WorldWideScience

Sample records for caesarean section rate

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

    LENUS (Irish Health Repository)

    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.

  2. Rising caesarean section rate: a matter of concern?

    Directory of Open Access Journals (Sweden)

    Sanjivani A. Wanjari

    2014-06-01

    Methods: A one year observational study was done in a large government hospital receiving a large number of patients from urban as well as rural areas and also referrals from the periphery. An attempt was made to find out the caesarean section rate and to evaluate the indications that lead to a rise in caesarean section rate. Results: During the one year study period, there were total 14568 deliveries, out of which 5508 were caesarean sections giving a caesarean section rate of 37.8%. Repeat caesarean section after one prior caesarean delivery was the leading contributor of caesarean section rate and accounted for one in three caesarean sections carried out (32.80%. Other leading indications were foetal distress (9.36%, CPD (7.69%, PROM (7.31%, postdate pregnancy (6.62%, hypertensive disorders of pregnancy (6.0%. Conclusions: Some of the measures that can reduce caesarean section rate can be 1 reduction in primary caesarean sections 2 giving the option of VBAC to women with one prior caesarean section 3 use of foetal heart tracings and scalp blood sampling for foetal monitoring 4 judicious use of oxytocin and plotting of the partogram for every labour. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 728-731

  3. Assessment of competence for caesarean section with global rating scale

    International Nuclear Information System (INIS)

    Objective: To establish as reliable and valid the nine-point global rating scale for assessing residents' independent performance of Caesarean Section. Methods: The validation study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, from April to December 2008, and comprised 15 residents during 40 Caesarean Sections over 9 months. Independently two evaluators rated each procedure and the difficulty of each case. Results: The observations per faculty ranged from 1-8 (mean 4.07+- 2.56). The Year 4 residents were observed the most i.e. 32 (40%), followed by Year 3, 30 (37.5%); Year 2; 14 (17.5%); and Year 1, 4 (5%). Mean time required for observation of the surgery was 43.81+-14.28 (range: 20-90) with a mode of 45 min. Mean aggregate rating on all items showed gradual progression with the year of residency. The assessment tool had an internal consistency reliability (Cronbach's alpha) of 0.9097 with low inter-rater reliability. Conclusion: The evaluation tool was found to be reliable and valid for evaluating a resident's competence for performing Caesarean Section. Training of the assessors is required for a better inter-rater agreement. (author)

  4. International variation in caesarean section rates and maternal obesity.

    Science.gov (United States)

    O'Dwyer, V; Layte, R; O'Connor, C; Farah, N; Kennelly, M M; Turner, M J

    2013-07-01

    This study examined variations in caesarean section (CS) rates associated with a woman's birthplace and differences in maternal adiposity. Women were enrolled in the 1st trimester. Maternal adiposity was assessed by body mass index (BMI) and bioelectrical impedance analysis (BIA). Irish women were compared with women born in the 14 countries who joined the European Union (EU) before 2004 (EU 14), and with those born in 12 countries who joined following enlargement (EU 12). Of the 2,811 women enrolled, 2,235 women were born in Ireland, 100 in EU 14 countries and 476 in EU 12 countries. Based on a BMI > 29.9 kg/m(2), maternal obesity was higher in Irish (19.8%; n = 443) and EU 14 women (19.0%; n = 19) compared with EU 12 women (9.5%; n = 45), p < 0.001. BIA of maternal body composition confirmed increased adiposity in both the Irish and EU 14 women. Variations in emergency CS rates in primigravidas based on the woman's birthplace were associated with maternal adiposity and induction of labour, both modifiable risk factors for CS. We recommend, therefore, that induction of labour in obese primigravidas should be undertaken only in carefully considered clinical circumstances. Our findings also suggest economic development in Europe may drive an increase in the CS rates mediated through increased levels of maternal obesity and, therefore, public health interventions should focus on optimising a woman's prepregnancy weight. PMID:23815198

  5. A global reference for caesarean section rates (C-Model): a multicountry cross-sectional study

    OpenAIRE

    Souza, JP; Betran, AP; Dumont, A; de Mucio, B.; Gibbs Pickens, CM; Deneux-Tharaux, C.; Ortiz-Panozo, E; Sullivan, E; Ota, E.; Togoobaatar, G; Carroli, G; Knight, H; Zhang, J.; Cecatti, JG; Vogel, JP

    2015-01-01

    ObjectiveTo generate a global reference for caesarean section (CS) rates at health facilities. DesignCross-sectional study. SettingHealth facilities from 43 countries. Population/SampleThirty eight thousand three hundred and twenty-four women giving birth from 22 countries for model building and 10045875 women giving birth from 43 countries for model testing. MethodsWe hypothesised that mathematical models could determine the relationship between clinical-obstetric characteristics and CS. The...

  6. Rate and indications of elective and emergency caesarean section; a study in a tertiary care hospital of peshawar

    International Nuclear Information System (INIS)

    The study was conducted to determine the rate and clinical indications for emergency and elective caesarean section. Methods: This was a cross-sectional descriptive study conducted from December 2010 to January 2011 in Gynaecology unit-A of Lady Reading Hospital Peshawar. Consecutive patients who gave birth in the hospital during the study period were included in the study. There were a total of 966 patients. Mode of delivery and basic demographics of the patients who underwent elective and emergency caesarean section were noted down. Clinical indications were recorded. Results: Out of 966 patients, 210 underwent caesarean section. Therefore, the rate of caesarean section was 21.7 per 100. Among those 78% (n=164) were emergency caesarean sections and others were elective caesarean sections. Top six indicators for caesarean sections were foetal distress 17.1 % (n=36), obstructive labour/failure to progress 16.1% (n=34), previous caesarean section 15.2% (n=32), breech presentation 9.5% (n=20), cephalopelvic disproportion 6.1% (n=13), failed induction 5.7% (n=12) and pregnancy induced hypertension (PIH) 5.7% (n=12). Conclusion: The rate of caesarean section was only slightly higher than recommended by the WHO. Most of caesarean sections were emergency caesarean sections. (author)

  7. What is the optimal caesarean section rate? An outcome based study of existing variation.

    OpenAIRE

    Joffe, M.; Chapple, J; Paterson, C.; Beard, R. W.

    1994-01-01

    STUDY OBJECTIVE--To investigate the consequences of different levels of caesarean section (CS) rate in terms of fetal and maternal outcomes. DESIGN--Comparison of outcome variables between four categories of maternity units stratified according to CS rates. Data were collected concurrently. SETTINGS--All 17 maternity units in one health region. SUBJECTS--Data for the perinatal mortality analysis: all 221,867 deliveries in 1983-87 (excluding severe malformations) (1462 deaths); maternity infor...

  8. 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

  9. Perimortem caesarean section.

    Science.gov (United States)

    Parry, Richard; Asmussen, Tilo; Smith, Jason E

    2016-03-01

    This review describes a simple approach to perimortem caesarean section (PMCS) that can be used by a doctor in the resuscitation room or prehospital environment when faced with a mother of more than 20 weeks gestation in cardiac arrest. It explores the indications for and contraindications to the procedure, the physiological rationale behind it, equipment needed, technical aspects of the procedure and reviews recent literature on maternal and fetal outcomes. Like other uncommon procedures such as emergency department thoracotomy, rehearsal and preparation for a PMCS is essential to give both mother and baby the best chance of survival. PMID:25714106

  10. Evaluating the ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme’: A mixed method study in England

    OpenAIRE

    Marshall, Joyce; Spiby, Helen; McCormick, Felicia

    2015-01-01

    Background Caesarean section plays an important role in ensuring safety of mother and infant but rising rates are not accompanied by measurable improvements in maternal or neonatal mortality or morbidity. The ‘Focus on Normal Birth and Reducing Caesarean section Rates Rapid Improvement Programme’ was a facilitative initiative developed to promote opportunities for normal birth and reduce Caesarean section rates in England. Objective To evaluate the ‘Focus on Normal Birth and Reduc...

  11. A cross sectional study of rate, indications and complications of primary caesarean section

    Directory of Open Access Journals (Sweden)

    Mahima Jain

    2016-06-01

    Conclusions: From this tudy, we concluded that overall CS rate is 18.5% and rate of vaginal delivery is 82.1% of the present study from 1st April 2014 to 31st March 2015. While primary cesarean section rate is 55.8%, more in primipara as compared to multipara. The malpresentation was the major indication in primary cesarean section, in both primipara and multipara women in our community, while APH is still a major problem of the multiparity. Anemia, malpresentation, eclampsia and preeclampsia were more common antenatal complications in primipara while APH was antenatal complication in multiparity. Malpresentation (34.3% was the commonest indication for cesarean section in both the groups. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1814-1819

  12. Neonatology and the caesarean section.

    Science.gov (United States)

    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. PMID:22958012

  13. Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan

    Science.gov (United States)

    Hajizadeh, Shayesteh; Tehrani, Fahimeh Ramezani; Simbar, Masoumeh; Farzadfar, Farshad

    2016-01-01

    Background The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density. Methods In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline. Results After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03–0.25) in women’s awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women’s preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22–0.85); P>0.001). Conclusions The results of this study

  14. Adhesive bowel strangulation after caesarean section, the rare puerperal complication.

    Science.gov (United States)

    Záhumenský, J; Zmrhalová, B; Sottner, O; Maxová, K; Brtnická, H; Horák, J; Binder, T; Halaska, M

    2010-01-01

    Caesarean section is the most frequent abdominal operation carried out in obstetric practice. Parturients undergoing this operation are still exposed to a substantial rate of short- and long-term complications. The incidence of re-laparotomy after caesarean section is 0.12-0.70%. The most common indication for re-laparotomy is intra-abdominal bleeding, uterine atony, eventration, haematoma in the muscle and intra-abdominal abscesses. We present the case report of an unusual life-threatening complication of caesarean section that led to re-laparotomy. Caesarean section rate has been continually increasing globally in the last few decades, thus we also have to take into account unusual complications e.g. intestinal complication. PMID:20359439

  15. Psychiatric illness in women requesting caesarean section

    OpenAIRE

    Sydsjö, Gunilla; Möller, Louise; Lilliecreutz, Caroline; Bladh, Marie; Andolf, E; Josefsson, Ann

    2014-01-01

    Objective To compare psychiatric in-and outpatient care during the 5 years before first delivery in primiparae delivered by caesarean section on maternal request with all other primiparae women who had given birth during the same time period. Design Prospective, population-based register study. Setting Sweden. Sample Women giving birth for the first time between 2002 and 2004 (n = 64 834). Methods Women giving birth by caesarean section on maternal request (n = 1009) were compared with all ot...

  16. Caesarean section survey in Galway--1973 through 1987.

    Science.gov (United States)

    Bolaji, I I; Meehan, F P

    1993-01-01

    We review the trend, indications and maternal mortality with caesarean section at University College Hospital Galway from 1973 to 1987. The caesarean section rate (CSR) rose from 6.06% in 1973 to 10.18% in 1987, primary sections from 3.58% to 6.51% and repeat sections from 2.49% to 3.67% during the same interval. The four major indications for section were cephalopelvic disproportion, foetal distress, previous section and malpresentations. Lower segment caesarean section was the commonest operation and a slight increase in the classical operation was noted due to an increased intervention in prematurity. The maternal mortality rate was 11.2/10,000 in the 15-year period and the complications leading to death were ultimately ascribable to primary postpartum haemorrhage. Strategies for reduction in the CSR are discussed. PMID:8449255

  17. Stress, sleep quality and unplanned Caesarean section in pregnant women.

    Science.gov (United States)

    Ko, Yi-Li; Lin, Pi-Chu; Chen, Shu-Chuan

    2015-10-01

    This study examines the relationship among prenatal maternal stress, sleep quality and unplanned Caesarean delivery. For this research, we adopted a prospective survey design and a sample of 200 women in the early stages of labour. The findings were as follows: (i) 11.5% of the participants underwent unplanned Caesarean sections; (ii) based on a Pittsburg Sleep Quality Index split point of 5, approximately 90.5% of the participants experienced poor sleep quality; and (iii) the odds ratio for primiparas undergoing an unplanned Caesarean section was 4.183 times that for multiparas (95% confidence interval (CI) = 1.177 to 14.864), indicating a statistically significant difference. The results also showed that stress was a significant factor related to unplanned Caesarean sections; a 1-point increase on the Pregnancy Stress Rating Scale was associated with a 1.033-fold higher probability of undergoing an unplanned Caesarean section (95% CI = 1.002 to 1.065). Furthermore, prenatal stress was a significant variable that can be used to predict unplanned Caesarean deliveries. PMID:24754483

  18. [Caesarean section in the context of free policy in Benin].

    Science.gov (United States)

    Mahieu, Céline

    2016-01-01

    Caesarean section was well appreciated by most beneficiaries. However, an audit of caesarean sections would ensure compliance with the principles of free care and better management of women at all levels of the health system.. PMID:27531438

  19. 'What about the Mother?' : Rising Caesarean Section Rates and their Association with Maternal Near-Miss Morbidity and Death in a Low-Resource Setting

    OpenAIRE

    Litorp, Helena

    2015-01-01

    In recent decades, there has been a seemingly inexhaustible rise in the use of caesarean section (CS) worldwide. The overall aim with this thesis is to explore the effects of and reasons for an increase in the CS rate at a university hospital in Dar es Salaam, Tanzania. In Study I, we analysed time trends in CS rates and maternal and perinatal outcomes between 2000 and 2011 among different obstetric groups. In Study II, we documented the occurrence and panorama of maternal ‘near-miss’ morbidi...

  20. Intervention for postpartum infections following caesarean section

    OpenAIRE

    Hyldig, Nana; Bille, Camilla; Kruse, Marie; Bøgeskov, Renee Anita; Jørgensen, Jan Stener

    2012-01-01

    The purpose of this study is to examine the effect on wound healing using Negative Pressure Wound Therapy (NPWT) compared with conventional wound treatment in women, who experience spontaneous dehiscence or reoperation for postoperative infection after caesarean section (CS). In addition the study seeks to elucidate the health economic cost and consequences of this type of infection and treatment.Background: Obesity is an increasing problem in the health care system. Today more than 12% of al...

  1. 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.

  2. INDICATIONS FOR CAESAREAN SECTION IN NULLIPAROUS AND MULTIPAROUS WOMEN

    Directory of Open Access Journals (Sweden)

    Sheela

    2014-12-01

    Full Text Available INTRODUCTION: Within few years’ number of caesarean sections increased dramatically in our hospital. This study was done to find out whether increasing the number of caesarean sections were due to improving patients transportation and maternal and child welfare program or it was due to caesarean section were performed for improper indication. METHOD AND MATERIAL: It is a retrograded study conducted on the bases of caesarean section performed in Bundelkhand Medical college associated hospital from October 2013 to September 2014. 1536 caesarean section were performed of this 1104 (71.87% were nulliparous and 432 (23.43% were multiparous. During this period only 5 cases of rupture uterus were reported. All are multiparous women with no history of previous section. RESULT: The most common indication of caesarean section among nulliparous women (23.43% was cephalo-pelvic disproportion with other complications like fetal distress, premature rupture membrane, PIH, mal-presentation. Among multiparous women the most common indication for caesarean section was previous caesarean section with Cephalo-pelvic disproportion (26.62% CONCLUSION: In our hospital majority of caesarean sections were compulsory for maternal and fetal wellbeing. Minority of cases there may be difference of opinion or error of judgment. But attempts should be made to decrease even these minorities of cases by critical evaluation of decision to perform caesarean section especially in nulliparous women. First caesarean section itself an indication for subsequent caesarean section but in these cases also presence of other risk factors should identified and if possible careful trial of labour should perform.

  3. VBAC Scoring: Successful vaginal delivery in previous one caesarean section in induced labour

    International Nuclear Information System (INIS)

    Objective: To develop a scoring system for the prediction of successful vaginal birth after caesarean section, following induction of labour with intra-vaginal E2 gel (Glandin). Methods: The cross-sectional study was conducted from January 2010 to August 2011, at the Pakistan Institute of Medical Sciences in Islamabad. Trial of labour in previous one caesarean section, undergoing induction with intra-vaginal E2 gel, was attempted in 100 women. They were scored according to six variables; maternal age; gestation; indications of previous caesarean; history of vaginal birth either before or after the previous caesarean; Bishop score and body mass index. Multivariate and univariate logistic regression analysis was used to develop the scoring system. Results: Of the total, 67 (67%) women delivered vaginally, while 33 (33%) ended in repeat caesarean delivery. Among the subjects, 55 (55%) women had no history of vaginal delivery either before or after previous caesarean section; 15 (15%) had history of vaginal births both before and after the previous caesarean; while 30 (30%) had vaginal delivery only after the previous caesarean section. Rates of successful vaginal birth after caesarean increased from 38% in women having a score of 0-3 to 58% in patients scoring 4-6. Among those having a score of 7-9 and 10-12, the success rates were 71% and 86% respectively. Conclusion: Increasing scores correlated with the increasing probability of vaginal birth after caesarean undergoing induction of labour. The admission VBAC scoring system is useful in counselling women with previous caesarean for the option of induction of labour or repeat caesarean delivery. (author)

  4. Intervention for Postpartum Infections following Caesarean Section

    DEFF Research Database (Denmark)

    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...... cost and consequences of NPWT is planned. Methods: A randomized controlled trial. The study will be performed at two large obstetrical units in Denmark. Data will be collected prospectively. We expect to include 50 women, of whom two-thirds will be randomized to NPWT. The primary endpoint is the...... treatment for one change with NPWT to be cost effective. Concussion: The preliminary results indicate that NPWT reduce the risk of re-rupture significantly. The benefit of the treatment is expected to be twofold: a) A reduction in health care costs (inpatient bed days and readmissions) b) An increase in the...

  5. Effective education to decrease elective caesarean section

    International Nuclear Information System (INIS)

    Objective: To examine the effect of education on deciding about natural delivery in women opting for elective caesarean section. Methods: The quasi-experimental study was carried out between January and March 2012 and comprised a sample of 200 women in their third trimester of pregnancy attending women's clinics of Imam Ali Hospital, Zahedan, Iran, with the intention of having elective caesarean section. The subjects were voluntarily classified into three groups: one group received an educational package; the other had educational package along with group discussion, and the last one without any intervention was considered the control group. Post-test was conducted a month after intervention. Data were analysed using Kruskal Wallis, and logistic regression tests. Results: Group A represented the controls and had 100 (50%) women; Group B with the educational package had 40 (20%), while there were 60 (30%) women in Group C who had exposure to the educational package as well as group discussion. There were significant changes in behaviour in Group B and C (p <0.01) but no change among the controls in Group A. In Group C, 25 (42%) women decided to go for natural delivery, while 1 (2.5%) woman had a change of opinion in Group B. Four (4%) women in the control Group A had ultimately natural delivery, but they were all emergency cases. Conclusion: The two educational methods increased model construct scores, including awareness, attitude, perceived behaviour control, subjective norms and behavioural intention. Nevertheless, educational package in conjunction with group discussion was more effective in influencing the choice towards natural delivery. (author)

  6. Predictors of post-caesarean section pain and analgesic consumption

    Directory of Open Access Journals (Sweden)

    Luana Buhagiar

    2011-01-01

    Full Text Available Background: Ideally, the intensity of postoperative pain should be predicted so as to customize analgesia. The objective of this study was to investigate whether preoperative electrical and pressure pain assessment can predict post-caesarean section pain and analgesic requirement. Materials and Methods: A total of 65 subjects scheduled for elective caesarean section, who gave written informed consent, were studied. Preoperatively, PainMatcher® was used to evaluate electrical pain threshold, while manual PainTest™ FPN 100 Algometer and digital PainTest™ FPX 25 Algometer determined pressure pain threshold and tolerance. Postoperatively, numerical rating scales were used to assess pain at regular time intervals. Patients received intramuscular pethidine (100mg, 6 hourly, rectal diclofenac (100mg, 12 hourly, and oral paracetamol (1g, p.r.n. for pain relief. Statistical analysis was conducted using PASW Statistics 18 software. Results: Preoperative electrical pain threshold correlated significantly with post-caesarean pain scores at 6 and 24 hours (r = -0.26, P < 0.02; r = -0.23, P < 0.04, respectively, and with the quantity of paracetamol consumed by the patient within 48 hours of surgery (r = -0.33, P < 0.005. Preoperative pressure pain tolerance measured by PainTest™ FPX 25 Algometer was significantly correlated with pain scores 6 hours postsurgery (r = -0.21, P < 0.05. Pain scores 6 hours post-caesarean section correlated significantly with anesthesia--general or spinal (F = 4.22, v 1 = 1, v 2 = 63, P < 0.05. Conclusions: The predictive methods proposed may aid in identifying patients at greater risk for postoperative pain. Electrical pain threshold could be useful in personalizing the postoperative analgesic protocol.

  7. 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.

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

    DEFF Research Database (Denmark)

    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...

  9. Caesarean section scar ectopic pregnancy following postcoital contraception.

    Science.gov (United States)

    Fabunmi, Laura; Perks, Nigel

    2002-07-01

    This is believed to be the first reported case of an ectopic pregnancy following failed progestogen-only emergency contraception. The ectopic pregnancy was at the site of a previous caesarean section scar and was managed conservatively. PMID:16259837

  10. Techniques and materials for skin closure in caesarean section

    DEFF Research Database (Denmark)

    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....

  11. Preference for Institutional Delivery and Caesarean Sections in Bangladesh

    OpenAIRE

    Kamal, S M Mostafa

    2013-01-01

    In Bangladesh, preference for place of delivery and socioeconomic factors associated with caesarean section are not well-understood. This paper examines the socioeconomic correlates of preference for institutional delivery and caesarean sections in Bangladesh. The study used data from the nationally-representative 2007 Bangladesh Demographic and Health Survey. Both bivariate and multivariate binary logistic regression models were constructed to assess the effect of sociodemographic factors on...

  12. Challenges in the Caesarean Section of a Severely Kyphotic Parturient

    OpenAIRE

    Manisha Chhetry; Basudeb Banerjee; Shanti Subedi; Narayan Bahadur Gharti Chhetri; Yogendra Gupta

    2016-01-01

    Caesarean section in a severely kyphotic patient presents with unique challenges. We report a case of obstructed labor in case of a pregnant lady with severe kyphosis of spine that was managed by caesarean section. Lateral recumbent position with adequate assistance and paramedian or vertical skin incision was used and found to provide good exposure. Baby was delivered by lower segment uterine incision by reverse breech extraction. Postpartum hemorrhage was managed with uterotonics and bilate...

  13. Scar endometriosis following caesarean section: a rare case report

    OpenAIRE

    Manisha Sharma; Ruchira Nautiyal; Jaya Chaturvedi; Surbhi Bhargava

    2015-01-01

    Endometriosis is presence of functioning endometrial tissue (glands and stroma) outside the uterine cavity. Endometriosis can sometimes occur in previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynaecological surgeries. We present here a case report of a patient who developed scar endometriosis following a caesarean section which was dealt adequately in the subsequent caesarean section. [Int J Reprod Contracept Obstet Gynecol 2015...

  14. Caesarean section in Ancient Greek mythology.

    Science.gov (United States)

    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. PMID:26203550

  15. 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.

  16. Challenges in the Caesarean Section of a Severely Kyphotic Parturient.

    Science.gov (United States)

    Chhetry, Manisha; Banerjee, Basudeb; Subedi, Shanti; Gharti Chhetri, Narayan Bahadur; Gupta, Yogendra

    2016-01-01

    Caesarean section in a severely kyphotic patient presents with unique challenges. We report a case of obstructed labor in case of a pregnant lady with severe kyphosis of spine that was managed by caesarean section. Lateral recumbent position with adequate assistance and paramedian or vertical skin incision was used and found to provide good exposure. Baby was delivered by lower segment uterine incision by reverse breech extraction. Postpartum hemorrhage was managed with uterotonics and bilateral uterine artery ligation. Tubal ligation though advised was refused by the patient. Prolonged catheterization was done in view of obstructed labor. Postoperative period was uneventful. PMID:27066281

  17. Challenges in the Caesarean Section of a Severely Kyphotic Parturient

    Directory of Open Access Journals (Sweden)

    Manisha Chhetry

    2016-01-01

    Full Text Available Caesarean section in a severely kyphotic patient presents with unique challenges. We report a case of obstructed labor in case of a pregnant lady with severe kyphosis of spine that was managed by caesarean section. Lateral recumbent position with adequate assistance and paramedian or vertical skin incision was used and found to provide good exposure. Baby was delivered by lower segment uterine incision by reverse breech extraction. Postpartum hemorrhage was managed with uterotonics and bilateral uterine artery ligation. Tubal ligation though advised was refused by the patient. Prolonged catheterization was done in view of obstructed labor. Postoperative period was uneventful.

  18. 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...

  19. 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 ...

  20. 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 of evi...

  1. Ectopic Pregnancy in caesarean section scar: A case report

    Directory of Open Access Journals (Sweden)

    Rajarshi Aich, MBBS

    2015-12-01

    Full Text Available We report a rare case of ectopic pregnancy occurring in the scar of a previous caesarean section, diagnosed by ultrasonography and confirmed by 3.0-T magnetic resonance imaging of pelvis. We present the clinical details and imaging findings, followed by discussion of the etiology, pathogenesis, and imaging of this condition.

  2. 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

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

    Science.gov (United States)

    Mashalla, Yohana J.S.; Thupayagale-Tshweneagae, Gloria

    2016-01-01

    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 socio-economic 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.

  4. 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

  5. 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.

