 2004. Despite a relatively greater increase in rural than urban areas, utilization remained much lower among the poorest rural women without formal education (18% compared with the richest urban women with secondary or higher education (99%. Professional attendance at delivery increased by 50% (from 9% to 14%, more rapidly in rural than urban areas, and caesarean sections trebled (from 2% to 6%, but these indicators remained low even by developing country standards. Within these trends there were huge inequalities; 86% of live births among the richest urban women with secondary or higher education were attended by a health professional, and 35% were delivered by caesarean section, compared with 2% and 0.1% respectively of live births among the poorest rural women without formal education. The trend in professional attendance was entirely confounded by socioeconomic and demographic changes, but education of the woman and her husband remained important determinants of utilization of obstetric services. Conclusion Despite commendable progress in improving uptake of antenatal care, and in equipping health facilities to provide emergency obstetric care, the very low utilization of these facilities, especially by poor women, is a

  9. ROPIVACAINE CONTINUOUS WOUND INFUSION VERSUS CONTINUOUS EPIDURAL VERSUS SYSTEMIC ANALGESIA FOR POST CAESAREAN DELIVERY UNDER SPINAL ANAESTHESIA: A PROSPECTIVE RANDOMISED CONTROLLED STUDY

    Directory of Open Access Journals (Sweden)

    Paleti

    2014-07-01

    Full Text Available BACKGROUND: Opioid based analgesic regimens have been the gold standard for post caesarean analgesia until recently. Regional techniques like local intra-wound infusion techniques are becoming popular now. Our aim is to evaluate the efficacy of 0.2% Ropivacaine continuous wound infusion versus continuous epidural versus conventional systemic analgesia for post caesarean delivery. METHODOLOGY: 60 healthy parturients of ASA I/II were randomized after elective caesarean section into 3 groups of 20 each. Group-A: Received 0.2% Ropivacaine via an epidural catheter placed into subcutaneous tissue and fascia before skin closure at the rate of 5ml/hr. through infusion pump. Group-B: Received 0.2% Ropivacaine continuous epidural infusion via an epidural catheter at the rate of 8ml/hr. An initial bolus of 10ml was given in groups A&B. Group-C: Received standard systemic analgesia with diclofenac sodium and rescue opioid. Post operatively parturients were assessed for VAS scores for pain at rest and during movement, total Ropivacaine consumption, Tramadol consumption and side effects. Data were analyzed using SPSS software version 22. RESULTS: There were no significant differences in the mean VAS scores at rest and at movement between groups A or B and C. The consumption of Tramadol was significantly greater in Group C (p value AC=0.025, BC=0.0000 than A or B. Mean Ropivacaine consumption is significantly higher in Group B (p=0.000 than Group A. CONCLUSION: Continuous local intra-wound analgesia with Ropivacaine produced comparable analgesia to that of continuous epidural and superior analgesia compared to standard systemic analgesia.

  10. Individual and institutional determinants of caesarean section in referral hospitals in Senegal and Mali: a cross-sectional epidemiological survey

    Directory of Open Access Journals (Sweden)

    Briand Valérie

    2012-10-01

    Full Text Available Abstract Background Two years after implementing the free-CS policy, we assessed the non-financial factors associated with caesarean section (CS in women managed by referral hospitals in Senegal and Mali. Methods We conducted a cross-sectional survey nested in a cluster trial (QUARITE trial in 41 referral hospitals in Senegal and Mali (10/01/2007–10/01/2008. Data were collected regarding women’s characteristics and on available institutional resources. Individual and institutional factors independently associated with emergency (before labour, intrapartum and elective CS were determined using a hierarchical logistic mixed model. Results Among 86 505 women, 14% delivered by intrapartum CS, 3% by emergency CS and 2% by elective CS. For intrapartum, emergency and elective CS, the main maternal risk factors were, respectively: previous CS, referral from another facility and suspected cephalopelvic-disproportion (adjusted Odds Ratios from 2.8 to 8.9; vaginal bleeding near full term, hypertensive disorders, previous CS and premature rupture of membranes (adjusted ORs from 3.9 to 10.2; previous CS (adjusted OR=19.2 [17.2-21.6]. Access to adult and neonatal intensive care, a 24-h/day anaesthetist and number of annual deliveries per hospital were independent factors that affected CS rates according to degree of urgency. The presence of obstetricians and/or medical-anaesthetists was associated with an increased risk of elective CS (adjusted ORs [95%CI] = 4.8 [2.6-8.8] to 9.4 [5.1-17.1]. Conclusions We confirm the significant effect of well-known maternal risk factors affecting the mode of delivery. Available resources at the institutional level and the degree of urgency of CS should be taken into account in analysing CS rates in this context.

  11. The application of the Ten Group classification system (TGCS in caesarean delivery case mix adjustment. A multicenter prospective study.

    Directory of Open Access Journals (Sweden)

    Gianpaolo Maso

    Full Text Available BACKGROUND: Caesarean delivery (CD rates are commonly used as an indicator of quality in obstetric care and risk adjustment evaluation is recommended to assess inter-institutional variations. The aim of this study was to evaluate whether the Ten Group classification system (TGCS can be used in case-mix adjustment. METHODS: Standardized data on 15,255 deliveries from 11 different regional centers were prospectively collected. Crude Risk Ratios of CDs were calculated for each center. Two multiple logistic regression models were herein considered by using: Model 1- maternal (age, Body Mass Index, obstetric variables (gestational age, fetal presentation, single or multiple, previous scar, parity, neonatal birth weight and presence of risk factors; Model 2- TGCS either with or without maternal characteristics and presence of risk factors. Receiver Operating Characteristic (ROC curves of the multivariate logistic regression analyses were used to assess the diagnostic accuracy of each model. The null hypothesis that Areas under ROC Curve (AUC were not different from each other was verified with a Chi Square test and post hoc pairwise comparisons by using a Bonferroni correction. RESULTS: Crude evaluation of CD rates showed all centers had significantly higher Risk Ratios than the referent. Both multiple logistic regression models reduced these variations. However the two methods ranked institutions differently: model 1 and model 2 (adjusted for TGCS identified respectively nine and eight centers with significantly higher CD rates than the referent with slightly different AUCs (0.8758 and 0.8929 respectively. In the adjusted model for TGCS and maternal characteristics/presence of risk factors, three centers had CD rates similar to the referent with the best AUC (0.9024. CONCLUSIONS: The TGCS might be considered as a reliable variable to adjust CD rates. The addition of maternal characteristics and risk factors to TGCS substantially increase the

  12. Intrathecal clonidine with hyperbaric bupivacaine administered as a mixture and sequentially in caesarean section: A randomised controlled study

    Directory of Open Access Journals (Sweden)

    Prachee Sachan

    2014-01-01

    Full Text Available Background and Aims: Mixing adjuvants with hyperbaric bupivacaine in a single syringe before injecting the drugs intrathecally is an age old practice. In doing so, the density of the hyperbaric solution and also of the adjuvant drugs may be altered, thus affecting the spread of drugs. Administering local anaesthetic and the adjuvants separately may minimise the effect of the changes in densities. We aimed to compare block characteristics, intraoperative haemodynamics and post-operative pain relief in parturients undergoing caesarean section (CS after administering hyperbaric bupivacaine and clonidine intrathecally as a mixture and sequentially. Methods: In this single-blind prospective randomised controlled study at a tertiary care centre from 2010 to 12, 60 full-term parturients scheduled for elective CSs were divided into two groups on the basis of technique of intrathecal drug administration. Group M received mixture of clonidine (75 mcg and hyperbaric bupivacaine 0.5% (10 mg intrathecally, whereas Group B received clonidine (75 mcg followed by hyperbaric bupivacaine 0.5% (10 mg through separate syringes. Observational descriptive statistics, analysis of variance test, Wilcoxon test and Chi-square test were used as applicable. Results: Duration of analgesia was significantly longer in Group B (474.33 ± 20.79 min in which the drug was given sequentially than in Group M (337 ± 18.22 min. Furthermore, the time to achieve highest sensory block and complete motor block was significantly less in Group B without any major haemodynamic instability and neonatal outcome. Conclusions: When clonidine and hyperbaric bupivacaine were administered in a sequential manner, block characteristics improved significantly compared to the administration of the mixture of the two drugs.