  6. Prolonged labour as indication for emergency caesarean section

    DEFF Research Database (Denmark)

    Maaløe, N; Sørensen, Bjarke Lund; Onesmo, R;

    2012-01-01

    OBJECTIVE: To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour. DESIGN: A quality assurance analysis of a retrospective criterion-based audit supplemented by in-depth interviews with hospital staff. SETTING: Two Tanzanian rural mission hospitals....... Amongst the hospital staff interviewed, the awareness of evidence-based guidelines was poor. Word of mouth, personal experience, and fear, especially of HIV transmission, influenced management decisions. CONCLUSION: The lack of use and awareness of evidence-based guidelines led to misinterpretation of....... POPULATION: Audit of 144 cases of women undergoing caesarean sections for prolonged labour; in addition, eight staff members were interviewed. METHODS: Criteria of realistic best practice were established, and the case files were audited and compared with these. Hospital staff were interviewed about what...

  7. 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.)

  8. Anaesthetic Management of Caesarean Section in an Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Kirti N Saxena

    2008-01-01

    A twenty year old parturient with short stature presented to the hospital in early labour. An elective lower segment caesarean section(LSCS was planned in view of cephalopelvic disproportion. She had papers which suggested that she had been diagnosed as a case of achondroplasia though details were not available. Combined spinal epidural(CSE anaesthesia was planned in the patient in view of the death of her first baby following caesarean section under general anaesthesia. Repeatedly dry taps were achieved on attempting dural puncture. Dural puncture was abandoned and an 18 G epidural catheter was threaded via the Tuohy needle. Sensory block till T 6 was achieved with 6ml of local anaesthetic solution. The patient was stable during the intraoperative and postoperative period.

  9. 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.

  10. Emergency caesarean section in low risk nulliparous women

    DEFF Research Database (Denmark)

    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 and...... association between risk factors and indications for ECS. Smoking during pregnancy (OR 2.33; CI 1.18-4.61) and BMI ≥ 30 (OR 2.87, CI 1.34-6.16) were associated with increased risk of ECS due to SFD. Birth weight (BW) ≥ 4,000 (OR 2.95; CI 1.92-4.53) and smoking cessation during pregnancy (OR 2.02; CI 1...

  11. Caesarean Section, Vaginal Delivery and Post Natal Depression

    OpenAIRE

    MH Baghianimoghadam; D Shodjaee zadeh; AH Aminian

    2009-01-01

    "nBackground: Depression is a kind of sorrow that decreases the level of juiciness. Most studies have maintained that psy­chological risk factors have the most profound effect on the development of postnatal depression (PND). We compared the postnatal depression among the women with elective caesarean and vaginal delivery. "nMethods: This cross- sectional study was carried out on 120 women 1-4 months after their delivery. Samples were divided in two groups (60 mothe...

  12. 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.

  13. Fetal circulation during epidural analgesia for caesarean section.

    OpenAIRE

    Lindblad, A; Marsál, K; Vernersson, E; Renck, H

    1984-01-01

    Fetal blood flow was examined during epidural analgesia in six women with uncomplicated pregnancies undergoing elective caesarean section. A non-invasive, ultrasonic technique was used to measure blood flow in the fetal descending aorta and intra-abdominal part of the umbilical vein before induction of analgesia with etidocaine and bupivacaine and 15 and 30 minutes afterwards. No appreciable change in fetal blood flow was observed.

  14. Prediction of successful trial of labour in patients with a previous caesarean section

    International Nuclear Information System (INIS)

    Objective: To determine the prediction rate of success in trial of labour after one previous caesarean section. Methods: The cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Cantonment General Hospital, Rawalpindi, from January 1, 2012 to January 31, 2013, and comprised women with one previous Caesarean section and with single alive foetus at 37-41 weeks of gestation. Women with more than one Caesarean section, unknown site of uterine scar, bony pelvic deformity, placenta previa, intra-uterine growth restriction, deep transverse arrest in previous labour and non-reassuring foetal status at the time of admission were excluded. Intrapartum risk assessment included Bishop score at admission, rate of cervical dilatation and scar tenderness. SPSS 21 was used for statistical analysis. Results: Out of a total of 95 women, the trial was successful in 68 (71.6%). Estimated foetal weight and number of prior vaginal deliveries had a high predictive value for successful trial of labour after Caesarean section. Estimated foetal weight had an odds ratio of 0.46 (p<0.001), while number of prior vaginal deliveries had an odds ratio of 0.85 with (p=0.010). Other factors found to be predictive of successful trial included Bishop score at the time of admission (p<0.037) and rate of cervical dilatation in the first stage of labour (p<0.021). Conclusion: History of prior vaginal deliveries, higher Bishop score at the time of admission, rapid rate of cervical dilatation and lower estimated foetal weight were predictive of a successful trial of labour after Caesarean section. (author)

  15. 控制剖宫产率对高龄初产母婴结局影响的研究%Pregnancy outcomes in advanced maternal age pregnancies after taking measures to reduc-ing caesarean section rate

    Institute of Scientific and Technical Information of China (English)

    曹冬如; 张小燕; 包狄

    2015-01-01

    Objective To compare pregnancy outcomes in advanced maternal age pregnancies after taking measures to reducing caesarean section rate. Method A total of 1062 pregnant women aged 35 years or older who gave birth in beijing haidian district maternal and children healthcare hospital from 2013 to 2014 were retrospectively studied. 490 Pregnant women aged 35 years and over delivered in 2014 were included in study group and those 572 patients delivered in 2013 were included in the control group. Pregnant complications,delivery mode,postpartum hemorrhage rate,neonatal asphyxia rate were compared in both groups. Result ①No statistically significant difference was ob-served in the frequency of premature rupture of membrane,gestational diabetes mellitus, placenta previa,uterine my-oma,hypertensive disorders, preterm birth, or macrosomia in both groups;②The caesarean section rate in study group was statistically significantly lower than that in the control group(51. 63%vs 68. 88%,P0. 05). Conclusion With the measures of strengthening prenatal and intrapartum care, it is possible to reducing the caesarean section rate in advanced maternal aged pregnancies.%目的:探讨采取控制剖宫产率相关措施对高龄初产妇母婴结局的影响。方法回顾性分析1062例高龄初产孕产妇临床资料,2014年分娩的490例高龄初产妇作为研究组,2013年分娩的高龄初产妇572例作为对照组,比较两组妊娠并发症、分娩方式、产后出血率、新生儿窒息率。结果①两组胎膜早破、妊娠期糖尿病、前置胎盘、子宫肌瘤、妊娠期高血压疾病、早产、巨大儿发生率差异无显著性(P>0.05);②研究组和对照组剖宫产率分别为51.63%、68.88%,两者比较差异有显著性(P0.05)。结论综合孕期和产时管理,将高龄初产孕妇剖宫产率控制在较合理的水平是可能的。

  16. South African mothers' coping with an unplanned Caesarean section.

    Science.gov (United States)

    van Reenen, Samantha; van Rensburg, Esmé

    2015-01-01

    In this study, researchers explored mothers' coping strategies in dealing with birth by unplanned Caesarean section. Mothers' experiences of a traumatic birth could be influenced by perceived strengths when coping with the stress related to the incident. Coping strategies resulted in reassessment of the birth process and were associated with a more positive and memorable experience. In-depth interviews with 10 women explored their lived experiences of childbirth. Data were analyzed thematically. Phenomenological theory served as a framework for the structuring, organizing, and categorizing of data. Mothers described several factors and coping strategies that they perceived to be effective in reducing the impact of their traumatic birth experiences. PMID:24313379

  17. 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.

  18. Clinical study of primary caesarean section in multiparous women in a tertiary care hospital

    OpenAIRE

    Rupal Samal; Pallavee Palai; Seetesh Ghose

    2016-01-01

    Background: The objective of this study was to find the incidence and indications of primary caesarean section in parous women and evaluate the maternal and perinatal outcomes there from. Methods: Prospective study of primary caesarean sections in parous women at our institute from June 2013 to May 2014 was done. Age, indications and the maternal as well as perinatal outcomes were analyzed. Data was expressed as number and percentage. Results: Out of 1124 caesarean deliveries, 68 primar...

  19. 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.

  20. Management of pregnancy with previous lower segment caesarean section in Modern obstetric practice

    Directory of Open Access Journals (Sweden)

    Rajita Jani

    2013-07-01

    of labour. Out of 20 patients who were given trial of labour, 12 patients had vaginal delivery and repeat LSCS was done in 8 patients  Out of 50 patients, 12 patients delivered withvaginal delivery while 38 patients underwent repeat LSCS. Repeat LSCS rate is higher due to trend towards less trial of labour and early decision of repeat LSCS.  Indication of previous LSCS plays an important role in taking decisions and an outcome in present pregnancy. Patients with non-recurrent indication had more chance of delivering vaginally as compared to those with recurrent indications. In present study, commonest indication for repeat LSCS was previous two LSCS followed by CPD and fetal distress. Vaginal delivery is more likely when there is past history of vaginal delivery before and after previous LSCS. Abandoning of a trial was mainly due to fetal distress and non-progress of labour in majority of cases.Conclusion: For successful delivery after a previous cesarean section, the obstetrician requires to have the expertise to carefully select the patients, for trial of vaginal birth because rupture of scar can endanger the life of the mother and the child.  VBAC should be considered in cases of previous one caesarean section done for non recurrent indications. Repeat LSCS rate is higher due to trend towards less trial of labour and early decision of repeat LSCS

  1. Management of pregnancy with previous lower segment caesarean section in Modern obstetric practice

    OpenAIRE

    Rajita Jani; Devangi Munshi

    2013-01-01

    Objective: In today’s obstetric practice we encounter increasing number of post caesarean pregnancies because of rise in primary caesarean due to multi factorial reasons. There is increasing concern by obstetricians for managing these cases for medical and legal point of view. Present study was undertaken to decide appropriate mode of delivery and to conduct the proper management of patients with previous lower segment caesarean section.Study design: This is a prospective study carried out on...

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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

  7. Attitude of pregnant women in south western Nigeria towards caesarean section as a method of birth

    Directory of Open Access Journals (Sweden)

    Adenike Funmilola Faremi

    2014-06-01

    Full Text Available Background: Choice of the method of birth is an essential decision for pregnant women and the spouse. This choice is sometimes based on a number of factors. This study assesses knowledge of pregnant women about caesarean section, their attitude towards it and level of acceptance of the methods of birth among women. Methods: This descriptive study was carried out in a government owned hospital in south western Nigeria. Respondents were selected using accidental sampling techniques. Questionnaire whose validity and reliability has been previously ascertained was the instrument used for data collection. Data generated was analysed using SPSS. Results: Results show that 17.1% of the women have good knowledge of caesarean section as a method of birth. Majority of the respondents agreed that vaginal delivery creates more mother-baby relationship than caesarean section. 69.5% of the respondents agreed that caesarean section is preferable to vaginal delivery as the pain in vaginal delivery is usually unpleasant, 66.0% disagreed that babies born through caesarean section are more healthy than their other counterpart that are born through vaginal delivery. Only 6.9% accept caesarean section. Conclusions: Mothers should therefore be educated on the process involved in caesarean birth and the advantage of this method of birth over other birth method. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 709-714

  8. Decisions to Perform Emergency Caesarean Sections at a University Hospital

    Science.gov (United States)

    Pillai, Silja A.; Vaidyanathan, Gowri; Al-Shukri, Maryam; Al-Dughaishi, Tamima R.; Tazneem, Shahila; Khan, Durdana; El-Tayeb, Saniya; Mathew, Mariam

    2016-01-01

    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. PMID:26909212

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

    OpenAIRE

    Jafar S Tabrizi; Samira Askari; Zahra Fardiazar; Hossein Koshavar; Kamal Gholipour

    2014-01-01

    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...

  10. Caesarean section in a patient with varicella: Anaesthesia considerations and clinical relevance

    Directory of Open Access Journals (Sweden)

    Nandini M Dave

    2007-01-01

    Full Text Available A primigravida with chicken pox was posted for an emergency caesarean section. General anaesthesia was administered. Key issues in anaesthesia management and the clinical implications are discussed.

  11. Comparison of peritoneal closure versus non-closure during caesarean section

    International Nuclear Information System (INIS)

    In modern obstetrics caesarean sections are commonly used and in all caesarean sections either peritoneal closure is done or not. This cases series was conducted to record outcomes in our setup. Methods: Cases of caesarean sections were followed for adhesions and non-adhesions in peritoneal closure and non-closure cases from 1st January to December 2011 at DHQ Hospital Haripur. In non-peritoneal closure cases adhesions were marked as compare to non-adhesions in eritoneal closure cases. Results: Sixty-five cases of peritoneal closure and 30 cases of non-peritoneal closure were followed up. There were more cases of adhesions in non-closure group (p<0.05). Conclusion: Peritoneal closure is beneficial in routine caesarean sections. (author)

  12. 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 in...... 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 with...... emergency caesarean section: adjusted OR = 0.81 (95% CI: 0.48-1.36) and OR = 0.97 (95% CI: 0.55-1.71), respectively. CONCLUSION: In this prospective observational study, women with FOC did not have an increased risk of emergency caesarean section compared to women with no such fear....

  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. Maternal height as a risk factor for Caesarean section due to failure to progress in labour.

    Science.gov (United States)

    McGuinness, B J; Trivedi, A N

    1999-05-01

    We examined for a regional sample of the New Zealand population, the relationship between maternal height and an increased risk of emergency Caesarean section due to arrested labour, to identify a height below which the risk of Caesarean section increases markedly and to quantify the risk of a Caesarean section for a range of maternal heights. The data of nulliparous singleton pregnancies over the period 1994-1998 was sorted into 2 study groups, one resulting in emergency Caesarean section for arrested labour and the other a group of women who had normal vaginal delivery requiring no intervention. The means and standard deviations of these 2 groups were found and 99% confidence intervals calculated. They were analysed for statistical difference and then a logistical regression calculation tried to identify a height at which the risk of a Caesarean section increased suddenly. There were 81 women in the Caesarean section group and 997 in the normal vaginal delivery group. Mean heights and confidence intervals were 161.0 cm (158.9-163.1) and 164.6 cm (164.0-165.2) respectively. There was a statistically significant difference between these means (plogistic regression analysis showed that risk of Caesarean section increased gradually with decreasing height, and even then did not reach more than 30% risk until a height of less than 140 cm. Low maternal height was associated with increased risk of Caesarean section due to labour arrest. Because the likelihood of having a normal vaginal delivery was still very good (>80 %) at modest degrees of short stature, this risk factor alone is unlikely to affect management. However the combination of other risk factors with maternal height may be of clinical use. PMID:10755767

  15. Use of a computerised maternity information system to improve clinical effectiveness: thromboprophylaxis at caesarean section

    OpenAIRE

    Taylor, G.; Mckenzie, C.; Mires, G.

    2000-01-01

    An audit of the introduction of a protocol for thromboprophylaxis at caesarean section revealed over treatment of low risk women and the under treatment of high risk women. A routine computer generated risk assessment profile was introduced as part of a maternity information system. Reaudit showed a significant improvement in adherence to the thromboprophylaxis protocol in all risk groups.


Keywords: thromboprophylaxis; caesarean section; computerised assessment

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

    OpenAIRE

    Roduit, C.; Scholtens, S.; Jongste, de, 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 sensitisation at the age of 8 years, taking into account the allergic status of the parents. METHODS: 2917 children who participated in a birth cohort study were followed for 8 years. The definition of...

  17. Comparison of suture material and technique of closure of subcutaneous fat and skin in caesarean section

    OpenAIRE

    Aliya Islam; Ambreen Ehsan

    2011-01-01

    Background : A large number of women undergo caesarean section throughout the world. These women pass through a period of post operative pain and a morbidity period. These women translate into a substantial portion of population and hence there is a load on the financial resources of healthcare system. Use of the appropriate technique to approximate the wound after caesarean section would not only avoid financial load but also help in early recovery of the patient. Aim : The aim of this study...

  18. Double balloon device compared to oxytocin for induction of labour after previous caesarean section

    OpenAIRE

    José García-Adanez; Irene Diez-Itza; Miren Arrue Gabilondo; Estefanía Rodríguez Ferradas; Izaskun Lasa Alvarado

    2013-01-01

    Objective: To assess cervical changes, duration of oxytocin infusion, mode of delivery and complications after cervical ripening using a double balloon device in women with a previous caesarean section. Methods: Longitudinal study including 80 women with a previous caesarean section, no previous vaginal delivery and an unfavourable cervix (Bishop score < 4). Two groups were established: a double balloon device was used with 32 women (exposed) and not with the others (non-exposed) (48). Stati...

  19. After surgery: the effects of life-saving caesarean sections in Burkina Faso

    OpenAIRE

    Filippi, Véronique; Ganaba, Rasmané; Calvert, Clara; Murray, Susan F.; Storeng, Katerini T.

    2015-01-01

    Background In African countries, caesarean sections are usually performed to save mothers and babies’ lives, sometimes in extremis and at considerable costs. Little is known about the health and lives of women once discharged after such surgery. We investigated the long-term effects of life-saving caesarean section on health, economic and social outcomes in Burkina Faso. Methods We conducted a 4 year ...

  20. Behavioural, educational and respiratory outcomes of antenatal betamethasone for term caesarean section (ASTECS trial)

    OpenAIRE

    Stutchfield, Peter Roy; Whitaker, Rhiannon; Gliddon, Angela E; Hobson, Lucie; Kotecha, Sailesh; Doull, Iolo J M

    2013-01-01

    Objectives To determine whether antenatal betamethasone prior to elective term caesarean section (CS) affects long term behavioural, cognitive or developmental outcome, and whether the risk of asthma or atopic disease is reduced. Design A questionnaire based follow-up of a multicentre randomised controlled trial (Antenatal Steroids for Term Elective Caesarean Section, BMJ 2005). Setting Four UK study centres from the original trial. Participants 862 participants from the four largest recruiti...

  1. Protocol for a randomised controlled trial of fetal scalp blood lactate measurement to reduce caesarean sections during labour: the Flamingo trial [ACTRN12611000172909

    OpenAIRE

    East, Christine E.; Stefan C. Kane; Davey, Mary-Ann; Kamlin, C. Omar; Brennecke, Shaun P.; ,

    2015-01-01

    Background The rate of caesarean sections around the world is rising each year, reaching epidemic proportions. Although many caesarean sections are performed for concerns about fetal welfare on the basis of abnormal cardiotocography, the majority of babies are shown to be well at birth, meaning that the operation, with its inherent short and long term risks, could have been avoided without compromising the baby’s health. Previously, fetal scalp blood sampling for pH estimation was performed i...

  2. Comparison of suture material and technique of closure of subcutaneous fat and skin in caesarean section

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-03-01

    Full Text Available Background: A large number of women undergo caesarean section throughout the world. These women pass through a period of post operative pain and a morbidity period. These women translate into a substantial portion of population and hence there is a load on the financial resources of healthcare system. Use of the appropriate technique to approximate the wound after caesarean section would not only avoid financial load but also help in early recovery of the patient. Aim: The aim of this study is to compare the effects of alternative techniques for closure of subcutaneous fat and skin on maternal health and use of healthcare resources in caesarean section. Materials and Methods: Patients undergoing Caesarean section were divided in two groups of one thousand patients each. Patients with hematological disorders or a malignancy, diabetes, septicemia or chorioamnionitis were excluded from the study. In all the patients, after stitching the uterus, the rectus sheath was stitched with thread vicryl No.1 (synthetic absorbable braided sutures with polyglycolic acid, polycaprolactone and calcium stearate coating, using a round body needle. Then the patients were divided into two groups. In group I, vicryl No.1 thread used in stitching of the rectus sheath was continued into the skin with application of subcuticular stitches, after securing the edges with a knot. In group II, after stitching the rectus sheath with vicryl No. 1, the thread was cut and interrupted sutures were applied in subcutaneous fat with thread vicryl No. 2. Skin was stitched with subcuticular stitches using proline 2, a non-absorbable propylene suture. The two groups of patients were observed for the duration of surgery, post-operative pain in stitches, patient satisfaction about removal of stitches, evidence of wound infection or seroma, and cosmetic results. Results: It was noted that the duration of surgery in group I was on average 7.5 minutes less as compared to the duration in

  3. Comparison of suture material and technique of closure of subcutaneous fat and skin in caesarean section

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-01-01

    Full Text Available Background : A large number of women undergo caesarean section throughout the world. These women pass through a period of post operative pain and a morbidity period. These women translate into a substantial portion of population and hence there is a load on the financial resources of healthcare system. Use of the appropriate technique to approximate the wound after caesarean section would not only avoid financial load but also help in early recovery of the patient. Aim : The aim of this study is to compare the effects of alternative techniques for closure of subcutaneous fat and skin on maternal health and use of healthcare resources in caesarean section. Materials and Methods : Patients undergoing Caesarean section were divided in two groups of one thousand patients each. Patients with hematological disorders or a malignancy, diabetes, septicemia or chorioamnionitis were excluded from the study. In all the patients, after stitching the uterus, the rectus sheath was stitched with thread vicryl No.1 (synthetic absorbable braided sutures with polyglycolic acid, polycaprolactone and calcium stearate coating, using a round body needle. Then the patients were divided into two groups. In group I, vicryl No.1 thread used in stitching of the rectus sheath was continued into the skin with application of subcuticular stitches, after securing the edges with a knot. In group II, after stitching the rectus sheath with vicryl No. 1, the thread was cut and interrupted sutures were applied in subcutaneous fat with thread vicryl No. 2. Skin was stitched with subcuticular stitches using proline 2, a non-absorbable propylene suture. The two groups of patients were observed for the duration of surgery, post-operative pain in stitches, patient satisfaction about removal of stitches, evidence of wound infection or seroma, and cosmetic results. Results : It was noted that the duration of surgery in group I was on average 7.5 minutes less as compared to the duration in

  4. 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.

  5. 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 ...

  6. 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

    phenylephrine reduced ScO2 (-8.6 ± 2.8%; p = 0.005) with a 10.7% difference in ScO2between groups (p = 0.0106). Also maternal heart rate was maintained with ephedrine (+3 ± 3 bpm) but decreased with phenylephrine (-11 ± 3 bpm); difference 14 bpm (p = 0.0053), but no significant difference in mean arterial...... pressure (p = 0.1904) or CO (p = 0.0683) was observed between groups. The two drugs also elicited an equal increase in fetal heart rate (by 19 ± 3 vs. 18 ± 3 bpm; p = 0.744). CONCLUSION: In the choice between phenylephrine and ephedrine for maintenance of blood pressure during caesarean section with spinal...

  7. Post-caesarean section surgical site infections at a Tanzanian tertiary hospital: a prospective observational study.

    Science.gov (United States)

    De Nardo, P; Gentilotti, E; Nguhuni, B; Vairo, F; Chaula, Z; Nicastri, E; Nassoro, M M; Bevilacqua, N; Ismail, A; Savoldi, A; Zumla, A; Ippolito, G

    2016-08-01

    Few data are available on the determinants and characteristics of post-caesarean section (CS) surgical site infections (SSIs) in resource-limited settings. We conducted a prospective observational cohort study to evaluate the rates, determinants, and microbiological characteristics of post-CS SSI at the Dodoma Regional Referral Hospital (DRRH) Gynaecology and Obstetrics Department in Tanzania. Spanning a three-month period, all pregnant women who underwent CS were enrolled and followed up for 30 days. SSI following CS occurred in 224 (48%) women. Only 10 (2.1%) women received pre-incision antibiotic prophylaxis. Urgent intervention is needed to prevent and control infections and contain the rising rate of post-CS SSI at the DRRH. PMID:27125664

  8. 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.

  9. 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. PMID:26810083

  10. 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

  11. 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......: Healthy mothers received a single dose of cefuroxime 15 to 60 minutes before skin incision. One blood sample was drawn from the umbilical cord and two blood samples were drawn from the infant after delivery. Total plasma cefuroxime (μg/ml) was measured using high-pressure liquid chromatography. RESULTS......: Cefuroxime was given to 22 mothers, including two who had twins. The concentration of cefuroxime varied significantly among infants (p<0.001), while the rate of decline did not (p=0.24). The median cefuroxime half-life was 3.5 hours (range 2.9-5.5), which was approximately three times longer than in normal...

  12. Caesarean section on maternal request in north-eastern Nigeria: Women’s knowledge, perception and attitude

    Directory of Open Access Journals (Sweden)

    Bukar M

    2014-03-01

    Full Text Available Background: Caesarean delivery is the most widely performed major obstetric surgery globally and the incidence is rising. Aim: To document the views of pregnant women in two tertiary institutions in Nigeria towards caesarean delivery on maternal request. Methods: A cross-sectional study of pregnant women who attended the antenatal clinics of the University of Maiduguri Teaching Hospital and Federal Medical Centre, Yola from August to October 2009. Results: A total of 254 women were interviewed. The age ranged from 18-43 years with a mean of 28.56+5.60 years. The mean parity was 2.71+1.96. Majority, 204 (80.3% respondents were aware of caesarean delivery with 90 (44.1% of the information obtained from friends. Sixteen (6.3% believed that having caesarean section was due to failure of reproductive function of a woman, with 106 (41.7% citing destiny as reason for caesarean delivery. Most, 226 (89.0%, would not request for caesarean section. The commonest reason for caesarean section on maternal request was avoidance of labour pain, 16 (57.1%. Education (2 =33.561, P=0.000 and occupation (2 =26.205, P=0.003 had influence on knowledge of caesarean delivery. Education however, had no influence on maternal request for caesarean delivery (2 =5.810, P=0.121. Although majority (2 =2.589, P=0.000 would prefer vaginal delivery, none of the respondents would decline caesarean delivery if indicated. Conclusion: The knowledge, perception and attitude toward caesarean delivery are encouraging. The low number of maternal request for caesarean will serve as a benchmark for the future especially with the increasing penchant for smaller family sizes among the urban educated elites.