  13. Post operatory analgesia in caesarean surgery. Analgesia posoperatoria en la operación cesárea.

    Directory of Open Access Journals (Sweden)

    Rolando T. Espín González

    Full Text Available Background: Post-operatory pain is a spread and constant problem during the care of the surgical patient. The tendency to find new therapeutic techniques to alleviate pain has lead scientists to make and use a great variety of analgesics which are administered by different vias. The effects of narcotics on the new born are well known and the author´s worries about this problem has been the motivational point to search about the use of epidural and intratecal narcotics in the obstetric patient. Objective: To assess the use of peridural liophilized morphine in the Caesarean Section Method: A study of a series of cases was carried out at the Surgical Unit of the Gynecobstetric service of the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from February 2001 to August 2002 . This search included 120 patient who were selected to elective iterative caesarean section The variables under study were blood pressure, pulse and respiration during the pre- trans and post operative phases, onset of the anaesthetic effect and its duration, peri operatory complications , quality of the post operatory analgesia and its effect on the newborn measured by using Apgar values . The statistical procedure was developed by using the statistical package Epi Info 6. Results: The onset of the anesthetic effect and the duration of the anesthesia were not modified with the use of liophilized morphine. Vital signs remained within normal limits in most of the patients during the pre- trans and post operatory phases. The complications were: pruritus, urinary retention, nausea nad vomiting. The quality of the analgesia was satisfactory in most of the patients. The Apgar values were normal in all neonates. Conclusion: The administration of peridural liophilized morphine in elective caesarean sections is a reliable, sure and useful method in our environment.

  14. A NON-PARAMETER BAYESIAN CLASSIFIER FOR FACE RECOGNITION

    Institute of Scientific and Technical Information of China (English)

    Liu Qingshan; Lu Hanqing; Ma Songde

    2003-01-01

    A non-parameter Bayesian classifier based on Kernel Density Estimation (KDE)is presented for face recognition, which can be regarded as a weighted Nearest Neighbor (NN)classifier in formation. The class conditional density is estimated by KDE and the bandwidthof the kernel function is estimated by Expectation Maximum (EM) algorithm. Two subspaceanalysis methods-linear Principal Component Analysis (PCA) and Kernel-based PCA (KPCA)are respectively used to extract features, and the proposed method is compared with ProbabilisticReasoning Models (PRM), Nearest Center (NC) and NN classifiers which are widely used in facerecognition systems. The experiments are performed on two benchmarks and the experimentalresults show that the KDE outperforms PRM, NC and NN classifiers.

  15. NUMERICAL SIMULATION OF PARTICLE MOTION IN TURBO CLASSIFIER

    Institute of Scientific and Technical Information of China (English)

    Ning Xu; Guohua Li; Zhichu Huang

    2005-01-01

    Research on the flow field inside a turbo classifier is complicated though important. According to the stochastic trajectory model of particles in gas-solid two-phase flow, and adopting the PHOENICS code, numerical simulation is carried out on the flow field, including particle trajectory, in the inner cavity of a turbo classifier, using both straight and backward crooked elbow blades. Computation results show that when the backward crooked elbow blades are used, the mixed stream that passes through the two blades produces a vortex in the positive direction which counteracts the attached vortex in the opposite direction due to the high-speed turbo rotation, making the flow steadier, thus improving both the grade efficiency and precision of the turbo classifier. This research provides positive theoretical evidences for designing sub-micron particle classifiers with high efficiency and accuracy.

  16. 42 CFR 37.50 - Interpreting and classifying chest roentgenograms.

    Science.gov (United States)

    2010-10-01

    ... interpreted and classified in accordance with the ILO Classification system and recorded on a Roentgenographic... under the Act, shall have immediately available for reference a complete set of the ILO...

  17. A novel statistical method for classifying habitat generalists and specialists

    DEFF Research Database (Denmark)

    Chazdon, Robin L; Chao, Anne; Colwell, Robert K

    2011-01-01

    We develop a novel statistical approach for classifying generalists and specialists in two distinct habitats. Using a multinomial model based on estimated species relative abundance in two habitats, our method minimizes bias due to differences in sampling intensities between two habitat types...... as well as bias due to insufficient sampling within each habitat. The method permits a robust statistical classification of habitat specialists and generalists, without excluding rare species a priori. Based on a user-defined specialization threshold, the model classifies species into one of four groups...... fraction (57.7%) of bird species with statistical confidence. Based on a conservative specialization threshold and adjustment for multiple comparisons, 64.4% of tree species in the full sample were too rare to classify with confidence. Among the species classified, OG specialists constituted the largest...

  18. A semi-automated approach to building text summarisation classifiers

    Directory of Open Access Journals (Sweden)

    Matias Garcia-Constantino

    2012-12-01

    Full Text Available An investigation into the extraction of useful information from the free text element of questionnaires, using a semi-automated summarisation extraction technique, is described. The summarisation technique utilises the concept of classification but with the support of domain/human experts during classifier construction. A realisation of the proposed technique, SARSET (Semi-Automated Rule Summarisation Extraction Tool, is presented and evaluated using real questionnaire data. The results of this evaluation are compared against the results obtained using two alternative techniques to build text summarisation classifiers. The first of these uses standard rule-based classifier generators, and the second is founded on the concept of building classifiers using secondary data. The results demonstrate that the proposed semi-automated approach outperforms the other two approaches considered.

  19. 前置胎盘剖宫产产后出血的影响原因%Influence reasons of postpartum hemorrhage after placenta previa caesarean section

    Institute of Scientific and Technical Information of China (English)

    阙贵珍; 杨佩娴; 谭秀红

    2015-01-01

    目的:探讨前置胎盘剖宫产产后出血的影响原因。方法前置胎盘剖宫产产后出血的40例患者作为研究对象,分析导致产后出血的原因。结果中央型前置胎盘患者的出血量明显多于其他两种类型,有胎盘植入或粘连、有剖宫产史的患者出血量明显多于无胎盘植入或粘连和剖宫产史产妇,相比差异具有统计学意义(P<0.05);出血量与孕产妇年龄、胎盘附着部位、产妇流产频率无关。结论针对中央型前置胎盘,在产妇实施剖宫产手术时,需借助彩超对胎盘定位,确认子宫切口,从而确保手术的安全和新生儿的顺畅出生。%Objective To investigate the influence reasons of postpartum hemorrhage after placenta previa caesarean section. Methods There were 40 patients with postpartum hemorrhage after placenta previa caesarean section as the study subjects. Their causes of postpartum hemorrhage were analyzed. Results Patients with central placenta previa had larger bleeding volume than the other two types, and patients with history of placenta implantation, adhesion, and caesarean section had larger bleeding volume than patients without these history. The difference had statistical significance (P<0.05). Bleeding volume had no relationship with age, placenta adherent parts, and abortion frequency of pregnant women. Conclusion For central placenta previa in caesarean section, color Doppler ultrasound should be applied to positioning placenta and confirming uterine incision, so as to guarantee surgical and fetal safety.

  20. 前置胎盘合并剖宫产史临床分析%Clinical analysis of placenta previa complicated with previous caesarean section

    Institute of Scientific and Technical Information of China (English)

    马良坤; 韩娜; 杨剑秋; 边旭明; 刘俊涛

    2012-01-01

    目的 探讨前置胎盘合并剖宫产史患者的临床特点及处理.方法 回顾性分析2003年1月至2011年10月北京协和医院前置胎盘合并剖宫产史(再次剖宫产组,RCS组)患者母婴结局,并与同期前置胎盘行初次剖宫产(初次剖宫产组,FCS组)进行比较.结果 RCS组及FCS组分别有29例及243例患者.两组的平均年龄、孕周差异无统计学意义(P>0.05).RCS组患者手术时间长,产后出血量多,早产、产后出血、胎盘植入、输血、弥漫性血管内凝血和产科子宫切除的发生率均高于FCS组,差异有统计学意义(P<0.05),RCS组早产儿、新生儿窒息发生率及围产儿死亡率均高于FCS组(P<0.05).结论 前置胎盘合并剖宫产史更易发生胎盘植入,产后出血、产科子宫切除及围产儿病率高,需要高度重视.%Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods Twenty - nine cases of placenta previa complicated with previous caesarean section (RCS group) treated in Peking Union Medical College Hospital from 2003 to 2011 were retrospectively reviewed and compared with 243 cases of placenta previa complicated without previous caesarean section (FCS group) at the same time. Results The mean age and the average gravidity of RCS group and FCS group had no difference. The RCS group had longer operation time, more preterm birth, postpartum hemorrhage volume, blood transfusion, placenta accreta, disseminated intravascular coagulation and obstetric hysterectomy than FCS group (Pcaesarean section has more placenta accreta, postpartum hemorrhage, obstetric hysterectomy and perinatal morbidity rate. We need to pay more attention to these cases.

  1. One pass learning for generalized classifier neural network.

    Science.gov (United States)

    Ozyildirim, Buse Melis; Avci, Mutlu

    2016-01-01

    Generalized classifier neural network introduced as a kind of radial basis function neural network, uses gradient descent based optimized smoothing parameter value to provide efficient classification. However, optimization consumes quite a long time and may cause a drawback. In this work, one pass learning for generalized classifier neural network is proposed to overcome this disadvantage. Proposed method utilizes standard deviation of each class to calculate corresponding smoothing parameter. Since different datasets may have different standard deviations and data distributions, proposed method tries to handle these differences by defining two functions for smoothing parameter calculation. Thresholding is applied to determine which function will be used. One of these functions is defined for datasets having different range of values. It provides balanced smoothing parameters for these datasets through logarithmic function and changing the operation range to lower boundary. On the other hand, the other function calculates smoothing parameter value for classes having standard deviation smaller than the threshold value. Proposed method is tested on 14 datasets and performance of one pass learning generalized classifier neural network is compared with that of probabilistic neural network, radial basis function neural network, extreme learning machines, and standard and logarithmic learning generalized classifier neural network in MATLAB environment. One pass learning generalized classifier neural network provides more than a thousand times faster classification than standard and logarithmic generalized classifier neural network. Due to its classification accuracy and speed, one pass generalized classifier neural network can be considered as an efficient alternative to probabilistic neural network. Test results show that proposed method overcomes computational drawback of generalized classifier neural network and may increase the classification performance.

  2. A cardiorespiratory classifier of voluntary and involuntary electrodermal activity

    Directory of Open Access Journals (Sweden)

    Sejdic Ervin

    2010-02-01

    Full Text Available Abstract Background Electrodermal reactions (EDRs can be attributed to many origins, including spontaneous fluctuations of electrodermal activity (EDA and stimuli such as deep inspirations, voluntary mental activity and startling events. In fields that use EDA as a measure of psychophysiological state, the fact that EDRs may be elicited from many different stimuli is often ignored. This study attempts to classify observed EDRs as voluntary (i.e., generated from intentional respiratory or mental activity or involuntary (i.e., generated from startling events or spontaneous electrodermal fluctuations. Methods Eight able-bodied participants were subjected to conditions that would cause a change in EDA: music imagery, startling noises, and deep inspirations. A user-centered cardiorespiratory classifier consisting of 1 an EDR detector, 2 a respiratory filter and 3 a cardiorespiratory filter was developed to automatically detect a participant's EDRs and to classify the origin of their stimulation as voluntary or involuntary. Results Detected EDRs were classified with a positive predictive value of 78%, a negative predictive value of 81% and an overall accuracy of 78%. Without the classifier, EDRs could only be correctly attributed as voluntary or involuntary with an accuracy of 50%. Conclusions The proposed classifier may enable investigators to form more accurate interpretations of electrodermal activity as a measure of an individual's psychophysiological state.

  3. LESS: a model-based classifier for sparse subspaces.

    Science.gov (United States)

    Veenman, Cor J; Tax, David M J

    2005-09-01

    In this paper, we specifically focus on high-dimensional data sets for which the number of dimensions is an order of magnitude higher than the number of objects. From a classifier design standpoint, such small sample size problems have some interesting challenges. The first challenge is to find, from all hyperplanes that separate the classes, a separating hyperplane which generalizes well for future data. A second important task is to determine which features are required to distinguish the classes. To attack these problems, we propose the LESS (Lowest Error in a Sparse Subspace) classifier that efficiently finds linear discriminants in a sparse subspace. In contrast with most classifiers for high-dimensional data sets, the LESS classifier incorporates a (simple) data model. Further, by means of a regularization parameter, the classifier establishes a suitable trade-off between subspace sparseness and classification accuracy. In the experiments, we show how LESS performs on several high-dimensional data sets and compare its performance to related state-of-the-art classifiers like, among others, linear ridge regression with the LASSO and the Support Vector Machine. It turns out that LESS performs competitively while using fewer dimensions.

  4. Latin America`s emerging non-proliferation consensus

    Energy Technology Data Exchange (ETDEWEB)

    Redick, J.R.

    1994-03-01

    Latin America`s incorporation into the international nuclear non-proliferation regime is well advanced. The 1967 Tlatelolco Treaty, which established a regional nuclear-weapon-free zone (NWFZ), is nearing completion. A signal event occurred January 18, when Argentina and Chile deposited instruments of ratification to the treaty, leaving Brazil and Cuba the only major countries in Latin America that are not yet contracting parties. And after more than two decades of concern about the nuclear programs and policies in Argentina and Brazil, there is room for great optimism that Brazil may now be moving quickly on important non-proliferation issues. Even Cuba, the {open_quotes}bad boy of the neighborhood{close_quotes} in the eyes of many, which held aloof from the Tlatelolco process for three decades, has stated its willingness to join the zone in the future.

  5. 改良横切口子宫下段剖宫产术在产科剖宫产中应用的效果分析%Analysis of the Application Effect of Modified Lower Uterine Segment Cae-sarean Section via Transverse Incision in Obstetric Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    戚瑞虹

    2014-01-01

    Objective To study the use value of modified lower uterine segment caesarean section via transverse incision in obstet-ric caesarean section. Methods 68 puerperants underwent cesarean section in department of obstetrics of our hospital in the recent 1 year were selected. And the 68 cases were equally divided into the control group and the experimental group with 34 cases in each. The control group was treated by traditional lower uterine segment caesarean section via abdominal transverse incision, and the experimental group was treated by modified lower uterine segment caesarean section via transverse incision. And the curative effects of the two groups were observed. Results Compared with the control group, the amount of intraoperative bleeding, duration of operation, incidence of complications of the experimental group were less, the anal exhaust time was earlier, the neonatal Apgar score was higher with statistically significant difference (P<0.05). Conclusion Modified lower uterine segment caesarean section via transverse incision applied to the obstetric cesarean section has high use value and definite curative effect, so it is worthy of clini-cal promotion.%目的:研究改良式横切口子宫下段剖宫产术用于产科剖宫产的使用价值。方法选取68例在该院产科于近1年来接受剖宫产手术的产妇,将这68例产妇平均分为对照组34例和实验组34例,将传统腹部横切口子宫下段剖宫产手术应用于对照组,将改良横切口子宫下段剖宫产术用于实验组,观察两组疗效。结果实验组在术中出血量、手术持续时间、肛门排气时间、并发症发生率较对照组要低,且新生儿Apgar评分较对照组要高,差异有统计学意义(P<0.05),具有统计意义。结论改良横切口子宫下段剖宫产术在产科剖宫产手术中的使用价值较高,疗效肯定,值得于临床推广。

  6. [The transcultural process in Latin America].