  13. The effect of alfentanil on maternal haemodynamic changes due to tracheal intubation in elective caesarean sections under general anaesthesia

    Directory of Open Access Journals (Sweden)

    Seyedeh Masoumeh Hosseini Valami

    2015-01-01

    Full Text Available Background and Aims: Endotracheal intubation can produce severe maternal haemodynamic changes during caesarean sections under general anaesthesia. However, administration of narcotics before endotracheal intubation to prevent these changes may affect the Apgar score in neonates. This study was designed to evaluate the effect of intravenous alfentanil on haemodynamic changes due to endotracheal intubation in elective caesarean sections performed under general anaesthesia. Methods: Fifty parturients were randomly divided into two equal groups. Patients in the first group received alfentanil 10 μg/kg and in the second group received placebo intravenously 1 min before induction of anaesthesia for elective caesarean section. Haemodynamic parameters and bispectral index system (BIS in mothers, peripheral capillary oxygen saturation (SpO 2 and Apgar score in the newborn were assessed. Results: Changes in systolic blood pressure were significant at 1, 5 and 10 min after intubation between two groups. Changes in diastolic blood pressure were significantly less in alfentanil group, 1 min after induction of anaesthesia and 1 min after endotracheal intubation. Mean heart rate at 1 min after induction and at 1 and 5 min after intubation also reduced significantly in this group. Conclusion: Alfentanil use was associated with decreases or minimal increases in maternal systolic and diastolic blood pressures and heart rate after endotracheal intubation.

  14. Anaesthetic Management of Two Patients with Pompe Disease for Caesarean Section

    Directory of Open Access Journals (Sweden)

    I. J. J. Dons-Sinke

    2014-01-01

    Full Text Available The introduction of enzyme replacement therapy and the resultant stabilisation or improvement in mobility and respiratory muscle function afforded to patients with late-onset Pompe may lead to an increased number of Pompe patients prepared to accept the challenges of parenthood. In this case report, we describe our anaesthetic management of two patients with Pompe disease for a caesarean section.

  15. Trends in Caesarean Section Use from 1955-1999 in a Regional Perinatology Centre

    Czech Academy of Sciences Publication Activity Database

    Hájek, Z.; Reissigová, Jindra; Haaková, L.; Kolařík, D.; Binder, T.; Živný, J.

    2001-01-01

    Roč. 7, č. 2 (2001), s. 55-58. ISSN 1505-0580 R&D Projects: GA MZd NH4837 Institutional research plan: AV0Z1030915 Keywords : caesarean sections * increasing frequency * indications Subject RIV: BB - Applied Statistics, Operational Research

  16. Bioethical considerations: Caesarean section at the request of the patient and autonomy

    OpenAIRE

    Rogelio González Pérez

    2012-01-01

    A doctor who has to perform an on demand Caesarean section instead of a vaginal birth, without any medical need, must analyze several ethical elements to accept this request. To review and reflect on the principles of medical ethic can guide the physician to prioritize a medical-based decision, ensuring the best result possible for the mother and for the unborn child.

  17. 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 studie...

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    Shubhra Goel; Cat Nguyen Burkat

    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 des...

  3. 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.

  4. The Hidden Costs of a Free Caesarean Section Policy in West Africa (Kayes Region, Mali).

    Science.gov (United States)

    Ravit, Marion; Philibert, Aline; Tourigny, Caroline; Traore, Mamadou; Coulibaly, Aliou; Dumont, Alexandre; Fournier, Pierre

    2015-08-01

    The fee exemption policy for EmONC in Mali aims to lower the financial barrier to care. The objective of the study was to evaluate the direct and indirect expenses associated with caesarean interventions performed in EmONC and the factors associated with these expenses. Data sampling followed the case control approach used in the large project (deceased and near-miss women). Our sample consisted of a total of 190 women who underwent caesarean interventions. Data were collected from the health workers and with a social approach by administering questionnaires to the persons who accompanied the woman. Household socioeconomic status was assessed using a wealth index constructed with a principal component analysis. The factors significantly associated with expenses were determined using multivariate linear regression analyses. Women in the Kayes region spent on average 77,017 FCFA (163 USD) for a caesarean episode in EmONC, of which 70 % was for treatment. Despite the caesarean fee exemption, 91 % of the women still paid for their treatment. The largest treatment-related direct expenses were for prescriptions, transfusion, antibiotics, and antihypertensive medication. Near-misses, women who presented a hemorrhage or an infection, and/or women living in rural areas spent significantly more than the others. Although abolishing fees of EmONC in Mali plays an important role in reducing maternal death by increasing access to caesarean sections, this paper shows that the fee policy did not benefit to all women. There are still barriers to EmONC access for women of the lowest socio-economic group. These included direct expenses for drugs prescription, treatment and indirect expenses for transport and food. PMID:25874875

  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. Cervical tourniquet in case of uncontrollable haemorrhage during caesarean section owing to a placenta accreta.

    Science.gov (United States)

    Huijgen, Q C A; Gijsen, A F; Hink, E; Van Kesteren, P J M

    2013-01-01

    This case report describes a 38-year-old woman in whom a primary caesarean section for placenta previa was complicated by postpartum haemorrhage due to a placenta accreta. Despite tamponade with a Bakri balloon and placement of a B-Lynch suture, the amount of blood loss could not be effectively reduced. The blood loss was eventually minimised by the placement of a Penrose drain around the cervix as a cervical tourniquet. We think that a cervical tourniquet is an effective method of stopping haemorrhage during caesarean section, as shown in this case report, and we consider this technique to be a valuable addition to several existing methods through which fertility is preserved by preventing emergency hysterectomy. PMID:23608864

  7. 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

    tachypnoea of the newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn) and serious respiratory morbidity (oxygen therapy for more than two days, nasal continuous positive airway pressure, or need for mechanical ventilation). RESULTS: 2687 infants were delivered by...... 39 weeks' gestation (1.9, 1.2 to 3.0). The increased risks of serious respiratory morbidity showed the same pattern but with higher odds ratios: a fivefold increase was found at 37 weeks (5.0, 1.6 to16.0). These results remained essentially unchanged after exclusion of pregnancies complicated by...... diabetes, pre-eclampsia, and intrauterine growth retardation, or by breech presentation. CONCLUSION: Compared with newborns delivered vaginally or by emergency caesarean sections, those delivered by elective caesarean section around term have an increased risk of overall and serious respiratory morbidity...

  8. 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.

  9. Anaesthetic Management of Caesarean Section in a Patient with Large Mediastinal Mass

    International Nuclear Information System (INIS)

    Pregnancy is associated with both anatomical and physiological changes in the body, especially in cardiovascular and respiratory systems. Patients with anterior and middle mediastinal masses are recognized to be at risk for cardiorespiratory compromise. Likewise, pregnancy has a widely known constellation of potential complications that confront the anaesthesiologist. The combination of both (pregnancy and mediastinal mass) in a single patient presents an unusual anaesthetic challenge. Caesarean sections are usually the mode of delivery, therefore, the cardio-respiratory stability is very important. The following is the report of a 31 weeks pregnant patient with a large, symptomatic anterior and middle mediastinal mass, who required anaesthesia for emergency caesarean section. The anaesthetic management entailed Combined Spinal and Epidural (CSE) technique with safe feto-maternal outcome. (author)

  10. Anaesthetic management of caesarean section in a patient with large mediastinal mass.

    Science.gov (United States)

    Kashif, Sanum; Saleem, Jodat

    2015-02-01

    Pregnancy is associated with both anatomical and physiological changes in the body, especially in cardiovascular and respiratory systems. Patients with anterior and middle mediastinal masses are recognized to be at risk for cardiorespiratory compromise. Likewise, pregnancy has a widely known constellation of potential complications that confront the anaesthesiologist. The combination of both (pregnancy and mediastinal mass) in a single patient presents an unusual anaesthetic challenge. Caesarean sections are usually the mode of delivery, therefore, the cardio-respiratory stability is very important. The following is the report of a 31 weeks pregnant patient with a large, symptomatic anterior and middle mediastinal mass, who required anaesthesia for emergency caesarean section. The anaesthetic management entailed Combined Spinal and Epidural (CSE) technique with safe feto-maternal outcome. PMID:25703761

  11. Short and long term effects of caesarean section and vaginal delivery

    OpenAIRE

    Larsson, Christina

    2010-01-01

    The aim of this thesis was to study short and long term effects after caesarean section (CS) and vaginal delivery. We also studied the difficulty in estimating blood loss at delivery and birth experience estimated nine months after delivery. In Study I blood loss during delivery was measured in two ways, visually, according to the routine of the hospital, and with a laboratory method, the alkaline hematin method. The visual estimation tended to over-estimate the bleeding. ...

  12. 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.; N. Jamieson; 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....

  13. Bioethical considerations: Caesarean section at the request of the patient and autonomy

    Directory of Open Access Journals (Sweden)

    Rogelio González Pérez

    2012-04-01

    Full Text Available A doctor who has to perform an on demand Caesarean section instead of a vaginal birth, without any medical need, must analyze several ethical elements to accept this request. To review and reflect on the principles of medical ethic can guide the physician to prioritize a medical-based decision, ensuring the best result possible for the mother and for the unborn child.

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

    OpenAIRE

    Madhu Gupta; Shalini Subramanian; Preeti Adlakha

    2013-01-01

    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 th...

  15. Birth after emergency caesarean section: Women’s perspectives on the factors influencing their decision making

    OpenAIRE

    Hughes, Laura Jane

    2016-01-01

    The study explored the decisions women made in relation to mode of birth following a previous emergency lower segment caesarean section (emLSCS), particularly focusing on what different factors influenced women to choose a particular mode of birth and what they described as the rationale underpinning that decision. Participants were recruited from a population of students and staff within the School of Human and Health Sciences at a university in the north of England. Sixteen individuals...

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

    OpenAIRE

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

    2014-01-01

    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 defi...

  17. 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.

  18. 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

  19. LIVE CONJOINED TWIN BABIES DELIVERED BY CAESAREAN SECTION: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Biswas

    2014-07-01

    Full Text Available Conjoined twins, commonly referred to as Siamese twins, are babies connected physically to each other. Depending upon the point of connection, there are different types of conjoined twins. A targeted sonographic examination at midpregnancy can diagnose the entity in most cases. Fetal prognosis depends on the period of gestation at delivery, birth weight, extent of organ sharing by the fetuses and possibility of surgical separation. Viable conjoined twins should be delivered by caesarean section. Here we present a case of thoracopagus twin pregnancy where the fetuses were born alive by C Section but expired soon after delivery probably because of extreme prematurity and low birth weight

  20. 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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    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

  3. 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.

  4. Cervical tourniquet in case of uncontrollable haemorrhage during caesarean section owing to a placenta accreta

    OpenAIRE

    Huijgen, Q C A; Gijsen, A F; Hink, E; Van Kesteren, P J M

    2013-01-01

    This case report describes a 38-year-old woman in whom a primary caesarean section for placenta previa was complicated by postpartum haemorrhage due to a placenta accreta. Despite tamponade with a Bakri balloon and placement of a B-Lynch suture, the amount of blood loss could not be effectively reduced. The blood loss was eventually minimised by the placement of a Penrose drain around the cervix as a cervical tourniquet. We think that a cervical tourniquet is an effective method of stopping h...

  5. Anaesthetic management for emergency caesarean section in a patient with an untreated recently diagnosed phaeochromocytoma

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2011-01-01

    Full Text Available Phaeochromocytoma is a rare cause of hypertension during pregnancy with potentially fatal consequences. If not detected and treated early in pregnancy, it is catastrophic for both the mother and the baby. Management requires close co-ordination between the obstetrician, anaesthesiologist, paediatrician and the endocrinologist. Perioperative management for an emergency caesarean section in a parturient with untreated phaeochromocytoma is an anaesthetic challenge and no standard recommendations have been reported till date. In this case report, we present anaesthetic management in such a case with successful maternal and foetal outcome.

  6. Using a Caesarean Section Classification System based on characteristics of the population as a way of monitoring obstetric practice

    Directory of Open Access Journals (Sweden)

    Milanez Helaine M

    2010-06-01

    Full Text Available Abstract Objective to compare the distribution of caesarean rates in the Robson's 10 groups classification in order to see if any change occurred after the implementation of an audit and feedback intervention. Design: cross sectional, before and after an audit and feedback study. Setting: a university hospital in Brazil. Methods clinical records of all births during two three months-periods were evaluated. Each case of CS was classified into one of ten mutually exclusive categories according to obstetric characteristics. The proportion of CS in each group was compared in both periods. Results total number of deliveries and the high rate of CS were similar in both periods. Group 3 (multiparous excluding previous CS, single, cephalic, ≥ 37 weeks, spontaneous labour accounted for the largest proportion of deliveries, 28.5 and 26.8% in both periods. Group 1 (nulliparous, single, cephalic, ≥ 37 weeks, spontaneous labour was the second largest one, while Group 5 (previous caesarean section, single, cephalic, and ≥ 37 weeks was the third but the largest contributor to CS, accounting for 16.6 and 14.9% among all deliveries in both periods. Groups 2 (nulliparous, single, cephalic, ≥ 37 weeks, induction or CS before labour and 4 (multiparous excluding previous CS, single, cephalic, ≥ 37 weeks, induction or CS before labour were less prevalent, however had higher rates of CS. Only in Group 10 (All single, cephalic, ≤ 36 weeks, including previous CS, there was a significant decrease of CS rate from 70.5 to 42.6% between periods. Conclusion Robson's classification did not identify any significant change in the pattern of CS rates with the audit and feedback process, but showed to be useful for comparing trends among similar obstetric populations.

  7. Comparison of ephedrine versus fluid preload in prevention of hypotension after spinal anaesthesia for caesarean section

    International Nuclear Information System (INIS)

    Objective: To compare the effect of crystalloid preload versus prophylactic ephedrine on blood pressure after spinal anesthesia for elective caesarean section. Study Design: Randomized control trails (RCT). Place and Duration of Study: The study was carried out at Combined Military Hospital Peshawar, which is a tertiary care hospital from January 2007 to January 2008. Methodology: One hundred patients fulfilling the inclusion criteria were selected for this study and randomly divided into two groups of 50 each. Patients of group A were preloaded with Hartman's solution 15ml/kg body weight. Patients in group B received prophylactic intravenous ephedrine 0.25mg/kg body weight just before administration of spinal anesthesia. Blood pressure was recorded before and 03 minutes after administration of spinal anesthesia. Results: The mean age in group A was 25.54 +- 3.06 years and in group B was 25.34+-2.94 years. In group A, there were 6(12%) patients with no/mild hypotension 10(20%) patients of moderate while 34(68%) patients had severe hypotension. In group B 24(48%) patients had no/mild hypotension. Ten (20%) patients had moderate while 16(32%) patients had severe hypotension (p=0.001). Conclusion: Prophylactic administration of ephedrine is better than crystalloid preload in prevention of significant hypotension in spinal anesthesia for elective caesarean section. (author)

  8. Immediate or early skin-to-skin contact after a Caesarean section: a review of the literature.

    Science.gov (United States)

    Stevens, Jeni; Schmied, Virginia; Burns, Elaine; Dahlen, Hannah

    2014-10-01

    The World Health Organization and the United Nations International Children's Emergency Fund recommends that mothers and newborns have skin-to-skin contact immediately after a vaginal birth, and as soon as the mother is alert and responsive after a Caesarean section. Skin-to-skin contact can be defined as placing a naked infant onto the bare chest of the mother. Caesarean birth is known to reduce initiation of breastfeeding, increase the length of time before the first breastfeed, reduce the incidence of exclusive breastfeeding, significantly delay the onset of lactation and increase the likelihood of supplementation. The aim of this review is to evaluate evidence on the facilitation of immediate (within minutes) or early (within 1 h) skin-to-skin contact following Caesarean section for healthy mothers and their healthy term newborns, and identify facilitators, barriers and associated maternal and newborn outcomes. A range of electronic databases were searched for papers reporting research findings published in English between January 2003 and October 2013. Seven papers met the criteria. This review has provided some evidence that with appropriate collaboration skin-to-skin contact during Caesarean surgery can be implemented. Further evidence was provided, albeit limited, that immediate or early skin-to-skin contact after a Caesarean section may increase breastfeeding initiation, decrease time to the first breastfeed, reduce formula supplementation in hospital, increase bonding and maternal satisfaction, maintain the temperature of newborns and reduce newborn stress. PMID:24720501

  9. Caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation for the management of placenta accreta

    International Nuclear Information System (INIS)

    Aim: To determine the efficacy and safety of caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation (UAE) for the treatment of patients with placenta accreta. Materials and methods: This retrospective study involved 42 patients with placenta accreta. All patients underwent caesarean section combined with temporary aortic balloon occlusion followed by UAE through the right femoral approach. Results: All patients were confirmed to have placenta praevia and accreta, including five patients with placenta percreta, at the time of delivery. The technical success rate of the combined treatment was 97.6% (41/42). Forty-one patients underwent successful caesarean section with conservation of the uterus. Hysterectomy was required in one (3.1%) patient. The amount of blood loss and blood transfusion, and the operation time were was 586 ± 355 ml, 422 ± 83 ml and 65.5 ± 10.6 minutes, respectively. The mean postoperative hospital stay, occlusion time and fetal radiation dose were 5.5 ± 2.6 days, 22.4 ± 7.2 minutes and 4.2 ± 2.9 mGy, respectively. There were no significant changes before and 7 days after the endovascular procedure in creatinine levels (56.8 ± 13.8 μmol/l versus 63.4 ± 16.7 μmol/l, p = 0.09) or urea nitrogen (6.3 ± 2.5 μmol/l versus 7.4 ± 3.8 μmol/l, p = 0.17). There were no access-site complications after the endovascular procedure and no complications related to the intervention during follow-up. Conclusion: Temporary aortic balloon occlusion followed by UAE can effectively control postpartum haemorrhage during placental dissection, and reduce transfusion requirements, hysterectomy rate, and operation time in patients with placenta accreta. -- Highlights: •Aortic balloon occlusion can overcome the collateral flow from other arteries. •UAE can effectively manage secondary postpartum haemorrhage. •The aortic balloon can rapidly and easily insert. •The mean

  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

    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

  11. 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

  12. 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.

  13. Multidisciplinary team training reduces the decision-to-delivery interval for emergency Caesarean section

    DEFF Research Database (Denmark)

    Fuhrmann, Lone; Pedersen, T H; Atke, A;

    2015-01-01

    BACKGROUND: Emergency Caesarean section is performed when the life of the pregnant woman and/or the foetus is considered at risk. A 30-min standard for the decision-to-delivery interval (DDI) is a common practice and is supported by national organisations including The Danish Society of Obstetrics...... study aims to evaluate the effect of a simulation-based team training programme on the proportion of ECSs achieved within a 30-min time frame. METHOD: We performed an interventional before-and-after study. We evaluated a total of one hundred 30-min ECSs before and after the intervention. The primary...... outcome of interest was the proportion of 30-min ECSs achieved within a 30-min time frame. RESULTS: A total of 20 team training courses were held during May/June 2013. These courses trained 239 of 252 team members (comprised of: 36 obstetricians, 45 scrub nurses, 83 midwives, 38 anaesthesiologists, 37...

  14. 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.

  15. 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.

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

    International Nuclear Information System (INIS)

    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)

  17. 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).

  18. Patient-controlled oral analgesia versus nurse-controlled parenteral analgesia after caesarean section: a randomised controlled trial.

    Science.gov (United States)

    Bonnal, A; Dehon, A; Nagot, N; Macioce, V; Nogue, E; Morau, E

    2016-05-01

    We assessed the effectiveness of early patient-controlled oral analgesia compared with parenteral analgesia in a randomised controlled non-inferiority trial of women undergoing elective caesarean section under regional anaesthesia. Seventy-seven women received multimodal paracetamol, ketoprofen and morphine analgesia. The woman having patient-controlled oral analgesia were administered four pillboxes on the postnatal ward containing tablets and instructions for self-medication, the first at 7 h after the spinal injection and then three more at 12-hourly intervals. Pain at rest and on movement was evaluated using an 11-point verbal rating scale at 2 h and then at 6-hourly intervals for 48 h. The pre-defined non-inferiority limit for the difference in mean pain scores (patient-controlled oral analgesia minus parenteral) was one. The one-sided 95% CI of the difference in mean pain scores was significantly lower than one at all time-points at rest and on movement, demonstrating non-inferiority of patient-controlled oral analgesia. More women used morphine in the patient-controlled oral analgesia group (22 (58%)) than in the parenteral group (9 (23%); p = 0.002). The median (IQR [range]) number of morphine doses in the patient-controlled oral analgesia group was 2 (1-3 [1-7]) compared with 1 (1-1 [1-2]); p = 0.006) in the parenteral group. Minor drug errors or omissions were identified in five (13%) women receiving patient-controlled oral analgesia. Pruritus was more frequent in the patient-controlled oral analgesia group (14 (37%) vs 6 (15%) respectively; p = 0.03), but no differences were noted for other adverse events and maternal satisfaction. After elective caesarean section, early patient-controlled oral analgesia is non-inferior to standard parenteral analgesia for pain management, and can be one of the steps of an enhanced recovery process. PMID:26931110

  19. 6. Pattern of antimicrobial use in caesarean section in a tertiary care hospital in rural south India

    Directory of Open Access Journals (Sweden)

    J. Heethal

    2010-05-01

    Full Text Available Use of antimicrobials in caesarean section has become an accepted practice to minimize the incidence of post operative complications. Not many studies are available in India regarding the use of antimicrobial in caesarean section, hence this study. The study aims at finding the pattern of use of antimicrobial prophylaxis in caesarean section and also the frequency of post operative morbidity. This study is a retrospective case series analysis which included seventy five patients undergoing caesarean section admitted to the obstetrics and gynaecology department of Sri R.L.Jalappa hospital and research centre. Relevant information on each patient was collected according to the proforma designed for the study. Antimicrobial used, their dose dosage schedule were recorded. Investigations like pus, blood and urine culture and sensitivity was recorded for patients with post operative complications. Change of antimicrobial following culture sensitivity report was noted. In our analysis, most of the patients came from low socioeconomic status. We observed the use of third generation cephalosporin like ceftriaxone or cefotaxime and metronidazole in most of the patients. Two drugs or three drug combinations were used which commonly included third generation cephalosporin and metronidazole with gentamicin being added in three drug combinations. Thirty patients had post operative complications which included wound infection, urinary tract infection and fever. E. coli were the common organism isolated which was resistant to third generation cephalosporin and sensitive to amikacin. In conclusion, periodic surveillance of antimicrobial prophylaxis is essential to detect the emergence of antibiotic resistance.

  20. Study of adequacy of informed consent in caesarean section in a tertiary care, teaching and research institute of Northern India

    Directory of Open Access Journals (Sweden)

    Latika

    2015-06-01

    Conclusions: Majority of the caesarean sections were performed due to some emergency indications. It was found that overall patients were well informed about the procedure and the related consequences. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 780-784

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

    OpenAIRE

    vanderVaart, Sondra; Berger, Howard; Tam, Carolyn; Goh, Y. Ingrid; Gijsen, Violette M G J; de Wildt, Saskia N.; Taddio, Anna; Koren, Gideon

    2011-01-01

    Introduction 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, passes into breast milk, and may produce unwanted side effects in neonates; therefore, alternatives to opioids are being sought. Reiki is an ancient Japanese form of healing where practitioners transfer healing...

  2. Modest Rise in Caesarean Section from 2000-2010: The Dutch Experience

    Science.gov (United States)

    Zhao, Yanjun; Zhang, Jun; Hukkelhoven, Chantal; Offerhaus, Pien; Zwart, Joost; de Jonge, Ank; Geerts, Caroline

    2016-01-01

    Background The caesarean delivery (CD) rate has risen in most countries over the last decades, but it remains relatively low in the Netherlands. Our objective was to analyse the trends of CD rates in various subgroups of women between 2000 and 2010, and identify the practice pattern that is attributable to the relative stability of the Dutch CD rate. Methods A total of 1,935,959 women from the nationwide Perinatal Registry of the Netherlands were included. Women were categorized into ten groups based on the modified CD classification scheme. Trends of CD rates in each group were described. Results The overall CD rate increased slightly from 14.0% in 2000–2001 to 16.7% in 2010. Fetal, early and late neonatal mortality rates decreased by 40–50% from 0.53%, 0.21%, 0.04% in 2000–2001 to 0.29%, 0.12%, 0.02% in 2010, respectively. During this period, the prevalence of non-vertex presentation decreased from 6.7% to 5.3%, even though the CD rate in this group was high. The nulliparous women with spontaneous onset of labor at term and a singleton child in vertex presentation had a CD rate of 9.9%, and 64.7% of multiparous women with at least one previous uterine scar and a singleton child in vertex presentation had a trial of labor and the success rate of vaginal delivery was 45.9%. Conclusions The Dutch experience indicates that external cephalic version for breech presentation, keeping the CD rate low in nulliparous women and encouraging a trial of labor in multiparous women with a previous scar, could help to keep the overall CD rate steady. PMID:27192534

  3. Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section.