    Science.gov (United States)

    Yampey, N

    1981-07-01

    Are we living in an age of rapid changes, or are we actually experiencing an existencial mutation? The author believes the analysis of today's transcultural processes in Latin America to be vital to the understanding of the society which is an emergent of these processes. He defines the concepts of transculturation, aculturation, adaptation creative integration and of assimilation in its biological, cultural and religious aspects. He outlines the general characteristics of a complex problem: the unity or heterogenity of the Latin American people with relation to the interaction, juxtaposition or synthesis of their different indigenous, european and african cultures over a period of four centuries. He classifies five ideological proposals which have arisen from this process: 1) the ultraconservative proposal; 2) the nationalistic proposal; 3) the indigenistic proposal; 4) the proposal of imitation; 5) the proposal of a transcendent synthesis. The subject is the transcultural process in persons who have migrated from rural areas to large cities, and from one country to another. The author describes four adoptive or integrative phases; he emphasizes that this experience implies mourning, transition and working-through for both the individual and the community. Migrants are faced with "horizontal" as well as "vertical" mobility, thus having to deal with a mobilization implying changes which may cause persecutory, depresive and confusional anxieties. These crises test the person's degree of individuation and identity, as reflected in different types of behavior.

  7. Decision Tree Classifiers for Star/Galaxy Separation

    Science.gov (United States)

    Vasconcellos, E. C.; de Carvalho, R. R.; Gal, R. R.; LaBarbera, F. L.; Capelato, H. V.; Frago Campos Velho, H.; Trevisan, M.; Ruiz, R. S. R.

    2011-06-01

    We study the star/galaxy classification efficiency of 13 different decision tree algorithms applied to photometric objects in the Sloan Digital Sky Survey Data Release Seven (SDSS-DR7). Each algorithm is defined by a set of parameters which, when varied, produce different final classification trees. We extensively explore the parameter space of each algorithm, using the set of 884,126 SDSS objects with spectroscopic data as the training set. The efficiency of star-galaxy separation is measured using the completeness function. We find that the Functional Tree algorithm (FT) yields the best results as measured by the mean completeness in two magnitude intervals: 14 = 19 (82.1%). We compare the performance of the tree generated with the optimal FT configuration to the classifications provided by the SDSS parametric classifier, 2DPHOT, and Ball et al. We find that our FT classifier is comparable to or better in completeness over the full magnitude range 15 19), our classifier is the only one that maintains high completeness (>80%) while simultaneously achieving low contamination (~2.5%). We also examine the SDSS parametric classifier (psfMag - modelMag) to see if the dividing line between stars and galaxies can be adjusted to improve the classifier. We find that currently stars in close pairs are often misclassified as galaxies, and suggest a new cut to improve the classifier. Finally, we apply our FT classifier to separate stars from galaxies in the full set of 69,545,326 SDSS photometric objects in the magnitude range 14 <= r <= 21.

  8. Representative Vector Machines: A Unified Framework for Classical Classifiers.

    Science.gov (United States)

    Gui, Jie; Liu, Tongliang; Tao, Dacheng; Sun, Zhenan; Tan, Tieniu

    2016-08-01

    Classifier design is a fundamental problem in pattern recognition. A variety of pattern classification methods such as the nearest neighbor (NN) classifier, support vector machine (SVM), and sparse representation-based classification (SRC) have been proposed in the literature. These typical and widely used classifiers were originally developed from different theory or application motivations and they are conventionally treated as independent and specific solutions for pattern classification. This paper proposes a novel pattern classification framework, namely, representative vector machines (or RVMs for short). The basic idea of RVMs is to assign the class label of a test example according to its nearest representative vector. The contributions of RVMs are twofold. On one hand, the proposed RVMs establish a unified framework of classical classifiers because NN, SVM, and SRC can be interpreted as the special cases of RVMs with different definitions of representative vectors. Thus, the underlying relationship among a number of classical classifiers is revealed for better understanding of pattern classification. On the other hand, novel and advanced classifiers are inspired in the framework of RVMs. For example, a robust pattern classification method called discriminant vector machine (DVM) is motivated from RVMs. Given a test example, DVM first finds its k -NNs and then performs classification based on the robust M-estimator and manifold regularization. Extensive experimental evaluations on a variety of visual recognition tasks such as face recognition (Yale and face recognition grand challenge databases), object categorization (Caltech-101 dataset), and action recognition (Action Similarity LAbeliNg) demonstrate the advantages of DVM over other classifiers.

  9. Reverse breech extraction versus the standard approach of pushing the impacted fetal head up through the vagina in caesarean section for obstructed labour: A randomised controlled trial.

    Science.gov (United States)

    Nooh, Ahmed Mohamed; Abdeldayem, Hussein Mohammed; Ben-Affan, Othman

    2017-01-31

    The objective of this study was to assess effectiveness and safety of the reverse breech extraction approach in Caesarean section for obstructed labour, and compare it with the standard approach of pushing the fetal head up through the vagina. This randomised controlled trial included 192 women. In 96, the baby was delivered by the 'reverse breech extraction approach', and in the remaining 96, by the 'standard approach'. Extension of uterine incision occurred in 18 participants (18.8%) in the reverse breech extraction approach group, and 46 (47.9%) in the standard approach group (p = .0003). Two women (2.1%) in the reverse breech extraction approach group needed blood transfusion and 11 (11.5%) in the standard approach group (p = .012). Pyrexia developed in 3 participants (3.1%) in the reverse breech extraction approach group, and 19 (19.8%) in the standard approach group (p = .0006). Wound infection occurred in 2 women (2.1%) in the reverse breech extraction approach group, and 12 (12.5%) in the standard approach group (p = .007). Apgar score extraction approach group, and 21 (21.9%) in the standard approach group (p = .015). In conclusion, reverse breech extraction in Caesarean section for obstructed labour is an effective and safe alternative to the standard approach of pushing the fetal head up through the vagina.

  10. Combined use of hyperbaric and hypobaric ropivacaine significantly improves hemodynamic characteristics in spinal anesthesia for caesarean section: a prospective, double-blind, randomized, controlled study.

    Directory of Open Access Journals (Sweden)

    ZheFeng Quan

    Full Text Available To observe the hemodynamic changes of parturients in the combined use of hyperbaric (4 mg and hypobaric (6 mg ropivacaine during spinal anesthesia for caesarean section in this randomized double-blind study.Parturients (n = 136 undergoing elective cesarean delivery were randomly and equally allocated to receive either combined hyperbaric and hypobaric ropivacaine (Group A or hyperbaric ropivacaine (Group B. Outcome measures were: hemodynamic characteristics, maximum height of sensory block, time to achieve T8 sensory blockade level, incidence of complications, Apgar scores at 1 and 5 min, and neonatal blood gas analysis.Group A had a lower level of sensory blockade (T6 [T6-T7] and longer time to achieve T8 sensory blockade level (8 ± 1.3 min than did patients in Group B (T3 [T2-T4] and 5 ± 1.0 min, respectively; P < 0.001, both. The incidence rates for hypotension, nausea, and vomiting were significantly lower in Group A (13%, 10%, and 3%, respectively than Group B (66%, 31%, and 13%; P < 0.001, P = 0.003, P = 0.028.Combined use of hyperbaric (4 mg and hypobaric (6 mg ropivacaine significantly decreased the incidences of hypotension and complications in spinal anesthesia for caesarean section by extending induction time and decreasing the level of sensory blockade.Chinese Clinical Trial Register ChiCTR-TRC-13004622.

  11. Exploring novel infusion regimens of phenylephrine during spinal anesthesia for caesarean delivery: The effects on hemodynamic control and fetal acid-base status

    Directory of Open Access Journals (Sweden)

    Syed N Muzaffar

    2016-01-01

    Materials and Methods: Ninety parturients undergoing SA for elective caesarean delivery received an IV infusion of phenylephrine in one of three different concentration ratios. The groups contained a potency equivalent of 100 μg/min, 80μg/min, and 60 μg/min infusion doses. The infusions were adjusted to maintain systolic blood pressure (SBP near the baseline until uterine incision. Hemodynamic changes in mother and umbilical cord blood gases were compared. Results: As concentration of phenylephrine increased, following significant trends were noticed: in group A, 10/29 (34.5% patients had hypotension as compared to 2/28 (7.4% patients in group B and 4/28 (14.3% patients in group C. On the other hand, we found that the incidence of hypertension and bradycardia was higher in groups B (22/28; 4/28 and C (26/28; 10/28 as compared to those in group A (3/29; 2/29, respectively. Neonatal acid-base status in all three groups was favorable. Conclusions: As the concentration of phenylephrine increased, the tendency for SBP to be above the baseline increased, along with an incidence of bradycardia. Therefore, we conclude that low dose infusion regimens of phenylephrine, i.e. between 60 μg/min and 80 μg/min, will be more effective in prevention of hypotension during SA for caesarean delivery.

  12. Clear cell carcinoma derived from an endometriosis focus in a scar after a caesarean section--a case report and literature review.

    Science.gov (United States)

    Dobrosz, Zuzanna; Paleń, Piotr; Stojko, Rafał; Właszczuk, Paweł; Niesłuchowska-Hoxha, Anna; Piechuta-Kośmider, Ilona

    2014-10-01

    Endometriosis is defined as the occurrence of endometrial glands and endometrial stromal cells outside their typical localization within the uterus. Malignant transformation of endometriosis foci in a scar after a caesarean section (cc) is very rare--until 2013 (in a span of 40 years), about 40 such cases have been described. In our article, we describe a case of a 42-year-old woman with a tumour localized in a scar after a caesarean section. The tumour was diagnosed as clear cell carcinoma derived from an endometriosis focus. The long time interval--17 years in average (from 3 to 39 years) between the surgery (cesarean section in most cases) and the tumor diagnosis is characteristic. In the case we describe, the patient was diagnosed 16 years after the endometriosis focus in the scar had arised. Even though endometriosis is a benign lesion, it has many features distinctive for invasive carcinoma; it may itself undergo a malignant transformation as well as increase the risk of endometrial carcinoma or clear cell ovarian carcinoma. Maybe in future, more exhaustive studies will allow establishing a therapeutic protocol in patients with extra-ovarian malignant transformation of endometriosis foci.

  13. China-Latin America Relations

    DEFF Research Database (Denmark)

    Christensen, Steen Fryba; Silva Ramos Becard, Danielly

    2016-01-01

    The article discusses the research field of China-Latin American relations and suggests a broad and encompassing approach to the topic. It discusses the main themes and problem areas that analysts mostly emphasize in analyses of China-Latin America relations.......The article discusses the research field of China-Latin American relations and suggests a broad and encompassing approach to the topic. It discusses the main themes and problem areas that analysts mostly emphasize in analyses of China-Latin America relations....

  14. Fuglene. Audubon: Birds of America

    DEFF Research Database (Denmark)

    Schlichtkrull, Torsten

    2010-01-01

    The Royal Library owns one of the most exceptional works in book history, an original edition of John James Audubon Birds of America. This edition, in a format called “double elephant folio” was published from 1827 to 1838. On basis of existing literature, this article briefly describes the work...... the Royal Library and the University Library, joined the library cooperation of the 1800’s on an equal standing with the other two libraries. The Classen’s Library and the library’s founder, industrialist JF Classen are described briefly in this article. Due to two library mergers the Birds of America...

  15. [Horticultural plant diseases multispectral classification using combined classified methods].

    Science.gov (United States)

    Feng, Jie; Li, Hong-Ning; Yang, Wei-Ping; Hou, De-Dong; Liao, Ning-Fang

    2010-02-01

    The research on multispectral data disposal is getting more and more attention with the development of multispectral technique, capturing data ability and application of multispectral technique in agriculture practice. In the present paper, a cultivated plant cucumber' familiar disease (Trichothecium roseum, Sphaerotheca fuliginea, Cladosporium cucumerinum, Corynespora cassiicola, Pseudoperonospora cubensis) is the research objects. The cucumber leaves multispectral images of 14 visible light channels, near infrared channel and panchromatic channel were captured using narrow-band multispectral imaging system under standard observation and illumination environment, and 210 multispectral data samples which are the 16 bands spectral reflectance of different cucumber disease were obtained. The 210 samples were classified by distance, relativity and BP neural network to discuss effective combination of classified methods for making a diagnosis. The result shows that the classified effective combination of distance and BP neural network classified methods has superior performance than each method, and the advantage of each method is fully used. And the flow of recognizing horticultural plant diseases using combined classified methods is presented.

  16. Algunos Animales de Latino America = Some Animals of Latin America.

    Science.gov (United States)

    Thompson, Kathryn F. B.

    Developed by the Latin American Culture Studies Project for educators of elementary level children, these materials are designed to teach students the Spanish and English names of animals found in Latin America. The lesson includes coloring sheets, duplicating masters, fact sheets, the card game Maymayguashi, and directions for preparation. (DB)

  17. 剖宫产术后再次妊娠172例临床分析%Analysis of 172 cases of re-pregnancy after caesarean section

    Institute of Scientific and Technical Information of China (English)

    徐艳红; 吕玉人

    2010-01-01

    Objective To analyze the delivery ways of the re-pregnant women after caesarean section. Methods The mode of delivery and birth outcome of 172 cases re-pregnancy after caesarean section from Jan. 2005 to Dec. 2008 were retrospectively analyzed. 48 cases of vaginal delivery after cesarean section were compared with 48 cases of non-vaginal birth after cesarean section during the same period. 124 cases of re-cesarean section were compared with 124 random case of cesarean section for the first time during the same period. Results Among 172 cases , 54 cases had vaginal labor in whom 48 cases succeeded. The success rate was 88. 89%. There was no significant difference in postpartum hemorrhage scar uterus and no-scar uterus. There were 124 cases of re-caesarean section. There was a significant difference in postpartum hemorrhage re-caesarean section and cesarean section for the first time [ (265 ±14)ml vs (201 ±12)ml, P<0.05]. Conclusions Scar uterus can be applied to vaginal delivery. Caesarea section history is not the definite indication of caesarean birth.%目的 探讨剖宫产术后再次妊娠分娩方式的选择,以期减少分娩并发症.方法 选择民航总医院妇产科2005年1月至2008年12月住院的剖宫产术后再次妊娠孕妇172例,对其分娩方式、分娩结局进行回顾性分析.将其中剖宫产术后阴道分娩48例与同期非剖宫产术后子宫阴道分娩48例进行对照分析,再次剖宫产124例与随机抽取同期首次剖宫产124例进行对照分析.结果 172例剖宫产术后再次妊娠孕妇中,有54例阴道试产,48例试产成功,成功率88.89%,瘢痕子宫与正常子宫阴道分娩产后出血差异无统计学意义;再次剖宫产124例,手术产率72.09%,再次剖宫产与首次剖宫产产后出血量差异有统计学意义[(265±14)ml比(201±12)ml,P<0.05].结论 剖宫产术后再次妊娠的孕妇在一定条件下可阴道分娩,应给予试产机会,瘢痕子宫并非再次剖宫产的绝对指征.