    Science.gov (United States)

    Sagoo, Balvinder; Ng, Ka Ying Bonnie; Ghaleb, G; Brown, Heather

    2015-01-01

    We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid) in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery. PMID:26380133

  4. Spontaneous Expulsion of Intramural Fibroid Six Weeks after Emergency Caesarean Section

    Directory of Open Access Journals (Sweden)

    Balvinder Sagoo

    2015-01-01

    Full Text Available We present a thirty-six-year-old woman with a high risk pregnancy, complicated by multiple congenital anomalies, severe hyperemesis, a pulmonary embolus, and a large intramural fibroid. This fibroid grew in size during the pregnancy. At 34 + 5 weeks, there were reduced fetal movements and a pathological CTG. A live infant was delivered by an emergency cesarean section. Five weeks postpartum, she presented with abdominal pain, offensive vaginal discharge, and fevers. She was given antibiotics and ferrous sulphate. An abdominal ultrasound showed an 11 × 12 × 9 cm fibroid with a coarse degenerative appearance. Clinically, she showed signs of sepsis; a CT scan and laparotomy performed under general anesthetic did not find any collections as a source of sepsis. When stable, she was discharged. She re-presented two days later with a large mass (necrotic fibroid in her vagina. This is the first case of spontaneous expulsion of fibroid six weeks after caesarean section. Presentation of pain and fever after the delivery may be due to red degeneration of the fibroid, caused by diminished blood supply, ischaemia, and necrosis. This case highlights the importance of considering fibroids as a cause for abdominal pain during and after pregnancy, even up to 6 weeks after delivery.

  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. Comparison of epidural oxycodone and epidural morphine for post-caesarean section analgesia: A randomised controlled trial

    Science.gov (United States)

    Sng, Ban Leong; Kwok, Sarah Carol; Mathur, Deepak; Ithnin, Farida; Newton-Dunn, Clare; Assam, Pryseley Nkouibert; Sultana, Rehena; Sia, Alex Tiong Heng

    2016-01-01

    Background and Aims: Epidural morphine after caesarean section may cause moderate to severe pruritus in women. Epidural oxycodone has been shown in non-obstetric trials to reduce pruritus when compared to morphine. We hypothesised that epidural oxycodone may reduce pruritus after caesarean section. Methods: A randomised controlled trial was conducted in pregnant women at term who underwent caesarean section with combined spinal-epidural technique initiated with intrathecal fentanyl 15 μg. Women received either epidural morphine 3 mg or epidural oxycodone 3 mg via the epidural catheter after delivery. The primary outcome was the incidence of pruritus at 24 h after caesarean section. The secondary outcomes were the pruritus scores, treatment for post-operative nausea and vomiting (PONV), pain scores and maternal satisfaction. Results: One hundred women were randomised (group oxycodone O = 50, morphine M = 50). There was no difference between Group O and M in the incidence of pruritus (n [%] 28 [56%] vs. 31 [62%], P = 0.68) and the worst pruritus scores (mean [standard deviation] 2.6 (2.8) vs. 3.3 [3.1], P = 0.23), respectively. Both groups had similar pain scores at rest (2.7 [2.3] vs. 2.0 [2.7], P = 0.16) and sitting up (5.0 [2.3] vs. 4.6 [2.4], P = 0.38) at 24 h. Pruritus scores were lower at 4–8, 8–12 and 12–24 h with oxycodone, but pain scores were higher. Both groups had a similar need for treatment of PONV and maternal satisfaction with analgesia. Conclusion: There was no difference in the incidence of pruritus at 24 h between epidural oxycodone and morphine. However, pruritus scores were lower with oxycodone between 4 and 24 h after surgery with higher pain scores in the same period. PMID:27053782

  7. Is vaginal delivery or caesarean section the safer mode of delivery in patients with adult congenital heart disease?

    OpenAIRE

    Asfour, Victoria; Murphy, Michael O; Attia, Rizwan

    2013-01-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: is vaginal delivery or caesarean section (CS) the safer mode of delivery in patients with adult congenital heart disease? Of the 119 studies, 13 papers represented the best evidence on the topic. Recommendations are based on 29 262 patients. Those having undergone successful corrective or palliative cardiac surgery for congenital heart disease, in addition to patients with unop...

  8. Caesarean-sections in the Press: the said and the not said.

    Directory of Open Access Journals (Sweden)

    Tatiana Augustinho Rocha

    2006-04-01

    Full Text Available This paper aimed at knowing the cultural caesarean representations present in magazines addressed to the laic public. One of the attributions of the nurse is health education. The press is source of informal education. So, the nurse must provide women with subsidies so that they can make decisions with autonomy and knowledge, demystifying or incrementing what is thought about the surgical delivery. Upon analyzing editions of Revista Crescer, two themes have arisen: the “said” and the “not said” about caesarean. Regarding the “said” category, the articles appraise pathologies in the gestation and their inter-occurrences with explicit association between pathologies and the caesarean; the magazine searched for the adequacy of the woman to the hospital routine and softened the caesarean consequences. As to the “not said” category, the magazine did not emphasize the control and prevention of the complications that are inherent to pregnancy and, somehow, led women to opt for the caesarean as the safest mode of delivery.

  9. 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

  10. INTRATHECAL CLONIDINE AS AN ADJUVANT WITH HYPERBARIC BUPIVACAINE FOR CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Sunil

    2014-06-01

    Full Text Available BACKGROUND: Intrathecal adjuvants has gained popularity with the aim of prolonging the duration of block, quality of block and decreased resource utilization compared with general anaesthesia. However they are not free from side effects. We evaluated the effect of addition of intrathecal clonidine (45 micgm to hyperbaric bupivacaine on perioperative and neonatal outcome following lower segment caesarean section. Study period: January –July 2012. METHODS: 60 female Patients undergoing elective cesarean section (LSCS were randomly allocated to two groups of 30 each to receive intrathecally either 10 mg hyperbaric bupivacaine alone(group B or 45 µg of clonidine (group C, added to 10 mg hyperbaric bupivacaine. The onset time to reach T 6 sensory and Bromage 3 motor level, the regression time for L1 sensory and Bromage 0 motor block, Sedation scores, hemodynamic changes, APGAR score and side effects were recorded. RESULTS: Onset of bromage 3 motor block and time to reach T 6 sensory dermatome level was statistically similar between group B and group C. The time for regression of sensory block to L1 dermatome was increased by addition of clonidine (p <0.001 B vs. C. The duration of postoperative analgesia was 164.42±24.64 min in group B and 260.71±38.46 min in group C which was statistically significant. (P<0.001. New born apgar score shows that addition of clonidine is safe for new borns. CONCLUSION: Addition of 45 μg clonidine to hyperbaric bupivacaine in spinal anesthesia for LSCS significantly prolongs the duration of postoperative analgesia without any increase in maternal and neonatal side effects.

  11. The Effect of Music Therapy on Pain The Level of Postoperative Patients' with Caesarean Section at Islamic Hospital A.Yani, Surabaya

    OpenAIRE

    Nanik Handayani

    2015-01-01

    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 po...

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

    Directory of Open Access Journals (Sweden)

    Salvatore Gizzo

    Full Text Available 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.

  13. 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

  14. 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.

  15. Birth by Caesarean Section and the Risk of Adult Psychosis: A Population-Based Cohort Study.

    Science.gov (United States)

    O'Neill, Sinéad M; Curran, Eileen A; Dalman, Christina; Kenny, Louise C; Kearney, Patricia M; Clarke, Gerard; Cryan, John F; Dinan, Timothy G; Khashan, Ali S

    2016-05-01

    Despite the biological plausibility of an association between obstetric mode of delivery and psychosis in later life, studies to date have been inconclusive. We assessed the association between mode of delivery and later onset of psychosis in the offspring. A population-based cohort including data from the Swedish National Registers was used. All singleton live births between 1982 and 1995 were identified (n= 1,345,210) and followed-up to diagnosis at age 16 or later. Mode of delivery was categorized as: unassisted vaginal delivery (VD), assisted VD, elective Caesarean section (CS) (before onset of labor), and emergency CS (after onset of labor). Outcomes included any psychosis; nonaffective psychoses (including schizophrenia only) and affective psychoses (including bipolar disorder only and depression with psychosis only). Cox regression analysis was used reporting partially and fully adjusted hazard ratios (HR) with 95% confidence intervals (CI). Sibling-matched Cox regression was performed to adjust for familial confounding factors. In the fully adjusted analyses, elective CS was significantly associated with any psychosis (HR 1.13, 95% CI 1.03, 1.24). Similar findings were found for nonaffective psychoses (HR 1.13, 95% CI 0.99, 1.29) and affective psychoses (HR 1.17, 95% CI 1.05, 1.31) (χ(2)for heterogeneityP= .69). In the sibling-matched Cox regression, this association disappeared (HR 1.03, 95% CI 0.78, 1.37). No association was found between assisted VD or emergency CS and psychosis. This study found that elective CS is associated with an increase in offspring psychosis. However, the association did not persist in the sibling-matched analysis, implying the association is likely due to familial confounding by unmeasured factors such as genetics or environment. PMID:26615187

  16. 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. PMID:25646621

  17. Comparison of colloid (polygeline) over crystalloid (lactated ringer) preloading in preventing hypotension in patients undergoing caesarean-section under spinal anaesthesia

    International Nuclear Information System (INIS)

    Objective: To assess efficacy of colloid (Polygeline) over crystalloid (Lactated Ringer) preloading in preventing hypotension in patients undergoing caesarean-section under spinal anaesthesia. Study design: Randomized control trial. Settings: The study was conducted in department of Anesthesiology and Intensive care Combined Military Hospital Peshawar over a period of 6 months from 01 March 2007 to 31 August 2007. Material and Methods: One hundred patients fulfilling the inclusion criteria were selected for study and divided into two groups of 50 each. Group A was given 500 ml Polygeline as preloading solution while group B received 1 liter of Ringer's Lactate as preloading solution just before administration of spinal anaesthesia. Heart rate and systolic blood pressure were recorded at 01 min, 05 mins, 10 mins, 15 mins, 20 mins, 30 mins and 45 mins after the performance of spinal block. Dose of ephedrine given to treat hypotension after the block was also recorded. Results: There was significant difference in terms of heart rate and systolic arterial pressure 1 and 5 minutes after block between both the groups. There was also significant difference in terms of dose of ephedrine between both the groups. Conclusion: Polygeline is more effective than Ringer's Lactate as preloading fluid in preventing hypotension for caesarean section under spinal anaesthesia. (author)

  18. Laparoscopic excision of rudimentary horn pregnancy in a patient with previous caesarean section.

    Science.gov (United States)

    Jihong, Lu; Siow, Anthony; Chern, Bernard

    2009-03-01

    A rudimentary uterine horn is extremely rare and often difficult to diagnose. The frequency of this pathology is approximately 1:100,000. The diagnosis is sometimes elusive even at surgery. We present a case report of pregnancy in a rudimentary horn in the patient with one caesarean and one normal vaginal delivery, and we successfully conduct a removal of the rudimentary horn pregnancy laparoscopically. PMID:18629528

  19. Observational study comparing non-invasive blood pressure measurement at the arm and ankle during caesarean section.

    Science.gov (United States)

    Drake, M J P; Hill, J S

    2013-05-01

    Upper-arm non-invasive blood pressure measurement during caesarean section can be uncomfortable and unreliable because of movement artefact in the conscious parturient. We aimed to determine whether ankle blood pressure measurement could be used instead in this patient group by comparing concurrent arm and ankle blood pressure measured throughout elective caesarean section under regional anaesthesia in 64 term parturients. Bland-Altman analysis of mean difference (95% limits of agreement [range]) between the ankle and arm was 11.2 (-20.3 to +42.7 [-67 to +102]) mmHg for systolic arterial pressure, -0.5 (-21.0 to +19.9 [-44 to +91]) mmHg for mean arterial pressure and -3.8 (-25.3 to +17.8 [-41 to +94]) mmHg for diastolic arterial pressure. Although ankle blood pressure measurement is well tolerated and allows greater mobility of the arms than measurement from the arm, the degree of discrepancy between the two sites is unacceptable to allow routine use of ankle blood pressure measurement, especially for systolic arterial pressure. However, ankle blood pressure measurement may be a useful alternative in situations where arm blood pressure measurement is difficult or impossible. PMID:23480469

  20. 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.

  1. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta

    International Nuclear Information System (INIS)

    Aim: To report experience of prophylactic occlusion balloon catheters (POBCs) in both internal iliac arteries before caesarean section, with or without embolization, to preserve the uterus and reduce haemorrhage. Methods and materials: Twenty-seven women diagnosed with morbidly adherent placenta (MAP) and with suspected placenta percreta underwent POBC placement before caesarean section. The balloons were inflated immediately after delivery of the baby. The patients' case notes were reviewed retrospectively for histological grading of MAP, blood loss, transfusion, requirement of uterine artery embolization (UAE), or hysterectomy, radiation dose, and infant or maternal morbidity and mortality. Results: MAP was confirmed histologically as percreta in 17, accreta in eight, and increta in two women. Mean blood loss was 1.92 l (range 0.5–12 l). Postpartum haemorrhage (PPH) occurred in nine patients. Eight were referred for UAE, which was successful in six. Immediate peri-partum hysterectomy was performed in one patient. Three women in total required hysterectomy, two after recurrent haemorrhage after UAE. No foetal morbidity or mortality occurred. No maternal mortality occurred. There was one case of iliac artery thrombosis, which resolved with conservative therapy. Conclusion: POBC, with or without UAE, contributes to reduction of blood loss and preservation of the uterus in women with MAP. - Highlights: • Management of morbidly adherent placenta requires a multidisciplinary team approach. • Prophylactic occlusion balloon catheters reduce blood loss and help avoid hysterectomy. • Protocols ensure correct management of placenta percreta patients and minimise risk

  2. Objective Structured Assessment of Technical Skill in assessing technical competence to carry out caesarean section with increasing seniority.

    Science.gov (United States)

    Landau, Alex; Reid, Wendy; Watson, Andrew; McKenzie, Clare

    2013-04-01

    Since the incorporation of workplace-based assessment within the specialty training programme in obstetrics and gynaecology, the assessment of technical competence to carry out caesarean section has been undertaken by the Objective Structured Assessment of Technical Skill tool. This requirement has been formalised in the Matrix of Educational Progression, ensuring that the tool must assess trainees' technical competence in caesarean section procedures of varying levels of complexity throughout training. Trainee feedback suggests that the effectiveness of the tool diminishes as the seniority of the trainee increases, with technical competence assessed less effectively in more complex procedures. This seems to be a result of the generic design of the tool and insufficient training on the part of assessors. Both of these are due to be addressed within a division of the Objective Structured Assessment of Technical Skill tool into explicitly formative and summative assessments of technical skill, following a General Medical Council-led consultation on the future of workplace-based assessment. PMID:23062591

  3. 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 ... with pulse oximetry to disclose potential side effects. RESULTS: Pulse-oximetry recordings revealed a modest systemic effect by intramuscular adrenaline as the heart rate and the haemoglobin oxygen saturation were significantly higher in infants who received adrenaline. In contrast, the incidence...

  4. 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

  5. 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.

  6. Las cesáreas en México: tendencias, niveles y factores asociados Caesarean sections in Mexico: tendencies, levels and associated factors

    Directory of Open Access Journals (Sweden)

    Esteban Puentes-Rosas

    2004-02-01

    ón precisa de las razones para llevarla a cabo y el monitoreo de los porcentajes individuales de cesáreas entre los obstetras de los hospitalesOBJECTIVE: To describe the rate of caesarean sections in Mexico in the last 10 years and evaluate its relationship with several socioeconomic variables, type of health care services, and specialists' availability. MATERIAL AND METHODS: The Ministry of Health's register of births was used as source of information. The dependent variable was the type of delivery (vaginal or caesarean. The independent variables were: gross domestic product, human development index, illiteracy percentage among women, social exclusion index and, gynecology and obstetrics specialists supply. Correlations between variables were evaluated using Pearson's parametric test and Spearman range test. A lineal multiple regression was used to model the national caesarean data of 1999. RESULTS: National caesarean percentage increased in the last 10 years at an annual rate of 1%. It was considerably higher in social security institutions and the private sector. Caesareans percentages in 1999 were slightly above 35%. The highest values were those of the private sector with 53%, followed by social security institutions, with 38.2%. The variables more strongly associated with C sections were GDP, specialists' availability and human development index. CONCLUSIONS: It seems reasonable to advocate for a widespread descent in caesarean sections in Mexico. Important declines in certain contexts have been witnessed by implementing measures such as a second opinion before any C-section, a precise definition of the reasons for using it, and the monitoring of individual caesarean percentage among hospital obstetricians.

  7. 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

  8. 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

  9. Analysis of the current status and related factors of caesarean section in Zhangjiagang%张家港市剖宫产现状与相关因素分析

    Institute of Scientific and Technical Information of China (English)

    查建梅; 褚光萍

    2014-01-01

    Objective To analyze the current status and influencing factors of caesarean section in Zhangjiagang and to provide evidence for controlling caesarean section .Methods Retrospective study was conducted to understand the situation of caesarean section and the changes of caesarean section indications in Zhangjiagang from 2008 to 2012 with the monitoring data of delivery in maternal and child health annual report and questionnaires allocated randomly to pregnant women and medical staff .Results The rate of caesarean section in Zhangjiagang was always high, however, the high rate of caesarean section did not reduce prenatal mortality rate (r=0.500, P>0.05).The first 6 indications for cesarean section were social factors , scar uterus , intrauterine fetal distress , cephalopelvic disproportion , premature rupture of fetal membranes and umbilical cord around neck .Of all these factors , social factors came first .Survey among pregnant women showed significant differences between women with different delivery modes in the aspect of cognition on benefit of vaginal delivery (χ2 =15.225, P<0.01), support of family members on vaginal delivery (χ2 =73.569, P<0.01), mastering of nutrition knowledge during pregnancy (χ2 =11.367,P<0.05) and participating in natural delivery course (χ2 =13.300,P<0.01).Survey among medical staff showed that little understanding of long-term harm of caesarean section and social factors resulted in high rate of caesarean section .Conclusion The rate of caesarean section in Zhangjiagang has been at a relative high level .We should put more emphasis on health education among pregnant women, improving professional quality of medical staff and seeking for governmental support and social participation to reduce the rate of caesarean section so as to protect maternal and infant health .%目的:分析张家港市剖宫产现状及其影响因素,提出相关控制措施。方法采用张家港市2008至2012年的妇幼卫生年报分娩情况监测

  10. Comparison of the effects of general and epidural anaesthesia for caesarean section on the neurobehavioural responses of newborn infants.

    Science.gov (United States)

    Kangas-Saarela, T; Koivisto, M; Jouppila, R; Jouppila, P; Hollmén, A

    1989-05-01

    Thirty-one neonates delivered by elective caesarean section were evaluated at the ages of 3 h, 1 day, 2 days and 4-5 days using Scanlon's Early Neonatal Neurobehavioural Scale and tests for orientation. Thirteen of the mothers received general anaesthesia and 18 epidural anaesthesia. All the mothers were healthy and not in labour. All the neonates weighed 2500 g or more and had Apgar scores of 7 or more at 1, 5 and 15 min. The neonates delivered with epidural anaesthesia scored significantly lower on rooting at the age of 3 h than those delivered with general anaesthesia, but the latter scored significantly lower on habituation to sound and orientation to both animate and inanimate visual stimuli. General anaesthesia seemed to depress the infants' interactive processes (orientation items), and their ability to make an appropriate response to repetitive stimuli (habituation) more than did epidural anaesthesia, indicating greater global depression. This depression was short-lived, however, and there were no differences between the groups on any of the parameters after 24 h. PMID:2718708

  11. The effect of the use of a new type of partogram on the cesarean section rates

    Science.gov (United States)

    Vlachos, Georgios; Tsikouras, Panagiotis; Manav, Bachar; Trypsianis, Grigorios; Liberis, Vasileios; Karpathios, Sakellarios; Galazios, Georgios

    2015-01-01

    Objective To assess the contribution of a new type of partogram, used in labor monitoring, in caesarean section rates. Material and Methods The study included term singleton uncomplicated pregnancies divided into two groups. Two types of partogram were used in labor monitoring. In the first group, the classical WHO partogram (A) was used. In the second group, a new type of partogram, in which cervical dilatation and the position of descending head (B) (one line) were estimated and reported, was used. The labor duration and caesarean section rates were calculated and compared in the two groups. Results A statistically significant decrease in labor duration (from the initiation of the active phase of labor to the delivery time) (dt1+dt2+dt3) (p<0.001, A: median: 318.4±10.4 min, B: 246.56±8.28 min) and in caesarean section rates was noted (p<0.001, A: 89 vs B: 49). Conclusion The new type of partogram seems to have potential benefits such as reducing the incidence of prolonged labor and decreasing the caesarean section rates. PMID:26401106

  12. Increasing Trend in Caesarean Section Delivery in India: Role of Medicalisation of Maternal Health

    OpenAIRE

    Sancheeta Ghosh

    2010-01-01

    The paper tries to throw light on the current trends in c-section delivery in India. In developed and developing countries, including India, increasing use of medical technologies during childbirth is a matter of concern. It is evident that the development and application of reproductive technologies is creating contradictory possibilities for women. With the increasing numbers of institutionalised births in India, the trend of c-section delivery is also sharply rising. The objectives of the ...

  13. 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; Pryds, Ole

    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...... 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...... 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 <1.8 mmol/l measured 2 h after birth. The first 50 infants were monitored with...

  14. 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

    -section). MATERIALS AND METHODS: The study had an observational cohort protocol based on extracted information from governmental databases and nationwide registers concerning birth, social and educational levels and dental status. Children born at the Copenhagen University Hospital in 2005 were eligible and the final...

  15. ADVANTAGE OF NON-CLOSURE OF THE PERITONEUM AT CAESAREAN SECTION

    OpenAIRE

    Narayan

    2016-01-01

    OBJECTIVE To determine advantage of non-closure of peritoneum at LSCS over of closure of peritoneum with regard to postoperative complications. STUDY DESIGN Prospective randomized controlled trial. SETTING Tripura Medical College and Dr. BRAM Teaching Hospital, Hapania, Tripura. SUBJECTS AND METHODS Three hundreds term pregnant women undergoing first cesarean section were divided into 2 groups (N = 150). Group I: Non-closure of both visceral ...

  16. CHARACTERIZATION OF THE MATERNAL AND NEONATAL ADVERSE OUTCOMES AFTER CAESAREAN SECTION IN THE CLÍNICA DE MATERNIDAD RAFAEL CALVO

    Directory of Open Access Journals (Sweden)

    Rubio-Hoyos Sandra M

    2015-01-01

    Full Text Available Introduction: the World Health Organization (WHO recommends that the incidence of cesarean must not exceed 15%; however, its use has increased in the last two decades, which implies a public health problem. Objective: to characterize the maternal and neonatal adverse outcomes of caesarean in the Clínica Maternidad Rafael Calvo (CMRC,Cartagena-Colombia. Methodology: a descriptive cross-sectional study, where after cesarean maternal and neonatal adverse outcomes were characterized. Results: 1.804 cesarean sections (46.5% and 2.073 vaginal deliveries (53.5% were performed. The most common indications for cesarean section were before cesarean (35.5%, cephalo pelvic disproportion (30.6% and oligoamnios (10.8%. The most common adverse maternal outcomes were bleeding requiring transfusion (9.17%, surgical wound hematoma (3.28% and admission to ICU (1.5%. The most common adverse neonatal outcomes were APGAR <7 per minute (21.3%, transient tachypnea of the newborn (9.6% and Apgar <7 at 5 ‘(4.3%. Prenatal care (PNC was protective factor for uterine bleeding requiring transfusion (OR crude 0.54, CI 0.38 to 0.76, OR adjusted 0.53 IC 0.38 to 0.76, uterine bleeding which required hysterectomy (OR crude 0.20, CI 0.01 to 0.72, OR adjusted 0.11, IC: 0.11 to 0.72, obstetric shock (OR crude 0.06, IC: 0.00 to 0.55 ,OR adjusted 0.04, CI 0.04 to 0.38 and destination (rooming (OR 0.66, IC 0.49 to 0.90, APGAR <7 at 1 ‘( OR 0.78 IC 0.44 to 0.72, Apgar <7 at 5 ‘(adjusted OR 0.48, IC 0.28 to 0.82 and the presence of respiratory distress (OR crude 0,28 IC, 0.15 to 0.51; OR adjusted 0.53, IC 0.28 to 0.98 Conclusions: the proportion of cesarean sections performed in the CMRC (46.5% is above 15% recommended by WHO. Cesarean section leads to increased maternal and fetal morbidity. The CNP acted as a protective factor against the occurrence of adverse maternal and neonatal outcomes. Rev.cienc.biomed. 2015;6(2:241-250 KEYWORDS Cesarean; Obstetric; Hemorrhage.