  18. The Effect of Music Therapy on Pain The Level of Postoperative Patients' with Caesarean Section at Islamic Hospital A.Yani, Surabaya

    Directory of Open Access Journals (Sweden)

    Nanik Handayani

    2015-11-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Pain is the most common effects in patients after undergoing surgery of Caesarean section. Pain management using pharmacological and non pharmacological management, one of non-pharmacological management is using music therapy The purpose of this study was to analyze the effect of music therapy on pain level of postoperative patients' with Caesarean section. The type of study is analytic with True Experimental type with Pre Post Test Control Group Design done by Random Allocation. The study population is post-operative Caesarean section mothers who are hospitalized in Surabaya Islamic Hospital Surabaya Jl. A Yani since May 2011. The Sample are some populations above mentioned with amount of 24 respondents, 12 respondents as a control and 12 respondents were given music therapy. The Sampling technique uses Consecutive Sampling. Independent variable is music therapy and dependent variable is pain level. The instrument used to measure the independent variables is a check sheet lists while the dependent variable is Descriptive Pain Intensity Scale. To analyze the changes of pain level in the control group and the treatment used Paired T Test, the result showed that values of ρ is 0.166 or (ρ > 0.05, so there is no significant change of pain level on a pre test and post test control group, whereas in treatment group obtained value of ρ is 0.000 or (ρ < 0.05, so there is a significant change of pain level on a pre test and post test. To analyze differences of pain

  19. INFLUENCE OF PROLONGED SITTING POSITION ON EFFECTS OF SPINAL ANAESTHESIA ON CAESAREAN DELIVERY: A RANDOMIZED CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    Priti

    2014-08-01

    postoperative analgesia was prolonged in both the fentanyl Groups. CONCLUSION: prolonged sitting position after spinal anesthesia not only limit the spread of LA, producing lower sensory block height but also reduces the incidence of hypotension and Intraoperative ephedrine requirement in caesarean delivery.

  20. COMPARATIVE EVALUATION OF INTRATHECAL BUPIVACAINE-FENTANYL AND BUPIVACAINE - CLONIDINE FOR CAESAREAN SECTION IN PREGNANCY INDUCED HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Tripti

    2014-09-01

    Full Text Available BACKGROUND: Pain free postoperative period and early ambulation are the need of the day for mothers and their neonates for early initiation of breast feeding. It is moral responsibility of Anaesthesiologist to provide a safe and pain free postoperative period with use of various techniques and drug combinations. Spinal anaesthesia has been widely used for caesarean section in normalas well as preeclamptic parturients and has been found to be efficaciousand safe. The present study aimed to compare the analgesic efficacy and side effect profile of intrathecal Bupivacaine with Fentanyl and Bupivacaine with Clonidine in cesarean section of parturients with pregnancy induced hypertension (PIH. METHODS: 50 full term parturients with pregnancy induced hypertension scheduled for cesarean section were randomized into 2 groups of 25 each. GROUP BF (Bupivacaine with Fentanyl received 7.5mg of 0.5% hyperbaric Bupivacaine and 20µg Fentanyl intrathecally. GROUP BC (Bupivacaine with Clonidine received 7.5mg of 0.5% hyperbaric Bupivacaine and 60µg clonidine intrathecally. RESULTS: Patients in group BC showed long lasting analgesia compared to group BF (p value<0.05. Both the groups had satisfactory analgesia with hemodynamic stability, however the incidence of hypotension and vasopressor requirement was more in group BC compared to BF. Incidence of pruritus was exceptionally seen in group BF, however more patients were sedated and complained of dry mouth in group BC. Both the groups had comparable APGAR scores with no adverse neonatal effects. CONCLUSION: We conclude use of intrathecal clonidine 60µg and Fentanyl 20µg both provide excellent sensory and motor blockage with lower dose of bupivacaine. Both drugs improved intraoperative analgesia and prolonged the duration of effective analgesia without any adverse effect on neonate neurobehaviour. Fairly good analgesia with less sedation and better haemodynamic stability is observed with 20μg fentanyl

  1. Caesarean delivery in the Limbé and the Buea regional hospitals, Cameroon: frequency, indications and outcomes

    Science.gov (United States)

    Tanyi, Tanyi John; Atashili, Julius; Fon, Peter Nde; Robert, Tchounzou; Paul, Koki Ndombo

    2016-01-01

    Introduction Neonatal outcomes can be directly and indirectly affected by caesarean delivery (CD). Data on CD rates in semi-urban and rural hospitals in resource-limited settings are scarce and yet are needed to better guide the care of women and neonates in these settings. we carried out this study to determine the frequency of CD, its indications and the frequency of the various adverse neonatal outcomes (ANO) in the Limbe Regional Hospital (LRH) and the Buea Regional Hospital (BRH), Cameroon. We also assessed the relationship between the indication for CD and ANO in the said hospitals. Methods This was a hospital-based retrospective and prospective cross-sectional study using descriptive and analytic methods conducted in the LRH and the BRH maternity units within a nine months period in 2015. Informed consent was obtainedfrom mothers of the neonates. Data analyses were performed using Epi-Info 3.5.4 software. Results We recruited 199 neonates born through CD. The prevalence of CD was 13.3% with cephalopelvic disproportion (CPD) being the most frequent (32.2%) indication for CD. There were 52 (26.1%) ANO following CD and respiratory distress was the most common 24 (46.2%) of all ANO. Emergency indications for CD were associated with more ANO 49 (34.5%) as compared to elective indications for CD 3 (5.3%) [p-value<0.001]. We noted a significant association between indications for CD and the various type of ANO, with CPD having the worse prognostic neonatal outcomes 30.8% [p-value=0.02]. Conclusion The prevalence of ANO associated with CD in our hospitals was high with a worrying prognosis. While the exact reasons are unknown, the creation of well-equipped neonatal units with trained staff, may contribute to reduce neonatal morbidity and fatalities. Furthermore, the association of CPD to worse prognostic neonatal outcomes calls for clinicians, to consider additional management options, such as antibiotic prophylaxis and oxygen therapy to the neonates, prior to CD.

  2. Caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, northeastern Tanzania

    Directory of Open Access Journals (Sweden)

    Oneko Olola

    2011-07-01

    Full Text Available Abstract Background The inequity in emergency obstetric care access in Tanzania is unsatisfactory. Despite an existing national obstetric referral system, many birthing women bypass referring facilities and go directly to higher-level care centres. We wanted to compare Caesarean section (CS rates among women formally referred to a tertiary care centre versus self-referred women, and to assess the effect of referral status on adverse outcomes after CS. Methods We used data from 21,011 deliveries, drawn from the birth registry of a tertiary hospital in northeastern Tanzania, during 2000-07. Referral status was categorized as self-referred if the woman had bypassed or not accessed referral, or formally-referred if referred by a health worker. Because CS indications were insufficiently registered, we applied the Ten-Group Classification System to determine the CS rate by obstetric group and referral status. Associations between referral status and adverse outcomes after CS delivery were analysed using multiple regression models. Outcome measures were CS, maternal death, obstetric haemorrhage ≥ 750 mL, postpartum stay > 9 days, neonatal death, Apgar score Results Referral status contributed substantially to the CS rate, which was 55.0% in formally-referred and 26.9% in self-referred birthing women. In both groups, term nulliparous singleton cephalic pregnancies and women with previous scar(s constituted two thirds of CS deliveries. Low Apgar score (adjusted OR 1.42, 95% CI 1.09-1.86 and neonatal ward transfer (adjusted OR 1.18, 95% CI 1.04-1.35 were significantly associated with formal referral. Early neonatal death rates after CS were 1.6% in babies of formally-referred versus 1.2% in babies of self-referred birthing women, a non-significant difference after adjusting for confounding factors (adjusted OR 1.37, 95% CI 0.87-2.16. Absolute neonatal death rates were > 2% after CS in breech, multiple gestation and preterm deliveries in both referral