  17. 术中应用保温措施防止剖宫产产妇寒颤%Intraoperative body-temperature maintenance to prevent shivering during Caesarean section

    Institute of Scientific and Technical Information of China (English)

    陈少娟; 郭雅梅; 赖梅; 黄素娟; 张莹

    2010-01-01

    目的 探讨术中应用积极的保温措施对防止剖宫产产妇低体温寒颤的影响.方法 选取拟行剖宫产产妇100例,随机分为保温组和对照组,每组50例.对照组术中按传统护理常规进行护理,保温组采用多种积极的综合保温措施.结果 低体温寒颤发生率对照组为60%,保温组16%,两组比较差异有显著性(P<0.05).结论 术中采取积极有效的保温措施有助于预防剖宫产产妇低体温寒颤的发生.%Objective To explore the effect of aggressive intraoperative body-temperature maintenance on prevention of hypothermia-induced shivering in puerperas during Caesarean section.Methods 100 puerperas undergoing Caesarean section were randomly assigned to receive routine intraoperaive nursing (50 puerperas, control group)or various aggressive approachs for body-temperature maintenance (50 puerperas, study group). Results The rate of hypothermia-induced shivering differed significantly between the control group and the study group (60% vs. 16%, P< 0.05). Conclusions Aggressive intraoperative body-temperature maintenance is helpful for preventing the occurrence of hypothermia-induced shivering in puerperas undergoing Caesarean section.

  18. Recurarization in a successfully managed case of posterior reversible encephalopathy syndrome (PRES) for emergency caesarean section.

    Science.gov (United States)

    Parikh, Suchita; Tavri, Snehlata; Mohite, Shubha

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiologic syndrome of headache, visual changes, altered mental status and seizures with radiologic findings of posterior cerebral white matter edema. It is seen in hypertensive encephalopathy, renal failure, and autoimmune disorders or in patients on immunosuppressants. We report a case of 24-year-old primigravida who presented at term with sudden onset hypertension, neurological deficits, and an episode of the visual blackout. Magnetic resonance imaging showed features suggestive of PRES. She was posted for emergency lower segment cesarean section. General anesthesia was administered and blood pressure managed with antihypertensives. Postoperatively, she developed acute respiratory depression after prophylactic administration of injection magnesium sulfate. This case highlights that good clinical acumen along with early neuroimaging helps in prompt diagnosis, treatment and prevention of long-term neurological sequelae in PRES and the anesthetic implications of administering magnesium sulfate in the immediate post neuromuscular block reversal phase. PMID:27212776

  19. 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

  20. Development and Measurement of Guidelines-Based Quality Indicators of Caesarean Section Care in the Netherlands: A RAND-Modified Delphi Procedure and Retrospective Medical Chart Review.

    Directory of Open Access Journals (Sweden)

    Sonja Melman

    Full Text Available There is an ongoing discussion on the rising CS rate worldwide. Suboptimal guideline adherence may be an important contributor to this rise. Before improvement of care can be established, optimal CS care in different settings has to be defined. This study aimed to develop and measure quality indicators to determine guideline adherence and identify target groups for improvement of care with direct effect on caesarean section (CS rates.Eighteen obstetricians and midwives participated in an expert panel for systematic CS quality indicator development according to the RAND-modified Delphi method. A multi-center study was performed and medical charts of 1024 women with a CS and a stratified and weighted randomly selected group of 1036 women with a vaginal delivery were analysed. Quality indicator frequency and adherence were scored in 2060 women with a CS or vaginal delivery.The expert panel developed 16 indicators on planned CS and 11 indicators on unplanned CS. Indicator adherence was calculated, defined as the number of women in a specific obstetrical situation in which care was performed as recommended in both planned and unplanned CS settings. The most frequently occurring obstetrical situations with low indicator adherence were: 1 suspected fetal distress (frequency 17%, adherence 46%, 2 non-progressive labour (frequency 12%, CS performed too early in over 75%, 3 continuous support during labour (frequency 88%, adherence 37% and 4 previous CS (frequency 12%, with adequate counselling in 15%.We identified four concrete target groups for improvement of obstetrical care, which can be used as a starting point to reduce CS rates worldwide.

  1. 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.

  2. 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

  3. A systematic review of the Robson classification for caesarean section: what works, doesn't work and how to improve it.

    Directory of Open Access Journals (Sweden)

    Ana Pilar Betrán

    Full Text Available BACKGROUND: Caesarean sections (CS rates continue to increase worldwide without a clear understanding of the main drivers and consequences. The lack of a standardized internationally-accepted classification system to monitor and compare CS rates is one of the barriers to a better understanding of this trend. The Robson's 10-group classification is based on simple obstetrical parameters (parity, previous CS, gestational age, onset of labour, fetal presentation and number of fetuses and does not involve the indication for CS. This classification has become very popular over the last years in many countries. We conducted a systematic review to synthesize the experience of users on the implementation of this classification and proposed adaptations. METHODS: Four electronic databases were searched. A three-step thematic synthesis approach and a qualitative metasummary method were used. RESULTS: 232 unique reports were identified, 97 were selected for full-text evaluation and 73 were included. These publications reported on the use of Robson's classification in over 33 million women from 31 countries. According to users, the main strengths of the classification are its simplicity, robustness, reliability and flexibility. However, missing data, misclassification of women and lack of definition or consensus on core variables of the classification are challenges. To improve the classification for local use and to decrease heterogeneity within groups, several subdivisions in each of the 10 groups have been proposed. Group 5 (women with previous CS received the largest number of suggestions. CONCLUSIONS: The use of the Robson classification is increasing rapidly and spontaneously worldwide. Despite some limitations, this classification is easy to implement and interpret. Several suggested modifications could be useful to help facilities and countries as they work towards its implementation.

  4. 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

  5. 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.

  6. 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

  7. Asthma and atopy in children born by caesarean section: effect modification by family history of allergies – a population based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kolokotroni Ourania

    2012-11-01

    Full Text Available Abstract Background Studies on the association of birth by caesarean section (C/S and allergies have produced conflicting findings. Furthermore, evidence on whether this association may differ in those at risk of atopy is limited. This study aims to investigate the association of mode of delivery with asthma and atopic sensitization and the extent to which any effect is modified by family history of allergies. Methods Asthma outcomes were assessed cross-sectionally in 2216 children at age 8 on the basis of parents’ responses to the ISAAC questionnaire whilst skin prick tests to eleven aeroallergens were also performed in a subgroup of 746 children. Adjusted odds ratios of asthma and atopy by mode of delivery were estimated in multivariable logistic models while evidence of effect modification was examined by introducing interaction terms in the models. Results After adjusting for potential confounders, children born by C/S appeared significantly more likely than those born vaginally to report ever wheezing (OR 1.36, 95% CI 1.07-1.71, asthma diagnosis (OR 1.41, 95% CI 1.09-1.83 and be atopic (OR 1.67, 95% CI 1.08-2.60. There was modest evidence that family history of allergies may modify the effect of C/S delivery on atopy (p for effect modification=0.06 but this was not the case for the asthma outcomes. Specifically, while more than a two-fold increase in the odds of being a topic was observed in children with a family history of allergies if born by C/S (OR 2.62, 95% CI 1.38-5.00, no association was observed in children without a family history of allergies (OR 1.16, 95% CI 0.64-2.11. Conclusions Birth by C/S is associated with asthma and atopic sensitization in childhood. The association of C/S and atopy appears more pronounced in children with family history of allergies.

  8. SIMPLE: implementation of recommendations from international evidence-based guidelines on caesarean sections in the Netherlands. Protocol for a controlled before and after study

    Directory of Open Access Journals (Sweden)

    Melman Sonja

    2013-01-01

    Full Text Available Abstract Background Caesarean section (CS rates are rising worldwide. In the Netherlands, the most significant rise is observed in healthy women with a singleton in vertex position between 37 and 42 weeks gestation, whereas it is doubtful whether an improved outcome for the mother or her child was obtained. It can be hypothesized that evidence-based guidelines on CS are not implemented sufficiently. Therefore, the present study has the following objectives: to develop quality indicators on the decision to perform a CS based on key recommendations from national and international guidelines; to use the quality indicators in order to gain insight into actual adherence of Dutch gynaecologists to guideline recommendations on the performance of a CS; to explore barriers and facilitators that have a direct effect on guideline application regarding CS; and to develop, execute, and evaluate a strategy in order to reduce the CS incidence for a similar neonatal outcome (based on the information gathered in the second and third objectives. Methods An independent expert panel of Dutch gynaecologists and midwives will develop a set of quality indicators on the decision to perform a CS. These indicators will be used to measure current care in 20 hospitals with a population of 1,000 women who delivered by CS, and a random selection of 1,000 women who delivered vaginally in the same period. Furthermore, by interviewing healthcare professionals and patients, the barriers and facilitators that may influence the decision to perform a CS will be measured. Based on the results, a tailor-made implementation strategy will be developed and tested in a controlled before-and-after study in 12 hospitals (six intervention, six control hospitals with regard to effectiveness, experiences, and costs. Discussion This study will offer insight into the current CS care and into the hindering and facilitating factors influencing obstetrical policy on CS. Furthermore, it will allow

  9. Delivery times for caesarean section at Queen Elizabeth Central Hospital, Blantyre, Malawi: is a 30-minute 'informed to start of operative delivery time' achievable?

    Science.gov (United States)

    O'Regan, M

    2003-08-01

    A timesheet questionnaire was used to assess the time it took from informing the anaesthetist about a case to the start of operative delivery in 78 consecutive patients undergoing caesarean section. Median (IQR [range]) times for grade-1 cases (immediate threat to the life of the mother or fetus) and grade-2 cases (fetal or maternal compromise without immediate threat to life) were 20 (17-35 [6-75]) min and 41 (27-60 [17-136]) min, respectively. Delays occurred in all the component time intervals examined. The primary avoidable delay was the patient's late arrival in theatre. Many significant delays were apparently not perceived by the anaesthetist. In nine (69%) grade-1 cases, the 30-min target decreed by the Association of Anaesthetists of Great Britain & Ireland and the Obstetric Anaesthetists' Association was achieved. PMID:12859467

  10. Successful Delivery of Twin Pregnancy in Class U3b/C2/V1 Uterus by Bilateral Caesarean Section after Spontaneous Conception

    Directory of Open Access Journals (Sweden)

    Yasmine El-Masry

    2015-01-01

    Full Text Available A case of a 19-year-old female with class U3b/C2/V1 uterus conceived a twin pregnancy with a fetus in each horn after spontaneous conception. She referred to our department with presentation of premature rupture of membranes, with a history of cesarean delivery of a single full term living fetus a year and a half before this delivery. Examination revealed two completely separate uterine horns with a fetus in each horn, two distinct externally rounded cervices, and a single vagina with a short nonobstructing vaginal septum in the upper part of the vagina. And as the appropriate mode of delivery is still unclear, each case should be managed as the condition requires, and in our case urgent bilateral caesarean sections were performed.

  11. Reduction of severity of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine: a randomised comparison of prophylactic granisetron and ondansetron.

    LENUS (Irish Health Repository)

    Tan, T

    2012-02-01

    BACKGROUND: The incidence of pruritus after elective caesarean section under spinal anaesthesia with subarachnoid morphine may be 60-100%, and is a common cause of maternal dissatisfaction. Ondansetron has been shown to reduce pruritus but the effect is short-lived. The objective of this randomized double-blind trial was to evaluate the anti-pruritic efficacy of granisetron compared with ondansetron. METHODS: Eighty ASA I or II women undergoing elective caesarean section received spinal anaesthesia with 0.5% hyperbaric bupivacaine 10 mg, fentanyl 25 microg and preservative-free morphine 150 microg. After delivery of the baby and clamping of the umbilical cord, they were randomised to receive granisetron 3mg i.v. (group G) or ondansetron 8 mg i.v. (group O). RESULTS: The two groups were similar for age, gestational age, height and weight. According to visual analogue pruritus scores, patients in group G experienced less pruritus at 8h (P=0.003) and 24h (P=0.01). Fewer patients in group G (n=8) than group O (n=18) required rescue anti-pruritic medication (P=0.03). Satisfaction scores were also higher in group G than in group O (P=0.03). There was no difference in overall incidence of pruritus, nausea and vomiting, and visual analogue pain scores between the two groups. CONCLUSIONS: Administration of granisetron 3mg i.v. reduces the severity of pruritus and the use of rescue anti-pruritic medication, and improves satisfaction but does not reduce the overall incidence of pruritus in women who have received subarachnoid morphine 150 microg compared to ondansetron 8 mg i.v.

  12. THE EFFECTS OF ANTIBIOTIC PROPHYLAXIS ON INFECTIOUS COMPLICATIONS AFTER CAESAREAN SECTION: A RANDOMISED CONTROLLED TRIAL IN A TERTIARY HOSPITAL OF EASTERN INDIA

    Directory of Open Access Journals (Sweden)

    Shelley

    2013-04-01

    Full Text Available ABSTRACT: CONTEXT: Infectious complications after caesarean deliveries are an important and substantial cause of maternal morbidity and inc rease in the hospital stay and cost of treatment. Routine prophylaxis with antibiotics may reduce this risk. AIMS: To determine whether prophylactic antibiotic administration using ceftriaxone at the time of caesarean section significantly reduces maternal and neonatal infectious complications . SETTINGS AND DESIGN: The study was conducted in a tertiary teaching hospi tal of eastern India during March 2011 to October 2011. It was a prospective, double-b lind randomised placebo-controlled trial. METHODS AND MATERIAL: After exclusion due to different reasons, 288 patien ts were enrolled in study group and received prophylactic inje ction ceftriaxone. 293 patients were enrolled in control group who received placebo. Patie nts were randomly selected according to computerized randomization protocol. Postpartum infect ious complications were recorded, as were the duration of hospital stay and neonatal compl ications. STATISTICAL ANALYSIS USED: Analysis of statistical data was done by using stat istical software Open Epi, 8version 2.3.1. RESULTS: Wound indurations, discharge, erythema were 2.43% a nd 5.80% in study and control group respectively and it was statistically significa nt with p value 0.043 (RR=0.419, 95% confidence interval [CI] 0.405. Endomyometritis was more in control group (1.04% vs. 3.75% with p value 0.036 and RR=0.279 and CMLE OR= 0.272. No significant relationship with neonatal morbidities was found. Maternal stay in ho spital was significantly more with p=0.01 in control group. CONCLUSIONS: Antibiotic prophylaxis prior to skin incision of caes arean sections resulted in better maternal outcome when i nfectious morbidity and postoperative hospital stay were concerned, without influencing th e neonatal outcome.

  13. Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25G quince, 27G quince and 27G whitacre spinal needles

    International Nuclear Information System (INIS)

    To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles. Comparative, randomized, double-blind, interventional study. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I (25G Quincke spinal needle: n=168), Group II (27G Quincke spinal needle: n=160) and Group III (27G Whitacre spinal needle: n=152). Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I), 27G Quincke spinal needle (Group II) and 27G Whitacre spinal needle (Group III) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache (PDPH) were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke (Group I), 27G Quincke (Group II) and 27G Whitacre (Group III) spinal needles was 8.3% (14/168), 3.8% (6/160) and 2.0% (3/152) respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on 1st and 2nd postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used. (author)

  14. Impact of alternative reimbursement strategies in the new cooperative medical scheme on caesarean delivery rates: a mixed-method study in rural China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-07-01

    Full Text Available Abstract Background The rate of caesarean delivery (CD in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS, aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Methods Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs and in-depth key informant interviews (KIIs were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. Results The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for

  15. Nursing Experience and Comprehensive Nursing Intervention after Caesarean Section%剖腹产术后的护理体会和综合护理干预

    Institute of Scientific and Technical Information of China (English)

    陈启蓉

    2015-01-01

    Objective To explore the cesarean section postoperative application of the method and the ef ect of comprehensive nursing intervention.Methods Selection in February of 2012 ~ 2013 in our hospital in February 2013 underwent cesarean section of maternal as the research object, were randomly divided into observation group and control group, 60 cases;Postoperative nursing were given conventional cesarean section and comprehensive nursing intervention measures; The indicators on two groups of maternal satisfaction with care and comparison.Results Observation group, the incidence of postpartum hemorrhage and maternal postpartum depression were significantly lower than control group ( <0.05), maternal breastfeeding rate of observation group was obviously higher than that of control group ( <0.05); In addition, the observation group of maternal care (98.33%) of total satisfaction is significantly higher than the control group (68.33%). Two groups of data dif er significantly ( <0.05).Conclusion Implement comprehensive nursing intervention for caesarean section maternal postoperative ef ect significantly, can reduce maternal postpartum hemor hage, postpartum depression, and pain, increase the rate of breastfeeding, while increasing maternal satisfaction of nursing.%目的探究在剖腹产术后应用综合护理干预的方法及效果。方法选取2012年2月~2013年2月我院收治的120例行剖腹产术的孕产妇作为研究对象,随机分为观察组与对照组,各60例;分别给予常规剖腹产术后护理与综合护理干预措施;对两组孕产妇各项指标以及对护理的满意度进行比较。结果观察组产妇产后出血与产后忧郁症的发生率均明显低于对照组(<0.05),观察组产妇母乳喂养率明显高于对照组(<0.05);另外,观察组产妇对护理的总满意度(98.33%)明显高于对照组(68.33%);两组数据差异显著(<0.05)。结论对剖腹产术后产妇实施综合护理干预效果显著,能

  16. 异丙酚对剖宫产术硬膜外麻醉后寒战的疗效观察%Clinical effect of propofol in the treatment of shivering after epidural anesthesia during caesarean section

    Institute of Scientific and Technical Information of China (English)

    潘桂芳

    2015-01-01

    目的:研究异丙酚对剖宫产术硬膜外麻醉后寒战的疗效。方法将剖宫产术硬膜外麻醉后出现寒战的产妇随机分为A、B、C三组。三组产妇采取相同硬膜外麻醉及体温护理措施。A组产妇给予异丙酚治疗,B组产妇给予右美托咪定治疗,C组产妇给予等量生理盐水。比较围术期三组产妇生理指标及抗寒战效果。结果三组产妇围术期各时刻平均动脉压、心率及血氧饱和度比较无显著差异(P>0.05),寒战不同分级分布亦无显著差异(P>0.05);A组产妇抗寒战治疗有效率高于B组(P<0.05),且寒战持续时间明显短于B组(P<0.01)。结论对于剖宫产术硬膜外麻醉后寒战,异丙酚具有与右美托咪定相近的安全性,但其抗寒战效果及起效时间优于右美托咪定。%ObjectiveTo explore the clinical effect of propofol in the treatment of shivering after epidural anesthesia during caesarean section.MethodThe parturients who were shivering after epidural anesthesia during caesarean section were randomly divided into A, B, C group. All parturients were taken the same epidural anesthesia and temperature nursing care. Parturients in group A were taken propofol, parturients in group B were taken dexmedetomidine, parturients in group C were taken same volume of saline, the physiologic index during caesarean section and the clinical effect for the shivering were compared among the three groups.ResultThere were no signiifcant differences at the MAP, HR and SpO2 among the three groups (P>0.05), and it didn't showed signiifcant difference at shivering in different grade distribution among the three groups (P>0.05). The total effective rate in group A was higher than group B (P>0.05), and shiver lasting time in group A was obiviously shorter than group B (P<0.01).ConclusionPropofol is safe for parturients with shivering after epidural anesthesia during caesarean section as same as dexmedetomidine, and

  17. Patterns and Associated Factors of Caesarean Delivery Intention among Expectant Mothers in China: Implications from the Implementation of China’s New National Two-Child Policy

    Science.gov (United States)

    Wang, Lianlian; Xu, Xianglong; Baker, Philip; Tong, Chao; Zhang, Lei; Qi, Hongbo; Zhao, Yong

    2016-01-01

    Objective: This study explores the basic demographic characteristics of expectant mothers in the context of their intentions regarding mode of delivery, in particular, the preference for caesarean delivery, and analyzes the social and psychological factors that influence delivery preference. Method: A cross-sectional survey of pregnant women was conducted during June to August in 2015. This study adopted a stratified sampling method, and 16 representative hospitals in five provinces of China were included. Results: 1755 and 590 of expectant mothers in their first and second pregnancies, respectively, were enrolled in this study. 354 (15.10%) intended to deliver by caesarean section and 585 (24.95%) participants were uncertain prior to delivery. 156 (8.89%) of expectant mothers in their first pregnancy and 198 (33.56%) expectant mothers in their second pregnancy intended to deliver by caesarean section. Ordinal logistic regression analysis found that nationality, parity, trimester of pregnancy, and advanced maternal age were factors associated with intention to deliver by caesarean (ordered logistic regression/three-level caesarean delivery intention criterion; odds ratios p < 0.05). Conclusions: 8.89% of first pregnancy expectant mothers and 33.56% of second pregnancy expectant mothers intended to deliver by caesarean section. Any intervention program to reduce the rate of Caesarean delivery should focus on the Han population, older pregnant women, and expectant mothers in their second pregnancy, at an early gestation. PMID:27399752

  18. Clinical analysis of 39 cases of ectopic pregnancy in caesarean section scar%剖宫产疤痕部位妊娠39例诊治分析

    Institute of Scientific and Technical Information of China (English)

    赵松兰; 刘晓健; 李飞; 于红凤

    2011-01-01

    Objective To study the clinical characteristics, early diagnosis and effective treatment of pregnancy in caesarean section scar. Methods 39 cases of pregnancy in caesarean section scar treated in Jiangsu University Attached People's Hospital were retrospectively analyzed. Results All of the patients had undergone caesarean section at least once before pregnancy in caesarean scar, and they suffered vaginal bleeding of different severity after menolipsis. Pregnancy in caesarean section scar was suspicious by B-ultrasonography. There were 5 cases of hysterectomy, 15 cases of methotrexate chemotherapy, 6 cases of intervention and methotrexate chemotherapy, 6 cases of intervention, wedge resection of scar lesions in lower uterine segment and uterus neoplasty, and 7 cases of intervention, methotrexate chemotherapy, wedge resection of scar lesions in lower uterine segment and uterus neoplasty. Conclusion Once pregnancy in caesarean section scar is diagnosed, it should be interrupted in time so as to reduce the harmfulness of adverse pregnancy. Personalized treatment should be provided for different patients.%目的 探讨剖宫产疤痕部位妊娠的临床特点、早期诊断及适当的治疗方法.方法 分析就诊于江苏大学附属人民医院的39例剖宫产疤痕部位妊娠患者的临床资料及治疗结果.结果 39例患者均有剖宫产史,并都有不同程度停经后阴道流血史;患者经彩超检查显示有剖宫产疤痕部位妊娠可能.39例中有5例行子宫全切除术,15例行甲氨蝶呤化疗,6例行介入+甲氨蝶呤化疗,6例行介入+子宫下段疤痕病灶楔形切除术+子宫修补术,7例行介入+甲氨蝶呤化疗+子宫下段疤痕病灶楔形切除术+子宫修补术.结论 剖宫产疤痕部位妊娠的诊断一旦确认,应及时中止妊娠,从而降低不良妊娠带来的危害;并且要根据患者的具体情况给予个性化治疗.

  19. Propensity score matching with clustered data. An application to the estimation of the impact of caesarean section on the Apgar score.

    Science.gov (United States)

    Arpino, Bruno; Cannas, Massimo

    2016-05-30

    This article focuses on the implementation of propensity score matching for clustered data. Different approaches to reduce bias due to cluster-level confounders are considered and compared using Monte Carlo simulations. We investigated methods that exploit the clustered structure of the data in two ways: in the estimation of the propensity score model (through the inclusion of fixed or random effects) or in the implementation of the matching algorithm. In addition to a pure within-cluster matching, we also assessed the performance of a new approach, 'preferential' within-cluster matching. This approach first searches for control units to be matched to treated units within the same cluster. If matching is not possible within-cluster, then the algorithm searches in other clusters. All considered approaches successfully reduced the bias due to the omission of a cluster-level confounder. The preferential within-cluster matching approach, combining the advantages of within-cluster and between-cluster matching, showed a relatively good performance both in the presence of big and small clusters, and it was often the best method. An important advantage of this approach is that it reduces the number of unmatched units as compared with a pure within-cluster matching. We applied these methods to the estimation of the effect of caesarean section on the Apgar score using birth register data. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26833893

  20. A randomised controlled trial of oxytocin 5IU and placebo infusion versus oxytocin 5IU and 30IU infusion for the control of blood loss at elective caesarean section--pilot study. ISRCTN 40302163.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    OBJECTIVE: To compare the blood loss at elective lower segment caesarean section with administration of oxytocin 5IU bolus versus oxytocin 5IU bolus and oxytocin 30IU infusion and to establish whether a large multi-centre trial is feasible. STUDY DESIGN: Women booked for an elective caesarean section were recruited to a pilot randomised controlled trial and randomised to either oxytocin 5IU bolus and placebo infusion or oxytocin 5IU bolus and oxytocin 30IU infusion. We wished to establish whether the study design was feasible and acceptable and to establish sample size estimates for a definitive multi-centre trial. The outcome measures were total estimated blood loss at caesarean section and in the immediate postpartum period and the need for an additional uterotonic agent. RESULTS: A total of 115 women were randomised and 110 were suitable for analysis (5 protocol violations). Despite strict exclusion criteria 84% of the target population were considered eligible for study participation and of those approached only 15% declined to participate and 11% delivered prior to the planned date. The total mean estimated blood loss was lower in the oxytocin infusion arm compared to placebo (567 ml versus 624 ml) and fewer women had a major haemorrhage (>1000 ml, 14% versus 17%) or required an additional uterotonic agent (5% versus 11%). A sample size of 1500 in each arm would be required to demonstrate a 3% absolute reduction in major haemorrhage (from baseline 10%) with >80% power. CONCLUSION: An additional oxytocin infusion at elective caesarean section may reduce blood loss and warrants evaluation in a large multi-centre trial.

  1. Should the visceral peritoneum at the bladder flap closed at caesarean sections a post partum sonographic and clinical assessment?

    OpenAIRE

    Malvasi, A; Tinelli, A; M. Guido; Zizza, Antonella; Farine, D.; Stark, M.

    2010-01-01

    Objective. To compare cesarean section (CS) using open or closed visceral peritoneum of the bladder flap (BF) in relation to fluid collection in vesico-uterine space (VUS) by ultrasound (US) and clinical outcome. Material and methods. A prospective cohort of repeat CS in 474 in advanced first and second stage of labor was studied. All women underwent a Misgav Ladach CS, in local combined anesthesia. These were divided into two groups by surgical management of the BF at the time of CS: Group I...

  2. Pre-operative ondansetron vs. metoclopramide for prevention of post-operative nausea and vomiting in elective lower-segment caesarean section under spinal anaesthesia

    Directory of Open Access Journals (Sweden)

    Vasantha Kumar J

    2014-02-01

    Full Text Available Background: The problem of nausea and vomiting is a very old but a less thought of problem. Nausea and vomiting are the most common distressing symptom in the postoperative period. Antiemetic drugs play an important role in therapy of post-operative nausea and vomiting (PONV. Though many drugs have been tried as prophylaxis and treatment of PONV, no drug has been proved significantly effective and hence, the present study was undertaken to compare the efficacy and safety of IV metoclopramide and IV Ondansetron as prophylaxis for postoperative nausea and vomiting in lower-segment caesarean section (LSCS under spinal anaesthesia. Methods: After institutional approval and informed consent 100 ASA I & II patients undergoing non emergent LSCS taken for study. The patients were divided randomly into 2 groups of 50 each. Group I received IV metoclopramide 10mg and Group II received IV. Ondansetron 4mg. Anaesthetic management was standardized. The incidence of vomiting and retching as number of episodes was studied. Nausea was graded depending on the severity and data derived. Results: The mean age, weight and duration of surgery was not significantly different when compared group-1 parturiants with group-2. The mean episodes of emesis, nausea and retching at different postoperative duration were significantly decreased (p<0.05 in Ondansetron group when compared to metoclopramide group as postoperative time progresses. Conclusions: Injection ondansetron 4mg provided decrease in the incidence of PONV than metoclopramide as the side effects with these drugs were minimal. [Int J Res Med Sci 2014; 2(1.000: 175-179

  3. Impact of caesarean section on mode of delivery, pregnancy-induced and pregnancy-associated disorders, and complications in the subsequent pregnancy in Germany

    Directory of Open Access Journals (Sweden)

    Jacob, Louis

    2016-06-01

    Full Text Available Objectives: To analyze the impact of caesarean section (CS on mode of delivery, pregnancy-induced and pregnancy-associated disorders, as well as complications in the subsequent pregnancy within German gynecological practices.Methods: 1,801 women with CS and 1,801 matched women with vaginal delivery (VD from the IMS Disease Analyzer database were included. The impact of previous CS on the mode of delivery and pregnancy-associated disorders as well as complications prior to or during birth in the subsequent pregnancy were analyzed. Cox regressions were used to determine the influence of CS with regard to these outcomes.Results: Medical abortion and single spontaneous delivery were significantly less frequent in women with a history of CS compared to VD (OR equal to 0.52 and 0.04 respectively, whereas CS after CS was the significantly more common mode of delivery (79.0% versus 9.3%, OR=36.47. Gestational hypertension without significant proteinuria, gestational hypertension with significant proteinuria, and polyhydramnios were more frequent in women with CS than in women with VD (OR equal to 6.80, 1.71, and 2.29. Hemorrhage and maternal care for known or suspected disproportion were more common in the CS group than in the VD group (OR equal to 1.34 and 3.75. Prolonged pregnancy, preterm labor, abnormalities arising from forces of labor, and perineal laceration during delivery were significantly less frequent in women with CS than in women with VD (OR between 0.32 and 0.75, whereas long labor was more common (OR=2.09.Conclusion: Women with CS were more likely to undergo further CS and to develop major pregnancy-associated diseases in the following pregnancy compared to women with VD.

  4. 剖宫产子宫切除术相关情况分析%The Analysis of Cesarean Hysterectomy during Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    李湛

    2014-01-01

    Objective To investigate the related factors of cesarean hysterectomy during caesarean section. Methods From January 2003 to December 2012,a total of 14 601 women had delivery at department of obstetrical and gynecology in Bei-jing Chaoyang Hospital,among whom 7 178 momen received cesarean section,13 cases received cesarean hysterectomy during cesarean section,the general information,postpartum blood lossing,postoperative complications,and prognosis of mother and infant were analyzed retrospectively. Results Among 7 178 momen who received cesarean section during past 10 years,there were totally 13 cases who received cesarean hysterectomy,the incidence was 0. 18% ,10 cases received total hysterectomy,3 cases received subtotal hysterectomy. The indications of operation include placental factor(9 cases),hemorrhage and dissemi-nated intravascular coagulation(3 cases),and uterine atony(1 case). The postpartum hemorrhage was 600 to 12 600 ml(av-erage 3 800 ml). The postpartum hemorrhage,post - operative hospitalization duration,the proportion of cases with postopera-tive complications,and the proportion of cases who were transferred to ICU after operation of cases whose quantity of blood lossing≤1 500 ml when making the hysterectomy decision were significantly less than those of cases whose quantity of blood lossing >1 500 ml when making the hysterectomy decision(P 1500 ml 者产后出血量、术后住院日减少,术后并发症发生率及转 ICU 比例降低(P <0.05)。2例产妇分别于孕20周及孕24周因瘢痕子宫胎盘因素大量出血急诊行剖宫产术终止妊娠,其余11例进入围生期。13例产妇均治愈出院;11例围生儿中,早产儿7例,胎死宫内2例,新生儿重度窒息1例家属放弃抢救后死亡,轻度窒息1例。结论剖宫产子宫切除术胎盘因素是主要手术指征,剖宫产术中各种止血措施无效时应及时切除子宫。

  5. Temporal Changes of Protein Composition in Breast Milk of Chinese Urban Mothers and Impact of Caesarean Section Delivery

    Science.gov (United States)

    Affolter, Michael; Garcia-Rodenas, Clara L.; Vinyes-Pares, Gerard; Jenni, Rosemarie; Roggero, Iris; Avanti-Nigro, Ornella; de Castro, Carlos Antonio; Zhao, Ai; Zhang, Yumei; Wang, Peiyu; Thakkar, Sagar K.; Favre, Laurent

    2016-01-01

    Human breast milk (BM) protein composition may be impacted by lactation stage or factors related to geographical location. The present study aimed at assessing the temporal changes of BM major proteins over lactation stages and the impact of mode of delivery on immune factors, in a large cohort of urban mothers in China. 450 BM samples, collected in three Chinese cities, covering 8 months of lactation were analyzed for α-lactalbumin, lactoferrin, serum albumin, total caseins, immunoglobulins (IgA, IgM and IgG) and transforming growth factor (TGF) β1 and β2 content by microfluidic chip- or ELISA-based quantitative methods. Concentrations and changes over lactation were aligned with previous reports. α-lactalbumin, lactoferrin, IgA, IgM and TGF-β1 contents followed similar variations characterized by highest concentrations in early lactation that rapidly decreased before remaining stable up to end of lactation. TGF-β2 content displayed same early dynamics before increasing again. Total caseins followed a different pattern, showing initial increase before decreasing back to starting values. Serum albumin and IgG levels appeared stable throughout lactation. In conclusion, BM content in major proteins of urban mothers in China was comparable with previous studies carried out in other parts of the world and C-section delivery had only very limited impact on BM immune factors. PMID:27548208

  6. Temporal Changes of Protein Composition in Breast Milk of Chinese Urban Mothers and Impact of Caesarean Section Delivery

    Directory of Open Access Journals (Sweden)

    Michael Affolter

    2016-08-01

    Full Text Available Human breast milk (BM protein composition may be impacted by lactation stage or factors related to geographical location. The present study aimed at assessing the temporal changes of BM major proteins over lactation stages and the impact of mode of delivery on immune factors, in a large cohort of urban mothers in China. 450 BM samples, collected in three Chinese cities, covering 8 months of lactation were analyzed for α-lactalbumin, lactoferrin, serum albumin, total caseins, immunoglobulins (IgA, IgM and IgG and transforming growth factor (TGF β1 and β2 content by microfluidic chip- or ELISA-based quantitative methods. Concentrations and changes over lactation were aligned with previous reports. α-lactalbumin, lactoferrin, IgA, IgM and TGF-β1 contents followed similar variations characterized by highest concentrations in early lactation that rapidly decreased before remaining stable up to end of lactation. TGF-β2 content displayed same early dynamics before increasing again. Total caseins followed a different pattern, showing initial increase before decreasing back to starting values. Serum albumin and IgG levels appeared stable throughout lactation. In conclusion, BM content in major proteins of urban mothers in China was comparable with previous studies carried out in other parts of the world and C-section delivery had only very limited impact on BM immune factors.

  7. Psychosocial Factors for Women Requesting Cesarean Section

    OpenAIRE

    Yajuan Zhao; Shuangyun Chen

    2013-01-01

    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. The psychosocial factors for requesting cesarean section were analyzed in our study. Methods: A self-made questionnaire and the State-Trait Anxiety Inventory (STAI) and Self-rating Depression Scale (SDS) were ...

  8. 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 to...

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

    DEFF Research Database (Denmark)

    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...

  10. The right to informed choice. A study and opinion poll of women who were or were not given the option of a sterilisation with their caesarean section.

    Directory of Open Access Journals (Sweden)

    Douwe A Verkuyl

    Full Text Available BACKGROUND: In The Netherlands, caesarean sections (CSs are rarely combined with tubal occlusion (TO, partly because discussing CS/TO near delivery is considered unethical and earlier hypothetical counselling--i.e. suppose you happen to need a CS--is rare. This results in more unintended pregnancies and is inconsistent with informed choice. We explored whether TO should indeed not be made routinely available to eligible women. METHODS AND FINDINGS: A questionnaire was mailed to 515 Para ≥2 who underwent in the past ≥1 CS. 498 (96.7% responded. They were on average 35.3 years old, had 2.5 children, had undergone 1.6 CSs, and 3.3 years had passed since their index delivery, either a CS (393 or vaginal birth (105 after a previous CS. 87% of the 498 believed that pregnant mothers with ≥1 children should be routinely counselled about CS/TO. Indeed, 58% and 85% respectively, thought women/couples expecting their second or third child should still be given the TO option days before delivery, if omitted earlier. Counselled women, 138/498 (27.8%, were far more often satisfied than those without CS/TO option. 33/393 had a CS/TO. None indicated regret in the questionnaire. Another 119 also would have elected a CS/TO if given that option. Therefore, 152 (38.7% of 393 Para ≥2 had or would have liked a concurrent TO. 118/119 wrote they still regretted missing this opportunity. The exception's husband had had a vasectomy. 100/119 were good TO candidates: they were ≥28 years when they delivered an apparently healthy baby of ≥37 weeks. The current contraceptive use of these 100 suggests that this group will have at least 8 unintended pregnancies before age 50. CONCLUSION: The experiences and opinions of previous potential candidates for a CS/TO do not support the reluctance of Dutch obstetricians to counsel pregnant Para ≥1 about the TO option for a (potential CS.

  11. The DiAMOND trial protocol: a randomised controlled trial of two decision aids for mode of delivery among women with a previous caesarean section [ISRCTN84367722

    Directory of Open Access Journals (Sweden)

    Montgomery Alan A

    2004-12-01

    Full Text Available Abstract Background Caesarean section (CS has become an increasingly common method of delivery worldwide, rising in the UK from 9% of deliveries in 1980 to over 21% 2001. This increase, and the question of whether CS should be available to women on request, has been the subject of considerable debate, and national reports and guidelines have specifically highlighted the importance of patient choice in the decision making process. For women who have already experienced CS, the UK National Institute of Clinical Excellence recommends that the decision should consider maternal preferences and priorities in addition to general discussion of the overall risks and benefits of CS. Decision aids for many different medical treatment and screening decisions have been developed and evaluated, but there is relatively little evidence for the use of decision aids for choice of mode of delivery among women with a previous CS. The aim of the study is to evaluate two interventions to assist decision making about mode of delivery among pregnant women with one previous CS. Methods/design Women with one previous CS are recruited to the trial during their booking visit at approximately 12–20 weeks' gestation in participating maternity units in Bristol, Weston and Dundee. Using central randomisation, women are allocated to one of three arms: information programme and website; decision analysis; usual care. Both interventions are computer-based, and are designed to provide women with detailed information about the potential outcomes for both mother and baby of planned vaginal delivery, planned CS and emergency CS. The decision analysis intervention additionally provides a recommended 'preferred option' based on maximised expected utility. There are two primary outcomes (decisional conflict and actual mode of delivery, and five secondary outcomes (anxiety, knowledge, perceptions of shared decision making; satisfaction with decision making process, proportion of women

  12. 小剂量硫酸镁预防剖宫产术中寒战发生的临床观察%Clinical Observation of Low Dosage Magnesium Sulfate in Preventing Shivering in Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    王新妃

    2012-01-01

    Objective: To observe the effects of low dosage magnesium sulfate in preventing shivering in caesarean section. Method : Totally 60 patients scheduled for caesarean section with ASA grade Ⅰ-Ⅱ were enrolled and randomly divided into the magnesium sulfate group and the control group with 30 cases in each group. 25% magnesium sulfate with the dosage of 10 mg·kg-1 was intravenously administered ( lasting for 2 minutes ) in the magnesium sulfate group, while the same amount of normal saline was injected in the control group. Incidence and severity of shivering were observed in the both groups, Apgar scores in the first and 5th minute after the neonate expulsion were recorded, and the changes in BP and heart rate of the parturients during the operation were observed. Result: The severity of shivering in the magnesium sulfate group was lower than that in the control group,while there was no statistical significance in the incidence of shivering between the two groups( 23. 3% vs 40. 0% ). The heart rate in the magnesium sulfate group after the neonate expulsion was slower than that in the control group ( 87 ± 9 vs 96 ± 6, P<0. 05 ), however, there was no statistical significance in Apgar scores in the first and 5th min after the neonate expulsion and the neural adaptation in the 15th min between the two groups. Conclusion: Low dosage magnesium sulfate( 10 mg·kg-1 )is safe and effective in reducing the severity of shivering.%目的:观察小剂量硫酸镁预防剖宫产术中寒战发生的临床效果.方法:选择择期剖宫产,ASA分级 I~Ⅱ级患者60例.随机分成硫酸镁组和对照组各30例,麻醉平面固定后,硫酸镁组静脉缓慢注射25%硫酸镁10 mg·kg-1(2 min),对照组给予相同剂量的0.9%氯化钠注射液.观察两组寒战发生率和寒战程度,并记录新生儿娩出后1 min和5 min时的Apgar评分,监测产妇术中血压和心率的变化.结果:硫酸镁组寒战反应程度低于对照组(P<0.05),两组寒战发

  13. 陈皮汤和枳术汤对剖宫产后排气的影响观察%Clinical effect of dried orange peel soup and Zhizhu soup in promoting exhaust after caesarean section

    Institute of Scientific and Technical Information of China (English)

    沈少云

    2015-01-01

    目的 观察陈皮汤和枳术汤在剖宫产术后的助排气临床效果.方法 选取我院120例剖宫产术后产妇平均分为三组,其中分别服用陈皮汤、枳术汤的归为观察组,未服用的归为对照组.对比三组产妇自诉首次排气、排便时间,观察腹胀程度.结果 记录三组剖宫产术后排气时间和排便时间数据,观察组对比对照组在产妇术后排气时间、排便时间的差异有统计学意义(P<0.05),但两组观察组之间在排气时间、排便时间对比差异无统计学意义(P>0.05);三组腹胀程度均为不明显.服用枳术汤的观察组对促剖宫产后排气效果稍优.结论 服用枳术汤有利于剖宫产术后产妇胃肠道功能恢复,明显缩短肛门排气、排便时间,帮助产妇更快恢复正常饮食,利于产妇恢复,利于母乳喂养.%Objective To observe the clinical effect of dried orange peel soup and Zhizhu soup in promoting exhaust after caesarean section.Methods 120 puerperae who had underwent caesarean section in our hospital were selected and randomly divided into three groups.Group A took dried orange peel soup,group B took Zhizhu soup,group C as a control.Compared the time of first exhaust,defecation of three groups,observed abdominal distension degree.Results The time of first exhaust,defecation of group A,B were shorter than those of group C (P<0.05),while there were no statistically significant differences in the time of first exhaust,defecation between group A and B (P>0.05).There was no obvious abdominal distension in three groups.Zhizhu soup had better effect in promoting exhaust after caesarean section.Conclusions Zhizhu soup is helpful to the recovery of gastrointestinal function in puerperae who have underwent caesarean section,which can significantly shorten anus exhaust and defecation time,helps puerperae to return to normal diet as soon as possible,is helpful to body rehabilitation and breastfeeding.

  14. Impact of change in maternal age composition on the incidence of Caesarean section and low birth weight: analysis of delivery records at a tertiary hospital in Tanzania, 1999–2005

    Directory of Open Access Journals (Sweden)

    Kidanto Hussein L

    2009-07-01

    Full Text Available Abstract Background Previous studies on change in maternal age composition in Tanzania do not indicate its impact on adverse pregnancy outcomes. We sought to establish temporal changes in maternal age composition and their impact on annual Caesarean section (CS and low birth weight deliveries (LBWT at Muhimbili National Hospital in Tanzania. Methods We conducted data analysis of 91,699 singleton deliveries that took place in the hospital between 1999 and 2005. The data were extracted from the obstetric data base. Annual proportions of individual age groups were calculated and their trends over the years studied. Multiple logistic analyses were conducted to ascertain trends in the risks of CS and LBWT. The impact of age composition changes on CS and LBWT was estimated by calculating annual numbers of these outcomes with and without the major changes in age composition, all others remaining equal. In all statistics, a p value Results The proportion of teenage mothers (12–19 years progressively decreased over time while that of 30–34 years age group increased. From 1999, the risk of Caesarean delivery increased steadily to a maximum in 2005 [adjusted OR = 1.7; 95%CI (1.6–1.8] whereas that of LBWT declined to a minimum in 2005 (adjusted OR = 0.76; 95% CI (0.71–0.82. The current major changes in age trend were responsible for shifts in the number of CS of up to206 cases per year. Likewise, the shift in LBWT was up to 158 cases per year, but the 30–34 years age group had no impact on this. Conclusion The population of mothers giving birth at MNH is progressively becoming older with substantial impact on the incidence of CS and LBWT. Further research is needed to estimate the health cost implications of this change.

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

    OpenAIRE

    Naima Fathima

    2016-01-01

    Background: Quality improvement in health care is emerging as a science with proven, effective tools and methodologies. This article aims at presenting the importance of adopting one of the effective and simple methodologies and gives an example of a Driver Diagram in obstetrics. Methods: Usefulness of driver diagram in understanding the aim and the interventions or changes. Results: Various quality improvement tools can be used in the clinical context. Among them, driver diagram is mo...

  16. Effects of Sufentanil on Shivering after Caesarean Section%舒芬太尼对剖腹产寒颤的影响

    Institute of Scientific and Technical Information of China (English)

    张惠珍; 于振峰

    2014-01-01

    目的观察舒芬太尼用于剖宫产术中寒颤的变化情况。方法选择200例行剖宫产患者,随机分为A、B两组(n=100)。A组在术中胎儿安全取出后给予舒芬太尼0.2 ug/Kg而B组在术中未做任何处理,比较两组术中寒战情况。结果 A组100例产妇中有5例发生轻度寒战而没有重度寒颤发生者,寒颤发生率约为5%;B组100例产妇中有轻度寒颤38例,重度寒颤22例,寒颤发生率为60%,两组比较,A组寒颤发生显著低于B组(<0.01)。结论舒芬太尼可明显减少患者术中寒颤的发生及严重程度,减少并发症的发生,使患者更加舒适,进而配合医生尽快完成手术,值得临床推广应用。%Objective To observe the changes of sufentanil for cesarean section in the shivering. Methods 200 cases of cesarean section patients, randomly divided into A, B two group (n=100). A group in the operation safety after take out the fetal given sufentanil 0.2ug/kg and group B in patients without any treatment, the two groups were compared intraoperative shivering. Results 5 patients had mild chil s and no severe chil s occurred in A group 100 cases of maternal, shivering occurrence rate is about 5%; 100 cases in group B were slightly shivering in 38 cases, 22 cases of severe chil s, chil s, the incidence rate was 60%, the two groups, A group was significantly lower than that in B group (shivering during <0.01). Conclusion Sufentanil can obviously reduce and the severity of shivering during operation in patients, reduce the incidence of complications, make the patient more comfortable, and cooperate with the doctor as soon as possible to complete the operation, it is worthy of clinical application.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 咪达唑仑对剖宫产术初产妇情绪和记忆的影响%Emotion and memory effects of midazolam on primipara undergoing caesarean section

    Institute of Scientific and Technical Information of China (English)

    谭菁瑜; 董庆龙; 欧阳葆怡

    2007-01-01

    目的 探讨咪达唑仑对剖宫产手术产妇情绪和记忆的影响.方法 72例择期剖宫产术产妇随机分成4组,Ⅰ、Ⅱ和Ⅲ组麻醉前30 min分别肌注咪达唑仑0.05、0.06和0.07 mg/kg,Ⅳ组肌注生理盐水1.5 ml,同时肌肉注射阿托品0.01 mg/kg.于注药前和注药后30 min进行焦虑视觉类比试验(AVAT)、状态焦虑问卷(SAI)测试及Ramsay镇静水平评估.将麻醉准备到手术结束过程分为5阶段,每项告知产妇,记录剖宫产术后4 h产妇能准确回忆的项目.结果 注药后30 min时,Ⅰ~Ⅲ组AVAT分别下降36.4%、43.2%和43.1%;SAI分别下降20.9%、24.8%和26.9%,均获得Ramsay 2~4级镇静水平.Ⅰ~Ⅲ组和Ⅳ组比较记忆保留组间差异均有统计学意义(P均<0.01).Ⅰ~Ⅲ组以遗忘静脉穿刺过程的居多,4组产妇对椎管内麻醉穿刺和新生儿娩出后性别识别两过程全部记忆完觋整.结论 剖宫产手术前给予咪达唑仑0.05~0.07 mg/kg,对产妇有良好的镇静和抗焦虑作用,对外显记忆有一定程度的影响,其中对信息量小和关注程度低的信息能产生顺行性遗忘作用,能保留信息量大和关注程度高的信息的完整记忆.%Objective To investigate the emotion and memory effects of midazolam as a premedication on primipara undergoing caesarean section. Methods Seventy-two primiparous women scheduled for elective caesarean section were randomly divided into four groups. In group Ⅰ,Ⅱand Ⅲ,intramuscular midazolam 0.05 mg/kg,0.06 mg/kg and 0.07 mg/kg were given respectively. The primiparae in group Ⅳ were given intramuscular normal saline 1.5 ml. Anxiety vision analogy test(AVAT) , state anxiety index testing(SAIT) and Ramsay score were evaluated before and 30 min after injection of above drugs. The primiparae were informed when several stages of anesthesia and surgery began. Four hours after the caesarean section they would recall those stages. Accurate remembrance was recorded. Results Thirty minutes

  20. 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.

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

    Science.gov (United States)

    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. PMID:17590252

  2. A comparative study of the antibiotic utilization during the normal and caesarean section deliveries at Jawaharlal Nehru institute of medical sciences hospital, Imphal, Manipur, India

    Directory of Open Access Journals (Sweden)

    Joychandra Singh Oinam

    2016-06-01

    Conclusions: Pregnancy is just a natural process (not a disease or a medical condition and external intervention should occur only for sound medical conditions C section delivery cannot replace normal delivery in terms of low maternal mortality and neonatal morbidity and less cost. Prescribing antibiotics to mother of normal delivery may also be avoided if the complete sterilization process during and after the delivery is assured. [Int J Basic Clin Pharmacol 2016; 5(3.000: 794-797

  3. Determinants of Caesarean Risk Factor in Northern Region of Bangladesh: A Multivariate Analysis.

    Directory of Open Access Journals (Sweden)

    Mostafizur Rahman

    2014-01-01

    Full Text Available Caesarean section (c-section rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional fac-tors. Therefore, this study examines the impact of maternal, socio-demographic and relevant characteristics on caesar-ean delivery in the northern region of Bangladesh.This study is based on a total of 1142 delivery cases from four private hospitals and four public hospitals during the period of January to March 2010. The study was carried out using a cross-sectional design where data were collected by simple random sampling. In order to data analysis, first, an initial bivariate analysis was performed by the chi-square and Fisher exact test. Secondly, the risk factors which are associated with c-section identify by logistic re-gression model. Finally, a stepwise regression analysis was carried out to isolate the most influential risk factors.Among the 17 risk factors, nine were found significantly associated with type of delivery. Eight of the risk factors i.e. previous c-section, pregnancy-induced swollen of leg, prolonged labour, maternal education status, mater-nal age more than 25 years, low birth order, length of baby more than 45cm and irregular intake of a balanced diet remained independently significant for caesarean delivery. The value of P<0.05 was considered statistically significant. Maternal complications were found to be more significant in public hospitals than in private ones and conversely for the demographic characteristics.The findings of this study suggested that the above factors may influence the health-seeking behaviour of women in the northern region of Bangladesh.