  3. The pregnant woman and the good Samaritan: can a woman have a duty to undergo a caesarean section?

    Science.gov (United States)

    Scott, R

    2000-01-01

    Although a pregnant woman can now refuse any medical treatment needed by the fetus, the Court of Appeal has acknowledged that ethical dilemmas remain, adverting to the inappropriateness of legal compulsion of presumed moral duties in this context. This leaves the impression of an uncomfortable split between the ethics and the law. The notion of a pregnant woman refusing medical treatment needed by the fetus is troubling and it helps little simply to assert that she has a legal right to do so. At the same time, the idea that a pregnant woman fails in her moral duty unless she accepts any recommended treatment or surgery--however great the burden--is also not without difficulty. This article seeks to find a way between these two somewhat polarized positions by arguing that, instead of being a question primarily about whether legally to enforce moral obligations, the 'maternal-fetal conflict' begins with previously unrecognized difficulties in determining when a woman's prima facie moral rights invoked in the treatment context should 'give way' to the interests of the fetus. This difficulty is mirrored within the law. Thus, how can we tell when a pregnant woman has the moral or legal duty to submit to a caesarean section? Seen in this way, the conflict is a problem which lies at the interface between moral and legal rights and duties, showing that there are important conceptual links between the ethics and the law. Against this background, this article explores the limits of a pregnant woman's right to bodily integrity by focusing upon the idea of her moral duty to aid the fetus through her body. Here we find difficulties in determining the existence and extent of this somewhat extraordinary duty. Such a duty is contrasted with both negative and positive duties toward others in the course of 'general conduct.' Attention to the social context of pregnancy and the refusal of treatment within this is also instructive. Overall, the purpose is to foster understanding and

  4. WORD SENSE DISAMBIGUATION BASED ON IMPROVED BAYESIAN CLASSIFIERS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Word Sense Disambiguation (WSD) is to decide the sense of an ambiguous word on particular context. Most of current studies on WSD only use several ambiguous words as test samples, thus leads to some limitation in practical application. In this paper, we perform WSD study based on large scale real-world corpus using two unsupervised learning algorithms based on ±n-improved Bayesian model and Dependency Grammar(DG)-improved Bayesian model. ±n-improved classifiers reduce the window size of context of ambiguous words with close-distance feature extraction method, and decrease the jamming of useless features, thus obviously improve the accuracy, reaching 83.18% (in open test). DG-improved classifier can more effectively conquer the noise effect existing in Naive-Bayesian classifier. Experimental results show that this approach does better on Chinese WSD, and the open test achieved an accuracy of 86.27%.

  5. Iris Recognition Based on LBP and Combined LVQ Classifier

    CERN Document Server

    Shams, M Y; Nomir, O; El-Awady, R M; 10.5121/ijcsit.2011.3506

    2011-01-01

    Iris recognition is considered as one of the best biometric methods used for human identification and verification, this is because of its unique features that differ from one person to another, and its importance in the security field. This paper proposes an algorithm for iris recognition and classification using a system based on Local Binary Pattern and histogram properties as a statistical approaches for feature extraction, and Combined Learning Vector Quantization Classifier as Neural Network approach for classification, in order to build a hybrid model depends on both features. The localization and segmentation techniques are presented using both Canny edge detection and Hough Circular Transform in order to isolate an iris from the whole eye image and for noise detection .Feature vectors results from LBP is applied to a Combined LVQ classifier with different classes to determine the minimum acceptable performance, and the result is based on majority voting among several LVQ classifier. Different iris da...

  6. A Film Classifier Based on Low-level Visual Features

    Directory of Open Access Journals (Sweden)

    Hui-Yu Huang

    2008-07-01

    Full Text Available We propose an approach to classify the film classes by using low level features and visual features. This approach aims to classify the films into genres. Our current domain of study is using the movie preview. A movie preview often emphasizes the theme of a film and hence provides suitable information for classifying process. In our approach, we categorize films into three broad categories: action, dramas, and thriller films. Four computable video features (average shot length, color variance, motion content and lighting key and visual features (show and fast moving effects are combined in our approach to provide the advantage information to demonstrate the movie category. The experimental results present that visual features are the useful messages for processing the film classification. On the other hand, our approach can also be extended for other potential applications, including the browsing and retrieval of videos on the internet, video-on-demand, and video libraries.

  7. Optimal threshold estimation for binary classifiers using game theory.

    Science.gov (United States)

    Sanchez, Ignacio Enrique

    2016-01-01

    Many bioinformatics algorithms can be understood as binary classifiers. They are usually compared using the area under the receiver operating characteristic ( ROC) curve. On the other hand, choosing the best threshold for practical use is a complex task, due to uncertain and context-dependent skews in the abundance of positives in nature and in the yields/costs for correct/incorrect classification. We argue that considering a classifier as a player in a zero-sum game allows us to use the minimax principle from game theory to determine the optimal operating point. The proposed classifier threshold corresponds to the intersection between the ROC curve and the descending diagonal in ROC space and yields a minimax accuracy of 1-FPR. Our proposal can be readily implemented in practice, and reveals that the empirical condition for threshold estimation of "specificity equals sensitivity" maximizes robustness against uncertainties in the abundance of positives in nature and classification costs.

  8. An ɴ-ary λ-averaging based similarity classifier

    Directory of Open Access Journals (Sweden)

    Kurama Onesfole

    2016-06-01

    Full Text Available We introduce a new n-ary λ similarity classifier that is based on a new n-ary λ-averaging operator in the aggregation of similarities. This work is a natural extension of earlier research on similarity based classification in which aggregation is commonly performed by using the OWA-operator. So far λ-averaging has been used only in binary aggregation. Here the λ-averaging operator is extended to the n-ary aggregation case by using t-norms and t-conorms. We examine four different n-ary norms and test the new similarity classifier with five medical data sets. The new method seems to perform well when compared with the similarity classifier.

  9. A History of Classified Activities at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Quist, A.S.

    2001-01-30

    The facilities that became Oak Ridge National Laboratory (ORNL) were created in 1943 during the United States' super-secret World War II project to construct an atomic bomb (the Manhattan Project). During World War II and for several years thereafter, essentially all ORNL activities were classified. Now, in 2000, essentially all ORNL activities are unclassified. The major purpose of this report is to provide a brief history of ORNL's major classified activities from 1943 until the present (September 2000). This report is expected to be useful to the ORNL Classification Officer and to ORNL's Authorized Derivative Classifiers and Authorized Derivative Declassifiers in their classification review of ORNL documents, especially those documents that date from the 1940s and 1950s.

  10. A native Bayesian classifier based routing protocol for VANETS

    Science.gov (United States)

    Bao, Zhenshan; Zhou, Keqin; Zhang, Wenbo; Gong, Xiaolei

    2016-12-01

    Geographic routing protocols are one of the most hot research areas in VANET (Vehicular Ad-hoc Network). However, there are few routing protocols can take both the transmission efficient and the usage of ratio into account. As we have noticed, different messages in VANET may ask different quality of service. So we raised a Native Bayesian Classifier based routing protocol (Naive Bayesian Classifier-Greedy, NBC-Greedy), which can classify and transmit different messages by its emergency degree. As a result, we can balance the transmission efficient and the usage of ratio with this protocol. Based on Matlab simulation, we can draw a conclusion that NBC-Greedy is more efficient and stable than LR-Greedy and GPSR.