  4. A randomized study comparing rectally administered misoprostol after spinal anesthesia versus intramuscular oxytocin for prevention of postpartum hemorrhage in caesarean section

    Directory of Open Access Journals (Sweden)

    Madhuri Alwani

    2014-06-01

    Methods: In a double-blind randomized controlled trial, 200 pregnant women who had cesarean sections were assigned into two groups: to receive either oxytocin intramuscularly or misoprostol rectally after spinal anesthesia. Results: There was no significant difference between the two groups about change in postpartum hemoglobin, need for blood transfusion and incidence of PPH. We also did not observe any significant difference in any side effects. Conclusions: Misoprostol may be considered as an alternative for oxytocin in low resource clinical settings. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 512-515

  5. Intervention for postpartum infections following caesarean section

    DEFF Research Database (Denmark)

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

    2012-01-01

    seeks to elucidate the health economic cost and consequences of this type of infection and treatment. Background: Obesity is an increasing problem in the health care system. Today more than 12% of all pregnant women in Denmark are obese (BMI >30). There is a significant association between obesity in...... pregnant women and the risk of CS. Obesity is associated with an increased risk of postoperative complications such as wound infection, spontaneously dehiscence or reoperation due to infection and prolonged wound healing. Postoperative complications lead to higher costs in the health care sector, including...... time of health professionals, prolonged hospitalization, medications, blood samples and -cultures, reoperations and visits to the general practitioner. Complications may also lead to productivity losses and reduced quality of life. At Odense University Hospital (OUH), Denmark, the conventional...

  6. Evaluation of the perceived quality regarding pain management after obstetric surgery in female undergoing caesarean operation

    OpenAIRE

    Isabel Mª García Sánchez

    2004-01-01

    Appropriate pain management is closely related to the patient wellbeing, which is a main objective in any nursing intervention. This study is aimed to analyse the satisfaction of females undergoing caesarean, focusing on the effectiveness of the analgesic protocol used at Reanimation Ward as well as on identifying factors affecting the perception of pain.Methodology: Cross-sectional study including female admitted in a Reanimation ward of a University hospital after caesarean. A multiple choi...

  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. Analysis of awareness, acceptance, safety and continuation rate of post-placental and intra-caesarean insertion of intrauterine contraceptive device

    Directory of Open Access Journals (Sweden)

    Shivani Barala

    2016-06-01

    Conclusions: PPIUCD was demonstrably safe, effective and high retention rate (92%.The expulsion rate was not very high (2%. Awareness of PPIUCD among Indian women was very poor. Myths and misconception among community, limited access to skilled service providers and poor awareness among people were the reasons for low acceptance levels. Increasing awareness of benefits of PPIUCD will surely ensure the change in the acceptance rate. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 1974-1980

  9. 应用LiDCOrapid监测缩宫素所致产妇血流动力学变化的临床观察%The application of LiDCOrapid system in observation of oxytocin induced-hemodynamic changes in obstetric patients undergoing caesarean section

    Institute of Scientific and Technical Information of China (English)

    段庆芳; 肖玮; 张希峣; 王天龙

    2015-01-01

    目的 探讨LiDCOrapid提供的血流动力学指标能否在剖宫产手术患者中及时、有效地反映缩宫素引起的血流动力学改变.方法 选择美国麻醉医师协会(ASA)分级Ⅰ级,择期剖宫产手术20例,患者入室后应用LiDCOrapid指套、袖带建立无创血压监测(continuous noninvasive arterial blood pressure measurement,CNAP).记录患者入室、胎儿娩出、给予缩宫素后即刻、给药后每间隔10s记录至给药后180 s时患者的血流动力学指标:收缩压(systolic blood pressure,SBP)、舒张压(diastolicblood pressure,DBP)、平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)、心排血量(cardiac output,CO)、每搏量(stroke volume,SV).记录患者缩宫素相关副作用.结果 给予缩宫素后,LiDCOrapid记录到患者HR、CO、SV增高,同时SBP、DBP、MAP下降,这与国外应用LiDCOplus建立有创动脉压监测所得血流动力学变化趋势一致.以胎儿娩出时血流动力学指标为基础值,SBP、DBP、MAP、HR、CO、SV均于给药后40 s~60 s达峰,达峰时相对基础值百分比分别为(89±12)%、(73±14)%、(81±12)%、(116±12)%、(174±35)%、(150±27)%,差异有统计学意义(P<0.01).结论 LiDCOrapid与LiDCOplus比较,二者具有一致性,均可及时、有效地反映剖宫产手术中缩宫素引起的快速血流动力学变化.健康产妇给予10单位负荷剂量缩宫素后,SBP、DBP、MAP下降,而HR、CO、SV升高.%Objective To validate whether the application of LiDCOrapid system could provide timely and effective monitoring in oxytocin-induced hemodynamic changes in obstetric patients undergoing caesarean section.Methods Twenty ASA Ⅰ obstetric patients undergoing elective caesarean section were set the continuous noninvasive arterial blood pressure measurement (CNAP) using the LiDCOrapid monitor in operating room.The real-time hemodynamic parameters,including systolic blood pressure (SBP),diastolic blood pressure (DBP

  10. 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.

  11. 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.

  12. Pregnancy in uterus didelphys delivered by caesarean delivery: case report

    Directory of Open Access Journals (Sweden)

    Sneha S. Rao

    2016-07-01

    Full Text Available Uterus didelphys represents a uterine malformation where the uterus is present as paired organ. There is presence of double uterine bodies with two separate cervices and often a double or septate vagina. Women with congenital malformations of uterus usually have higher incidence of complications during pregnancy and delivery. We report the case in our institute of a pregnancy in the left sided body of a didelphys uterus delivered by caesarean section. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2434-2437

  13. 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

  14. Outcomes Assessment of Pain Relief Techniques Used in Labour in Order to Increase Painless Normal Delivery Rate

    Directory of Open Access Journals (Sweden)

    Sharareh Khanahmadi

    2013-05-01

    Full Text Available Statistics of world health organization show caesarean section rate has been growing worldwide. According to policy of World Health Organization (W.H.O, the reasonable percentage of caesarean section (C/S is 10-15% worldwide; however, increased rates of c/s are related to additional caesarean deliveries for 0.8 -3.2 million in low-income countries and for 4.0-6.2 million in middle and high-income countries. C/S rate is above 15% for 50% of countries on the average (1, 2. Although caesarean section must be just performed based on medical indications, elective caesarean rate is rising. Fear of childbirth is one the most important factors causing women especially nulliparous women to be interested in elective C/S. The amount of this fear depends on many factors, e.g. personality, history and experiences. Since this fear is not decreased even after psychological counselling, it is necessary to relieve the pain of normal delivery by offered methods (3. These pain relief techniques classify as pharmacological and non-pharmacological groups; non-pharmacological group includes methods helping women to cope with pain in labour and pharmacological methods are for relieving the labour pain.

  15. First trimester caesarean scar ectopic pregnancy evaluation using MRI

    International Nuclear Information System (INIS)

    Aim: To determine the features of caesarean scar ectopic pregnancy (CSP) by using magnetic resonance imaging (MRI) in the first trimester. Materials and methods: Thirty-nine women with CSP in the first trimester were initially selected and underwent transvaginal ultrasound and MRI examinations. Thirty-five patients with CSP were finally included in this study. Results: The CSPs were categorized into three groups: type I, in which a thin-walled diverticulum is present at the caesarean section scar (CSS) defect and the gestational sac (GS) is embedded in the diverticulum; type II, in which a thin-walled diverticulum is present at the CSS defect and the GS is partially embedded in the diverticulum; type III, in which a niche is present in the CSS defect and the GS is mainly embedded in the isthmus. Types I, II, and III CSP occurred in 40, 46, and 14% of the women, respectively. There was no significant difference between the three types in the minimum thickness of the CSS defect. In types I and II, there was a positive correlation in the maximum inlet diameter of the CSS defect and the approximate area of the GS. Conclusion: Using MRI, most CSPs present as a diverticulum at the CSS defect, and the CSS defect becomes weaker with the growth of the GS. MRI showed detailed features of the CSP

  16. Cesarean Section Birth

    Medline Plus

    Full Text Available ... you will experience the miracle of birth during a live Internet broadcast from Shawnee Mission Medical Center ... hour, operating surgeon Dr. Leah Ridgway will perform a caesarean section delivery while Dr. Reagan Wittek will ...

  17. Application effect comparison of pentazocine for intravenous analgesia and epidural analgesia after caesarean section%喷他佐辛在剖宫产术后静脉镇痛与硬膜外镇痛中的应用效果比较

    Institute of Scientific and Technical Information of China (English)

    罗新萍; 尹新武; 罗芳; 周生智

    2015-01-01

    Objective To compare the application effect of pentazocine on patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia (PCEA) after caesarean section. Methods 120 patients who needed postoperative analgesia after caesarean section in our hospital from November 2013 to April 2014 were selected and evenly divided into PCIA group and PCEA group in random.In PCEA group,90 mg pentazocine,215 mg ropivacaine,5 mg tropisetron,and normal saline were mixed to 100 ml,while in PCIA group,90 mg pentazocine,2 mg propacetamol,5 mg tropisetron,and normal saline were mixed to 100 ml.Fifteen minutes before the end of surgery,disposable patient-controlled analgesia pump (PCA) was connected in both groups.The mode of LCP referred to 5 ml load dosage,2 ml con-tinuous infusion dosage,and 2 ml self-controlled bolus for 15 set minutes.Scores of analgesia and sedation 6 h,12 h,24 h,36 h,and 48 h after surgery were observed.The adverse reactions like nausea,vomiting,respiratory depression,retention of urine after surgery,postoperative pump dropping,and numbness of lower limb were also observed in order to know pa-tient’s satisfaction. Results There was no significant difference about score of analgesia between the two groups (P>0.05).Within 24-hour application of PCA pump,there was significant difference in Ramsay sedation score between the two groups (P0.05)。在自控镇痛泵使用24 h内,两组Ramsay镇静评分差异有统计学意义(P<0.05)。 PICA组患者对镇痛泵的满意度为95%,高于PCEA组的85%,差异有统计学意义(P<0.05)。结论喷他佐辛用于剖宫产PCEA和PCIA镇痛效果相当,但PCIA还具有携带方便、操作简单等优点,可避免留置硬膜外导管可能发生的并发症,患者的满意度较高,PICA更适合剖宫产手术,值得推广。

  18. Morbidity of caesarean delivery: a comparative study between early and advanced stages of labour in an Indian tertiary care center

    Directory of Open Access Journals (Sweden)

    Amrutha Ramachandran

    2013-08-01

    Methods: A retrospective analysis of 131 women with singleton term pregnancies who underwent emergency caesarean section. The study was done in a tertiary care teaching hospital in India. In this study advanced labour was defined as one with cervical dilatation 8 cm or more at the time of caesarean section. The primary outcome variables were a maternal composite morbidity and a neonatal composite morbidity. Categorical data were compared using chi square test or Fischer’s exact test. Results: 73 women (56% underwent caesarean delivery in the early labour and 58(44% in advanced labour. 12/73 (16.4% patients in early stage of labour had at least one maternal complication (Composite maternal morbidity compared to 18/58 (31% women who had caesarean in advanced stage (p = 0.048. Seven patients out of 73 in the early labour and 14/58 in the advanced labour (p = 0.024 had at least one neonatal complication (Composite neonatal morbidity. Conclusions: The morbidity of primary caesarean sections done in the advanced stage of labour is associated with increased maternal and neonatal morbidity compared to that done in the early stage. A larger study will be needed to establish the inference. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 646-650

  19. COMPARISON OF TWO DOSES OF OXYTOCIN FOR THE PREVENTION OF POSTPARTUM UTERINE ATONY IN PARTURIENTS UNDERGOING EMERGENCY CAESAREAN DELIVERY: A RANDOMIZED DOUBLE BLIND STUDY

    Directory of Open Access Journals (Sweden)

    Fayaz Ahmad

    2016-04-01

    Full Text Available BACKGROUND The optimal dose of oxytocin at Caesarean section is unclear. Oxytocin may cause adverse cardiovascular effects including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomized double-blind trial. METHODS 80 patients undergoing emergency Caesarean section received an IV bolus of either 2 or 5 units (u of oxytocin after delivery, followed by an oxytocin infusion of 10 uh-1 . All patients received spinal anaesthesia with mean arterial pressure maintained by injection ephedrine. We compared changes in Heart Rate (HR, Mean Arterial Pressure (MAP, blood loss, uterine tone, the need for additional uterotonic drugs and antiemetics. RESULTS There was a greater increase in mean (SD HR in patients who received 5u of oxytocin [32 (17 beats min-1 ] than in those who received 2 u [24 (13 beats min-1 ] (P=0.015. There was a larger decrease in MAP in patients who received 5 u [13 (15 mmHg] than in those who received 2 u [6 (10 mmHg] (P=0.030. The frequency of nausea and antiemetic use was higher after 5 u (32.5% than 2 u (5% (P=0.003. There were no differences in blood loss, uterine tone or requests for additional uterotonic drugs (17.5% in both groups. CONCLUSIONS In emergency Caesarean section, a 2 u bolus of oxytocin results in less haemodynamic change than 5 u with less nausea and no difference in the need for additional uterotonics.

  20. Pyoderma Gangrenosum in Two Successive Pregnancies Complicating Caesarean Wound

    Directory of Open Access Journals (Sweden)

    Sapna Vinit Amin

    2014-01-01

    Full Text Available Pyoderma gangrenosum (PG is a rare ulcerative cutaneous disorder with tendency to recur in the injured area. Though most of the time is associated with chronic systemic conditions, it can occur in isolation and can be a diagnostic dilemma. The aetiology is poorly understood. The diagnosis is based on clinical features and excluding other causes of skin ulcers, as it does not have characteristic histopathology or laboratory findings. Lesions can develop after surgery, after trauma or de novo. We are reporting a 32-year-old pregnant lady with two previous instances of pyoderma gangrenosum in the previous pregnancy, who in postoperative period following caesarean section developed the same condition for the third time. She responded well to local wound care, oral Prednisolone, and Dapsone and made a good recovery. Pregnancy being an immunologically altered status can play a role in development of pyoderma gangrenosum and one should always rule out its possibility when there is a delayed wound healing.

  1. 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.

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

    OpenAIRE

    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.

  3. Clinical Efficacy Comparion of Ropivacaine and Levobupivacaine for Combined Spinal-Epidural Anesthesia(CSEA) on Caesarean Section%罗哌卡因与布比卡因用于腰硬联合麻醉剖宫产的临床效果对比

    Institute of Scientific and Technical Information of China (English)

    谢伟

    2011-01-01

    目的:探讨罗哌卡因与布比卡因用于腰硬联合麻醉剖宫产的临床效果.方法:采用随机双盲对照试验设计,将60 例择期行腰硬膜联合麻醉剖宫产产妇按照1:1 的比例随机分为罗哌卡因组和布比卡因组.罗哌卡因组:0.75% 罗哌卡因2ml,布比卡因组:0.75% 布比卡因2ml 用脑脊液稀释到3ml 注药2ml.结果:两组最高感觉阻滞平面、到达最高阻滞平面时间、感觉恢复时间、麻醉效果无显著性差异(P>0.05),罗哌卡因组感觉起效时间、运动阻滞起效时间明显晚于布比卡因组(P<0.05),运动恢复时间明显快于布比卡因组(P<0.05);罗哌卡因组低血压、心动过缓、恶心呕吐和头晕均少于布比卡因组,其中低血压有显著性差异(P<0.05).结论:与布比卡因比较,罗哌卡因麻醉效能相似,但运动恢复更快,利于早期下床活动,且不良反应少,更适用于腰硬联合麻醉剖宫产.%Objective: To investigation the of ropivacaine and levobupivacaine for combined spinal-epidural anesthesia(CSEA) on caesarean section.Methods: Use randomized double-blind controlled trial design,sixty primiparae schedualed for caesarean section were divided into ropivacaine group and bupivacaine group in 1:1 proportion.Ropivacaine group: 0.75% ropivacaine 2ml, bupivacaine group: 0.75% bupivacaine 2ml was diluted to 3ml with cerebrospinal fluid,injection 2ml.Results: There were no significant difference on the highest sensory block plane, reach the maximum block plane time, sensory recovery time, anesthesia effect in the two groups (P> 0.05), sensory onset time, motor block onset time of ropivacaine group was significantly later than that of bupivacaine group (P<0.05), motor recovery was significantly faster than the bupivacaine group (P<0.05); the cases of hypotension, bradycardia, nausea, vomiting and dizziness in ropivacaine group were less than the bupivacaine group, the hypotension cases has significantly differences (P<0

  4. Rising frequency of placenta previa and associated morbidity in women with previous casearean section

    International Nuclear Information System (INIS)

    To determine rising frequency of placenta previa and its associated morbidity in women with previous caesarean section. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted in the Department of Obstetrics and Gynecology at CMH Kohat from Jul 2010 to Jun 2011. Patients and Methods: This study included all pregnant women undergoing repeat caesarean sections. Of these, total 74 patients were admitted with placenta previa. The frequency and associated morbidity were determined. Results: In our study 74 patients with placenta previa were included. 71.62% were less than 35 yrs of age, while 28.38% were equal to or more than 35 years. The gestational age at presentation was 24-36 weeks in 74.3% and 37 + weeks in 5.7% at presentation, 89% patients were symptomatic and 11% were asympyomatic. The morbidities observed were placenta accrete 47%, urinary tract trauma in 63.51%, caesarean hysterectomy in 62.16%, post operative febrile morbidity in 77.03%, maternal mortality was nil, paralytic ileus in 28.38%, PPH in 82.43%, surgical site infection in 16.21%. Conclusion: Frequency of placenta previa and its associated morbidity was raised due to repeated caesarean section rate which must be reduced to decrease maternal morbidity and mortality. (author)

  5. What Determines the Nominal Exchange Rate? Some Cross Sectional Evidence

    OpenAIRE

    Philip Lane

    1999-01-01

    In this paper, the determination of long-run movements in nominal exchange rates across countries are examined. The author models the long-run movement in the nominal exchange rate as depending on (1) the long-run inflation differential and (2) the long-run change in the real exchange rate. He argues that the former depends on country characteristics such as openness, country size, the level of outstanding government debt, and central bank independence, and the latter on the rate of economic ...

  6. Study of patient satisfaction and self-expressed problems after emergency caesarean delivery under subarachnoid block

    Directory of Open Access Journals (Sweden)

    V R Hemanth Kumar

    2014-01-01

    Full Text Available Background and Aims: Subarachnoid block is one of the common modes of anaesthesia opted for emergency caesarean section, if the maternal and foetal conditions are favourable. Various factors influence the quality of care administered during the procedure. This questionnaire based study was undertaken to look for self-expressed problems in peri-operative period in patients undergoing emergency caesarean surgery under subarachnoid block. Methods: All the parturients who underwent emergency caesarean section under subarachnoid block during 6 months period were distributed a questionnaire in post-operative period. They were encouraged to fill and return the form within 15 days. Patient satisfaction and the self-expressed problems were analysed at the end of 6 months. Results: One hundred and seventy five out of 220 parturients responded. 58.3% of them said that they were explained about the anaesthesia prior to surgery and 85.3% overall remained anxious. With people around them, 93.1% of them felt comfortable and 91.4% expressed that they were made comfortable inside the theatre. The self-expressed problems were shivering (43.4%, breathlessness (21.7%, pain (20%, post-operative headache (15.4% and backache (19.4%. Parturients who heard their babies cry was 85.1%. After their babies were shown after delivery, 77.1% mothers slept well; 86.9% fed their babies within 4 h of delivery. Conclusion: Pre-operative communication in emergency caesarean section by health personnel did not reduce the anxiety level, which shows that communication was ineffective. Intra-operative psychological support like making the patient comfortable, showing baby to mother and early breast feeding improve bonding between child and mother and essentially contribute to patient satisfaction.

  7. Evaluation of different hemostatic methods during caesarean section with pernicious placenta previa ;and placenta accreta%凶险型前置胎盘伴胎盘植入剖宫产术中止血方式评价

    Institute of Scientific and Technical Information of China (English)

    金日男; 钟永红

    2014-01-01

    目的:探讨以子宫下段横行环状压迫缝合术联合子宫下段修补术为主的子宫外压迫止血法在凶险型前置胎盘伴胎盘植入剖宫产术中的止血效果及临床应用价值。方法收集广东省韶关市粤北人民医院自2012年1月至2014年6月收治的46例凶险型前置胎盘患者的临床资料,对胎盘植入发生率、诊断、处理方法及随诊情况进行回顾性分析。结果(1)46例凶险型前置胎盘中并发胎盘植入17例,发生率36.96%;穿透性胎盘植入9例,发生率19.57%。(2)术前彩色多普勒超声诊断胎盘植入7例,诊断率70.00%(7/10);术前行MR检查诊断胎盘植入8例,诊断率为88.89%。(3)保留子宫38例(82.61%),切除子宫8例,子宫切除率17.39%。(4)术后42~61 d随访8例胎盘植入保留子宫患者,均恶露干净、子宫复旧良好。结论彩色多普勒检查和盆腔MR 检查可提高凶险型前置胎盘伴胎盘植入的诊断率;剖宫产术中采用以子宫下段横行环状压迫缝合术联合子宫下段修补术为主的子宫外压迫止血法,可迅速有效地减少剖宫产术中出血量,缩短手术时间,降低子宫切除率。%Objective To evaluate the hemostatic effect of transverse annular compression sutures combined surgical repair in the lower uterine segment and its value on clinical application to control postpartum Hemorrhage at cesarean delivery for pernicious placenta previa with placenta accreta. Methods We conducted a retrospective study at 46 pregnant women with pernicious placenta previa, who were treated at the Affiliated Yuebei People's Hospital of Shantou University Medical College from January 2008 to June 2012. This study reviewed the incidence rates, diagnosis and treatment. Results Among the 46 patients, 17 were diagnosed pernicious placenta praevia with placenta accreta; the incidence rate was 36.5%;while 9 patients were pernicious placenta praevia with placenta

  8. Perspectives of cesarean section in buffaloes

    Institute of Scientific and Technical Information of China (English)

    G N Purohit; Mitesh Gaur; Amit Kumar; Chandra Shekher; Swati Ruhil

    2013-01-01

    Cesarean section in buffaloes is an emergency operative procedure being performed prinicipally for uncorrectable uterine torsions and for delivery of fetal monsters. Left paramedian (lateral and parallel to the milk vein) and oblique ventrolateral (above arcus cruralis) are the two common operative sites used for buffalo caesarean section. Although many anesthetic combinations including intravenous and inhalation anesthetic procedures have been experimented in the buffalo species yet most caesarean sections in buffaloes are satisfactorily performed in right lateral recumbency under mild sedation and local infiltration analgesia or paravertebral nerve blocks. The history, indications, anesthesia, operative procedures, post operative complications and future fertility following caesarean section in buffalo are described.

  9. On Fluctuations in the Cross-Sectional Distribution of Unemployment Rates

    OpenAIRE

    Fariba Hashemi

    2012-01-01

    The cross-sectional distribution of unemployment rates has been relatively neglected compared to the study of unemployment rate differences across countries over time. This paper helps fill the gap. A drift-diffusion model is proposed to describe the dynamics of the cross-sectional distribution of unemployment rates. The model is fitted to the evolution of unemployment rate distribution across five regions, to estimate the natural rates and speeds of convergence to natural rates once an econo...

  10. Caesarean section in a case of systemic lupus erythematosus

    OpenAIRE

    Varsha Vyas; Deepika Shukla; Surekha Patil; Shubha Mohite

    2014-01-01

    Systemic lupus erythematosus (SLE) is an autoimmune disease most frequently found in women of child bearing age and may co-exist with pregnancy. Disease exacerbation, increased foetal loss, neonatal lupus and an increased incidence of pre-eclampsia are the major challenges. Its multisystem involvement and therapeutic interventions like anticoagulants, steroids and immunosuppressive agents pose a high risk for both surgery and anaesthesia. We describe successful management of an antinuclear an...

  11. Single mode rate equations for two sections self-pulsating DFB laser

    Institute of Scientific and Technical Information of China (English)

    王春林; 伍剑; 林金桐

    2003-01-01

    We propose a set of single mode rate equations for multi-section distributed feedback (DFB) lasers. On the basis of the rate equations, the self-pulsation in the two-section DFB lasers with asymmetrical injection current was explained.It was found that the dynamic distribution of the power in two sections play key role in the self-pulsation running.

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

    Directory of Open Access Journals (Sweden)

    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

  13. Effect of bupivicaine to subarachnoid at different specific gravity on CSEA for caesarean section%蛛网膜下腔给予不同比重布比卡因腰-硬联合麻醉在剖宫产术中的效果比较

    Institute of Scientific and Technical Information of China (English)

    黄东林; 韩娜娜

    2012-01-01

    [目的]观察比较不同比重布比卡因腰-硬联合麻醉临床应用于剖宫产术的效果、并发症和安全性.[方法]选择ASA Ⅰ~Ⅱ级择期选取腰麻-硬膜外联合阻滞麻醉(CSEA)的产妇150例,随机分为3组.L组50例产妇为轻比重组,腰麻药为0.75%布比卡因2 mL+无菌注射用水1 mL;Ⅰ组50例产妇为等比重组,腰麻药为0.75%布比卡因2mL+生理盐水1 mL;H组50例产妇为重比重组,腰麻药为0.75%布比卡因2mL+ 10%葡萄糖1 mL.硬膜外导管向头侧置管3 ~4 cm,阻滞不完全者由硬膜外导管注入2%利多卡因联合麻醉.比较分析3组患者麻醉效果,术中不良反应及神经系统并发症的差异.[结果]3组患者麻醉从麻醉效果来看,起效时间及达到最高阻滞平面的时间,H组均小于其他两组,差异有显著性意义(P<0.05),L组起效时间最长,出现阻滞不完全,需追加2%利多卡因的例数较多,差异有显著性意义(P<0.05).H组最高平面维持时间大于其他两组,差异有显著性意义(P<0.05),但术中仰卧位综合征及术后神经系统并发症的发生均高于其他两组,差异有显著性意义(P<0.05).[结论]3种不同比重腰麻液中,0.5%等比重布比卡因用于CSEA剖宫产术效果确切,神经系统并发症少,安全可靠.%[Objective] Evaluating the effectiveness and complications by using bupivicaine at different specific gravity on CSEA for caesarean section. [ Methods ] 150 parturient (ASA I ~ II ) were randomly divided into three groups: L group with 0. 75% bupivicaine 2 mL and water for injection 1 mL as spinal fluid; I group with 0. 75% bupivicaine 2 mL and normal saline 1 mL; H group with 0. 75% bupivicaine 2 mL and 10% glucose 1 mL. 2% lidocaine was supplemented via fcpi-dural catheter if necessary. [Results] The onset time and the duration of reaching the height level of group H is shorter than the other. ( P < 0. 05). There was more incomplete block in group L (P<0.05 ). The

  14. 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.