  11. Automatically Classifying the Role of Citations in Biomedical Articles

    Science.gov (United States)

    Agarwal, Shashank; Choubey, Lisha; Yu, Hong

    2010-01-01

    Citations are widely used in scientific literature. The traditional model of referencing considers all citations to be the same; however, semantically, citations play different roles. By studying the context in which citations appear, it is possible to determine the role that they play. Here, we report on the development of an eight-category classification scheme, annotation using that scheme, and development and evaluation of supervised machine-learning classifiers using the annotated data. We annotated 1,710 sentences using the annotation schema and our trained classifier obtained an average F1-score of 76.5%. The classifier is available for free as a Java API from http://citation.askhermes.org. PMID:21346931

  12. A Topic Model Approach to Representing and Classifying Football Plays

    KAUST Repository

    Varadarajan, Jagannadan

    2013-09-09

    We address the problem of modeling and classifying American Football offense teams’ plays in video, a challenging example of group activity analysis. Automatic play classification will allow coaches to infer patterns and tendencies of opponents more ef- ficiently, resulting in better strategy planning in a game. We define a football play as a unique combination of player trajectories. To this end, we develop a framework that uses player trajectories as inputs to MedLDA, a supervised topic model. The joint maximiza- tion of both likelihood and inter-class margins of MedLDA in learning the topics allows us to learn semantically meaningful play type templates, as well as, classify different play types with 70% average accuracy. Furthermore, this method is extended to analyze individual player roles in classifying each play type. We validate our method on a large dataset comprising 271 play clips from real-world football games, which will be made publicly available for future comparisons.

  13. COMPARISON OF SVM AND FUZZY CLASSIFIER FOR AN INDIAN SCRIPT

    Directory of Open Access Journals (Sweden)

    M. J. Baheti

    2012-01-01

    Full Text Available With the advent of technological era, conversion of scanned document (handwritten or printed into machine editable format has attracted many researchers. This paper deals with the problem of recognition of Gujarati handwritten numerals. Gujarati numeral recognition requires performing some specific steps as a part of preprocessing. For preprocessing digitization, segmentation, normalization and thinning are done with considering that the image have almost no noise. Further affine invariant moments based model is used for feature extraction and finally Support Vector Machine (SVM and Fuzzy classifiers are used for numeral classification. . The comparison of SVM and Fuzzy classifier is made and it can be seen that SVM procured better results as compared to Fuzzy Classifier.

  14. Examining the significance of fingerprint-based classifiers

    Directory of Open Access Journals (Sweden)

    Collins Jack R

    2008-12-01

    Full Text Available Abstract Background Experimental examinations of biofluids to measure concentrations of proteins or their fragments or metabolites are being explored as a means of early disease detection, distinguishing diseases with similar symptoms, and drug treatment efficacy. Many studies have produced classifiers with a high sensitivity and specificity, and it has been argued that accurate results necessarily imply some underlying biology-based features in the classifier. The simplest test of this conjecture is to examine datasets designed to contain no information with classifiers used in many published studies. Results The classification accuracy of two fingerprint-based classifiers, a decision tree (DT algorithm and a medoid classification algorithm (MCA, are examined. These methods are used to examine 30 artificial datasets that contain random concentration levels for 300 biomolecules. Each dataset contains between 30 and 300 Cases and Controls, and since the 300 observed concentrations are randomly generated, these datasets are constructed to contain no biological information. A modest search of decision trees containing at most seven decision nodes finds a large number of unique decision trees with an average sensitivity and specificity above 85% for datasets containing 60 Cases and 60 Controls or less, and for datasets with 90 Cases and 90 Controls many DTs have an average sensitivity and specificity above 80%. For even the largest dataset (300 Cases and 300 Controls the MCA procedure finds several unique classifiers that have an average sensitivity and specificity above 88% using only six or seven features. Conclusion While it has been argued that accurate classification results must imply some biological basis for the separation of Cases from Controls, our results show that this is not necessarily true. The DT and MCA classifiers are sufficiently flexible and can produce good results from datasets that are specifically constructed to contain no

  15. Silicon nanowire arrays as learning chemical vapour classifiers

    Energy Technology Data Exchange (ETDEWEB)

    Niskanen, A O; Colli, A; White, R; Li, H W; Spigone, E; Kivioja, J M, E-mail: antti.niskanen@nokia.com [Nokia Research Center, Broers Building, 21 JJ Thomson Avenue, Cambridge CB3 0FA (United Kingdom)

    2011-07-22

    Nanowire field-effect transistors are a promising class of devices for various sensing applications. Apart from detecting individual chemical or biological analytes, it is especially interesting to use multiple selective sensors to look at their collective response in order to perform classification into predetermined categories. We show that non-functionalised silicon nanowire arrays can be used to robustly classify different chemical vapours using simple statistical machine learning methods. We were able to distinguish between acetone, ethanol and water with 100% accuracy while methanol, ethanol and 2-propanol were classified with 96% accuracy in ambient conditions.

  16. Text Classification: Classifying Plain Source Files with Neural Network

    Directory of Open Access Journals (Sweden)

    Jaromir Veber

    2010-10-01

    Full Text Available The automated text file categorization has an important place in computer engineering, particularly in the process called data management automation. A lot has been written about text classification and the methods allowing classification of these files are well known. Unfortunately most studies are theoretical and for practical implementation more research is needed. I decided to contribute with a research focused on creating of a classifier for different kinds of programs (source files, scripts…. This paper will describe practical implementation of the classifier for text files depending on file content.

  17. Classifying depth of anesthesia using EEG features, a comparison.

    Science.gov (United States)

    Esmaeili, Vahid; Shamsollahi, Mohammad Bagher; Arefian, Noor Mohammad; Assareh, Amin

    2007-01-01

    Various EEG features have been used in depth of anesthesia (DOA) studies. The objective of this study was to find the excellent features or combination of them than can discriminate between different anesthesia states. Conducting a clinical study on 22 patients we could define 4 distinct anesthetic states: awake, moderate, general anesthesia, and isoelectric. We examined features that have been used in earlier studies using single-channel EEG signal processing method. The maximum accuracy (99.02%) achieved using approximate entropy as the feature. Some other features could well discriminate a particular state of anesthesia. We could completely classify the patterns by means of 3 features and Bayesian classifier.

  18. Online classifier adaptation for cost-sensitive learning

    OpenAIRE

    Zhang, Junlin; Garcia, Jose

    2015-01-01

    In this paper, we propose the problem of online cost-sensitive clas- sifier adaptation and the first algorithm to solve it. We assume we have a base classifier for a cost-sensitive classification problem, but it is trained with respect to a cost setting different to the desired one. Moreover, we also have some training data samples streaming to the algorithm one by one. The prob- lem is to adapt the given base classifier to the desired cost setting using the steaming training samples online. ...

  19. Learning Continuous Time Bayesian Network Classifiers Using MapReduce

    Directory of Open Access Journals (Sweden)

    Simone Villa

    2014-12-01

    Full Text Available Parameter and structural learning on continuous time Bayesian network classifiers are challenging tasks when you are dealing with big data. This paper describes an efficient scalable parallel algorithm for parameter and structural learning in the case of complete data using the MapReduce framework. Two popular instances of classifiers are analyzed, namely the continuous time naive Bayes and the continuous time tree augmented naive Bayes. Details of the proposed algorithm are presented using Hadoop, an open-source implementation of a distributed file system and the MapReduce framework for distributed data processing. Performance evaluation of the designed algorithm shows a robust parallel scaling.

  20. Face recognition using composite classifier with 2DPCA

    Science.gov (United States)

    Li, Jia; Yan, Ding

    2017-01-01

    In the conventional face recognition, most researchers focused on enhancing the precision which input data was already the member of database. However, they paid less necessary attention to confirm whether the input data belonged to database. This paper proposed an approach of face recognition using two-dimensional principal component analysis (2DPCA). It designed a novel composite classifier founded by statistical technique. Moreover, this paper utilized the advantages of SVM and Logic Regression in field of classification and therefore made its accuracy improved a lot. To test the performance of the composite classifier, the experiments were implemented on the ORL and the FERET database and the result was shown and evaluated.