  15. Tables of nuclear cross sections and reaction rates: An addendum to the paper 'Astrophysical reaction rates from satistical model calculations'

    International Nuclear Information System (INIS)

    In a previous publication (ATOMIC DATA AND NUCLEAR DATA TABLES75, 1 (2000)), we gave seven-parameter analytical fits to theoretical reaction rates derived from nuclear cross sections calculated in the statistical model (Hauser-Feshbach formalism) for targets with 10≤Z≤83 (Ne to Bi) and for a mass range reaching the neutron and proton driplines. Reactions considered were (n,γ), (n,p), (n,α), (p,γ), (p,α), (α,γ), and their inverse reactions. Here, we present the theoretical nuclear cross sections and astrophysical reaction rates from which those rate fits were derived, and we provide these data as on-line electronic files. Corresponding to the fitted rates, two complete data sets are provided, one of which includes a phenomenological treatment of shell quenching for neutron-rich nuclei

  16. Preoperative administration of cephalosporins for elective caesarean delivery

    Directory of Open Access Journals (Sweden)

    Bogavac Mirjana

    2010-01-01

    Full Text Available Introduction. Antibiotic prophylaxis means administration of antibiotics in prevention of infections. Objective. To investigate the efficacy of a single dose preoperative administration of ceftriaxone and cefazolin in the prevention of intra- and postoperative infections in the parturients without high risk of inflammation. Methods. The first group of 45 pregnant and 4 non-pregnant women were preoperatively administered ceftriaxone in a dose of 2 g, i.v., 10 minutes before the planned surgery. The second group of 45 pregnant and 4 non-pregnant women were preoperatively administered cefazolin in a dose of 2 g i.v., 10 minutes before the planned surgery. The concentrations of antibiotics were estimated immediately and 6 hours following the operation, as well as in the amniotic fluid and umbilical cord in the group of pregnant women. The estimation of antibiotic concentration was done by the method of liquid chromatography. Results. The mean concentrations of antibiotics in the patients following the elective caesarean section were as follows: ceftriaxone - 22.7 μg/l. vs cefazolin - 44.8 μg/l. Six hours later, the concentration of antibiotic decreased, but the concentration of cefazolin was still over the MIC for sensitive bacteria. The mean concentrations of antibiotics following gynaecological surgery in the non-pregnant patients were as follows: ceftriaxone - 12.0 μg/l vs cefazolin - 30.1 μg/l. Six hours later, the concentration of antibiotic decreased. Conclusion. It is most optimal to administer a single-dose of the first generation cephalosporins-cefazolin-immediately following the clamping of the umbilical cord as well as in preoperative prophylaxis in gynaecological operations.

  17. Unemployment and business formation rates: reconciling time-series and cross-section evidence

    OpenAIRE

    Hamilton, R T

    1989-01-01

    Time-series analyses generally show rates of business formation increasing with unemployment. In cross-section studies the areas with the highest rates of formation are generally those with the lowest levels of unemployment. In a study using both types of data, the negative cross-section relationship is confirmed but it is suggested that the time-series may be nonlinear, becoming negative at a critical unemployment level around 20%. The paper concludes with a reconciliation of these findings.

  18. A Calculation of Direct Radiative Recombination Cross Sections and Rate Coefficients

    Institute of Scientific and Technical Information of China (English)

    XIA Hai-Ning; CHEN Chong-Yang; SHI Xi-Heng; QI Jing-Bo; WANG Yan-Sen

    2003-01-01

    We calculate direct radiative recombination cross sections and rate coefficients for Be-like O4+, Si10+ and Na-like Fe15+ using nonrelativistic dipole approximation. In order to incorporate the screening effect due to the inner-shell electrons in the calculation, we use the distorted wave method instead of pure Coulomb approximation with effective charge. The calculated cross sections and rate coefficients are in agreement with other theoretical calculations and the experimental data.

  19. COMPARISON OF SINGLE DOSE PROPHYLACTIC ANTIBIOTICS VERSUS FIVE DAYS ANTIBIOTIC IN CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Zeel

    2014-03-01

    Full Text Available AIMS AND OBJECTIVES: To compare if single dose antibiotic is as effective as multiple doses in prevention of post-operative infection in caesarean section. To compare the cost effectiveness of drugs in both the groups. MATERIAL AND METHOD: This prospective randomized controlled study was carried out to evaluate the effectiveness of single dose antibiotic versus multiple doses in caesarean section. The study population consisted of 600 patients that were randomly allocated to single or multiple dose groups. All potentially infected cases were excluded from this study. All patients received inj Cefotaxime IV half hour before surgery. In addition the multiple dose group received antibiotics for five days post-operatively. Each patient in the study was observed till discharge for presence of any morbidity like endometritis, urinary tract infections, and wound infections. STATISTICAL ANALYSISIS: Fischer exact test, unpaired t test used for analysis. RESULTS: There was no statistically significance in the rate of infections in both the groups. The rate of febrile morbidity, endometritis, urinary tract infection and wound infections were statistically not significant. However the difference in cost of antibiotic in both the groups was significant. CONCLUSIONS: Single dose antibiotics are effective as multiple doses in prevention of post-operative infections in caesarean sections Careful periodic surveillance of antibiotic prophylaxis is necessary to detect the emergence of drug resistant strains of bacteria in our institution because it caters to the needs of local population.

  20. COMPARISION BE T WEEN METOCLOPRAMIDE AND ONDANSETRON FOR PREVENTION OF NAUSEA AND VOMITING IN CAESAREAN DELIVERY UNDER SPINAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Upendra Singh

    2015-09-01

    Full Text Available AIM OF STUDY : To evaluate the anti - emetic efficacy of bolus doses of metoclopramide and ondansetron in preventing nausea and vomiting in caesarean section under spinal anaesthesia. METHODS: Sixty patients of ASA - Ī and ĪĪ undergoing elective caesarean section were randomly divided into 2 groups of 30 each. Group A (n=30 received IV metoclopramide 10mg and Group B (n=30 received IV ondansetron 4mg, 30 minutes prior to spinal anaesthesia. Anaesthetic management was standardized and incidence o f nausea , retching and vomiting was compared between the two groups. RESULTS: The maternal characteristics regarding age, weight and gestational period were not significantly different between the two groups. There was also no statistically significant (p> 0.05 difference of anti - emetic effects (N ausea, vomiting between the two studied drugs. CONCLUSION: No single intervention is available to completely eliminate nausea and vomiting. Metoclopramide is as effective as ondansetron in preventing the incidence of nausea and vomiting in caesarean delivery under spinal anaesthesia.

  1. Cross-section evaluation utilizing integral reaction-rate measurements in fast neutron fields

    International Nuclear Information System (INIS)

    The role of integral reaction-rate data for cross-section evaluation is reviewed. The subset of integral data considered comprises integral reaction rates measured for dosimeter, fission-product, and actinide-type materials irradiated in reactor dosimetry fast neutron benchmark fields and in the EBR-II. Utilization of these integral data for integral testing, multigroup cross-section adjustment and pointwise cross section adjustment is treated in some detail. Examples are given that illustrate the importance of considering a priori uncertainty and correlation information for these analyses. 3 figures, 3 tables

  2. Ultrasound-guided Transversus Abdominis plane block versus continuous wound infusion for post-caesarean analgesia: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Michel Chandon

    Full Text Available OBJECTIVE: To compare the analgesic effect of ultrasound-guided Transversus Abdominis Plane (TAP block versus Continuous Wound Infusion (CWI with levobupivacaine after caesarean delivery. METHODS: We recruited parturients undergoing elective caesareans for this multicenter study. Following written informed consent, they received a spinal anaesthetic without intrathecal morphine for their caesarean section. The postoperative analgesia was randomized to either a bilateral ultrasound guided TAP block (levobupivicaine = 150 mg or a CWI through an elastomeric pump for 48 hours (levobupivacaine = 150 mg the first day and 12.5 mg/h thereafter. Every woman received regular analgesics along with oral morphine if required. The primary outcome was comparison of the 48-hour area under the curve (AUC pain scores. Secondary outcomes included morphine consumption, adverse events, and persistent pain one month postoperatively. RESULTS: Recruitment of 120 women was planned but the study was prematurely terminated due to the occurrence of generalized seizures in one patient of the TAP group. By then, 36 patients with TAP and 29 with CWI had completed the study. AUC of pain at rest and during mobilization were not significantly different: 50 [22.5-80] in TAP versus 50 [27.5-130] in CWI (P = 0.4 and 190 [130-240] versus 160 [112.5-247.5] (P = 0.5, respectively. Morphine consumption (0 [0-20] mg in the TAP group and 10 [0-32.5] mg in the CWI group (P = 0.09 and persistent pain at one month were similar in both groups (respectively 29.6% and 26.6% (P = 0.73. CONCLUSION: In cases of morphine-free spinal anesthesia for cesarean delivery, no difference between TAP block and CWI for postoperative analgesia was suggested. TAP block may induce seizures in this specific context. Consequently, such a technique after a caesarean section cannot be recommended. TRIAL REGISTRATION: ClinicalTrials.gov NCT01151943.

  3. Comparison of ENDF/B-V and VI cross sections for dosimetry foil reaction rates

    International Nuclear Information System (INIS)

    The objective of this study was to compare calculations of pressure vessel surveillance dosimetry foil reaction rates computed using the ENDF/B-V and ENDF/B-VI cross-section libraries. Reaction rates for dosimetry foils irradiated in the cavity surrounding the pressure vessel of a pressurized water reactor (PWR) were determined using the MCNP4A code with ENDF/B-V and -VI cross sections. The computed reaction rates were compared to measured ones obtained during three fuel cycles of the Arkansas Nuclear One Unit 1 (ANO-1)

  4. Medida da espessura do segmento uterino inferior em gestantes com cesárea prévia: análise da reprodutibilidade intra- e interobservador por ultra-sonografia bi- e tridimensional Lower uterine segment thickness measurement in pregnant women with previous caesarean section: intra- and interobserver reliability analysis using bi- and tridimensional ultrasonography

    Directory of Open Access Journals (Sweden)

    Daniela de Abreu Barra

    2008-03-01

    interferir na conduta do obstetra ou antecipar o parto, foi feito por medidas bidimensionais abdominais da espessura total.PURPOSE: to compare the intra and interobserver reproducibility of the total thickness measurement of the inferior uterine segment (IUS, through the abdominal route, and of the muscle layer measurement, through the vaginal route, using bi and tridimensional ultrasonography. METHODS: the IUS thickness measurement of 30 women, between the 36th and 39th weeks of gestation with previous caesarean section, done by two observers, was studied. Abdominal ultrasonography with the patient in both supine and lithotomy position was performed. In the sagittal section, the IUS was identified and four bidimensional images and two tridimensional blocks of the total thickness were collected through the abdominal route, and the same for the muscle layer, through the vaginal route. Tridimensional acquisitions were manipulated in the multiplanar mode. The time was measured with a chronometer. Reproducibility was evaluated by the computation of the absolute difference between measurements, the ratio of differences smaller than 1 mm, the intraclass coefficient (ICC, and the Bland and Altman's concordance limits. RESULTS: the average bidimensional measurement of IUS thickness was 7.4 mm through the abdominal and 2.7 mm through the vaginal route, and the tridimensional measurement was 6.9 mm through the abdominal and 5.1 mm through the vaginal route. Intra- and interobserver reproducibility of vaginal versus abdominal route: smaller absolute difference (0.2-0.4 mm versus 0.8-1.5 mm, greater ratio of differences (85.8-97.8% versus 48.7-72,8%, with p0.05[A1] and similar lower concordance limits (-38 to 3.4 versus -3.6 to 4 mm for tridimensional ultrasonography and ICC (0.6-0.9 versus 0.7-0.9. CONCLUSIONS: from the above, we came to the conclusion that the measurement of the IUS muscle layer, through the vaginal route using tridimensional ultrasonography is more reproducible

  5. Charmonium dissociation cross sections and charmonium dissociation rates in hadronic matter

    CERN Document Server

    Liu, Feng-Rong; Xu, Xiao-Ming

    2016-01-01

    K*-charmonium dissociation reactions in hadronic matter are studied in the Born approximation, in the quark-interchange mechanism, and with a temperature-dependent quark potential. We obtain the temperature dependence of unpolarized cross sections for K*-charmonium dissociation reactions which produce charmed mesons and charmed strange mesons. We use the cross sections for charmonium dissociation in collisions with pion, rho meson, kaon, vector kaon, and eta meson to calculate dissociation rates of charmonium with the five types of mesons. Because of the temperature dependence of the meson masses, dissociation cross sections, and meson distribution functions, the charmonium dissociation rates generally increase with the increase of temperature and decrease with the increase of charmonium momentum from 2.2 GeV/c. We find that the first derivative of the dissociation rate with respect to the charmonium momentum is zero when the charmonium is at rest. While the eta + psi' and eta + chi_c dissociation reactions c...

  6. Cross sections and excitation rates for electron collisions with heliumlike ions

    International Nuclear Information System (INIS)

    We describe the techniques and the approximations used in extensive calculations for cross sections and reaction-rate parameters for electron-impact excitation of a number of heliumlike ions. All transitions involving the ground state and the n=2 states are considered. Calculations are made in the distorted-wave approximation using configuration-interaction wave functions to represent the target states. Autoionizing resonances in the scattering cross sections are included through bound-channel correlation-type functions and through quantum-defect-theory analysis of the reactance matrices. The resonances are shown to make considerable contributions to the cross sections and thereby, in many cases, to enhance the excitation-rate coefficients by a significant factor. This should have important consequences for practical applications in the analysis of laboratory and astrophysical plasmas. The accuracy of our approximations is also discussed

  7. Strategy for diagnosis and correction of vaginal dysbiosis in terms of preparation of pregnant for planned cesarean section and prevention of postpartum endometritis.

    OpenAIRE

    Voronin K.V.; Alale A.M.; Alale I.I.; Dzyba Y.N.

    2013-01-01

    Clinical features of vaginal dysbiosis as a factor in the high risk of septic complications, especially in pregnant women diagnosed with anaerobic vaginal dysbiosis were examined. Low efficiency of the traditional methods of treating bacterial dysbiosis, a high rate of recurrences and the risk of preterm delivery dictate the need to find alternative methods of treatment and prevention of antenatal and post-natal complications. The widespread introduction of caesarean section into obstetric pr...

  8. Modelling of N21P emission rates in aurora using various cross sections for excitation

    Directory of Open Access Journals (Sweden)

    O. Jokiaho

    2009-06-01

    Full Text Available Measurements of N21P auroral emissions from the (4,1 and (5,2 bands have been made at high temporal and spatial resolution in the region of the magnetic zenith. The instrument used was the auroral imager ASK, situated at Ramfjordmoen, Norway (69.6 N, 19.2 E on 22 October 2006. Measurements from the European Incoherent Scatter Radar (EISCAT have been combined with the optical measurements, and incorporated into an ionospheric model to obtain height profiles of electron density and emission rates of the N21P bands. The radar data provide essential verification that the energy flux used in the model is correct. One of the most important inputs to the model is the cross section for excitation to the B3Πg electronic state, as well as the cross sections to higher states from which cascading into the B state occurs. The balance equations for production and loss of the populations of all levels in each state are solved in order to find the cascade contributions. Several sets of cross sections have been considered, and selected cross sections have been used to construct "emission" cross sections for the observed bands. The resulting brightnesses are compared with those measured by ASK. The importance of specific contributions from cascading is found, with more than 50% of the total brightness resulting from cascading. The cross sections used are found to produce a range of brightnesses well within the uncertainty of both the modelled and measured values.

  9. 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.

  10. Increased cesarean section rate in Central Saudi Arabia: a change in practice or different maternal characteristics

    OpenAIRE

    Al-Kadri HM; Al-Anazi SA; Tamim HM

    2015-01-01

    Hanan M Al-Kadri,1 Sultana A Al-Anazi,1 Hani M Tamim21Department of Obstetrics and Gynecology, King Abdulaziz Medical City, 2College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaBackground: Cesarean section (CS) rate has shown creepy increase. We aimed in this work to identify factors contributing to increasing rate of CS in central Saudi Arabia.Methods: A retrospective cohort study was conducted at King Abdulaziz Medical City. T...

  11. Self-reported eating rate and metabolic syndrome in Japanese people: cross-sectional study

    OpenAIRE

    Nagahama, Satsue; Kurotani, Kayo; Pham, Ngoc Minh; Nanri, Akiko; Kuwahara, Keisuke; Dan, Masashi; Nishiwaki, Yuji; Mizoue, Tetsuya

    2014-01-01

    Objectives To examine the association between self-reported eating rate and metabolic syndrome. Design Cross-sectional study. Setting Annual health checkup at a health check service centre in Japan. Participants A total of 56 865 participants (41 820 male and 15 045 female) who attended a health checkup in 2011 and reported no history of coronary heart disease or stroke. Main outcome measure Metabolic syndrome was defined by the joint of interim statement of the International Diabetes Federat...

  12. Effects of acupressure on progress of labor and cesarean section rate: randomized clinical trial

    OpenAIRE

    Reginaldo Roque Mafetoni; Antonieta Keiko Kakuda Shimo

    2015-01-01

    OBJECTIVE To analyze the effects of acupressure at the SP6 point on labor duration and cesarean section rates in parturients served in a public maternity hospital. METHODS This controlled, randomized, double-blind, pragmatic clinical trial involved 156 participants with gestational age ≥ 37 weeks, cervical dilation ≥ 4 cm, and ≥ 2 contractions in 10 min. The women were randomly divided into an acupressure, placebo, or control group at a university hospital in an inland city in the state of Sa...

  13. Absorption Cross-section and Decay Rate of Rotating Linear Dilaton Black Holes

    CERN Document Server

    Sakalli, I

    2016-01-01

    We analytically study the scalar perturbation of non-asymptotically flat (NAF) rotating linear dilaton black holes (RLDBHs) in 4-dimensions. We show that both radial and angular wave equations can be solved in terms of the hypergeometric functions. The exact greybody factor (GF), the absorption cross-section (ACS), and the decay rate (DR) for the massless scalar waves are computed for these black holes (BHs). The results obtained for ACS and DR are discussed through graphs.

  14. Cross sections and reaction rates of d+8Li reactions involved in Big Bang nucleosynthesis

    International Nuclear Information System (INIS)

    We have measured angular distributions of the 2H(8Li, 7Li)3H and 2H(8Li, 9Be)n reactions at Ec.m.=1.5 to 2.8 MeV using an 8Li-radioactive-beam technique. Astrophysical S-factors and reaction rates were calculated from the measured cross sections. Although the 2H(8Li, 9Be)n cross section is small, it can contribute to 9Be synthesis. The 2H(8Li, 7Li)3H reaction has a sufficiently large cross section to destroy 8Li, which may decrease the synthesis of heavier elements. No products from the 2H(8Li, 9Li)p reaction were detected. We also present the results of calculations using the inhomogeneous model of primordial nucleosynthesis in several regions of parameter space. ((orig.))

  15. Effects of acupressure on progress of labor and cesarean section rate: randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Reginaldo Roque Mafetoni

    2015-01-01

    Full Text Available OBJECTIVE To analyze the effects of acupressure at the SP6 point on labor duration and cesarean section rates in parturients served in a public maternity hospital. METHODS This controlled, randomized, double-blind, pragmatic clinical trial involved 156 participants with gestational age ≥ 37 weeks, cervical dilation ≥ 4 cm, and ≥ 2 contractions in 10 min. The women were randomly divided into an acupressure, placebo, or control group at a university hospital in an inland city in the state of Sao Paulo, Brazil, in 2013. Acupressure was applied to the SP6 point during contractions for 20 min. RESULTS The average labor duration was significantly different between the SP6 acupressure group [221.5 min (SD = 162.4] versus placebo [397.9 min (SD = 265.6] and versus control [381.9 min (SD = 358.3] (p = 0.0047; however, the groups were similar regarding the cesarean section rates (p = 0.2526 and Apgar scores in the first minute (p = 0.9542 and the fifth minute (p = 0.7218 of life of the neonate. CONCLUSIONS The SP6 acupressure point proved to be a complementary measure to induce labor and may shorten the labor duration without causing adverse effects to the mother or the newborn. However, it did not affect the cesarean section rate.

  16. Accuracy rate of frozen section studies in ovarian cancers: A regional cancer institute experience

    Directory of Open Access Journals (Sweden)

    A Subbian

    2013-01-01

    Full Text Available Background: Frozen section is a valuable diagnostic procedure in the categorization of ovarian tumors as benign, borderline and malignant. Thus, it guides in tailoring surgical therapy, particularly in young women. Aim: This study was undertaken to determine the accuracy of frozen section in ovarian neoplasms. Materials and Methods: A retrospective analysis was done of intraoperative frozen sections for suspected ovarian neoplasms. The frozen and permanent section reports were compared and overall accuracy, sensitivity, specificity, positive and negative predictive values were determined. Results: The study included 135 patients and the overall accuracy of frozen section in determining malignancy was 84.25%. Twenty cases were incorrectly diagnosed, of which 16 cases were under-diagnosed and four were over-diagnosed. With respect to malignant potential, the sensitivity for malignant tumors was highest (91.5% with specificity of 98.2%. For benign tumors, the sensitivity and specificity were 90.4% and 82.6%, respectively. Borderline tumors had the lowest sensitivity of 31.2% with specificity of 94%. Sensitivity for benign, borderline and malignant tumors in the non-mucinous group was 91.3%, 60% and 95% respectively, whereas the sensitivity was 75%, 18% and 57%, respectively, for mucinous tumors revealing low sensitivity in borderline, mucinous tumors. The low sensitivity rates were due to restriction in the sampling of an adequate number of bits in the large sized tumors. Conclusion: The present study concurs that frozen section is an accurate test for diagnosis of benign and malignant tumors. However, accuracy rates for borderline and mucinous tumors are low.

  17. Absolute absorption cross-section and photolysis rate of I2

    Directory of Open Access Journals (Sweden)

    J. M. C. Plane

    2004-05-01

    Full Text Available Following recent observations of molecular iodine (I2 in the coastal marine boundary layer (MBL (Saiz-Lopez and Plane, 2004, it has become important to determine the absolute absorption cross-section of I2 at reasonably high resolution, and also to evaluate the rate of photolysis of the molecule in the lower atmosphere. The absolute absorption cross-section (σ of gaseous I2 at room temperature and pressure (295 K, 760 Torr was therefore measured between 182 and 750 nm using a Fourier Transform spectrometer at a resolution of 4 cm−1 (0.1 nm at λ=500 nm. The maximum absorption cross-section in the visible region was observed at λ=533.0 nm to be σ=(4.84±0.60×10−18cm2 molecule−1. The spectrum is available as supplementary material accompanying this paper. The photo-dissociation rate constant (J of gaseous I2 was also measured directly in a solar simulator, yielding J(I2=0.12±0.03 s−1 for the lower troposphere. This agrees well with the value of 0.15±0.03 s−1 calculated using the measured absorption cross-section, terrestrial solar flux for clear sky conditions and assuming a photo-dissociation yield of unity. A two-stream radiation transfer model was then used to determine the variation in photolysis rate with solar zenith angle (SZA, from which an analytic expression is derived for use in atmospheric models. Photolysis appears to be the dominant loss process for I2 during daytime, and hence an important source of iodine atoms in the lower atmosphere.

  18. Absolute absorption cross-section and photolysis rate of I2

    Directory of Open Access Journals (Sweden)

    A. Saiz-Lopez

    2004-01-01

    Full Text Available Following recent observations of molecular iodine (I2 in the coastal marine boundary layer (MBL (Saiz-Lopez and Plane, 2004, it has become important to determine the absolute absorption cross-section of I2 at reasonably high resolution, and also to evaluate the rate of photolysis of the molecule in the lower atmosphere. The absolute absorption cross-section (σ of gaseous I2 at room temperature and pressure (295K, 760Torr was therefore measured between 182 and 750nm using a Fourier Transform spectrometer at a resolution of 4cm-1 (0.1nm at λ=500nm. The maximum absorption cross-section in the visible region was observed at λ=533.0nm to be σ=(4.24±0.50x10-18cm2molecule-1. The spectrum is available as supplementary material accompanying this paper. The photo-dissociation rate constant (J of gaseous I2 was also measured directly in a solar simulator, yielding J(I2=0.12±0.03s-1 for the lower troposphere. This is in excellent agreement with the value of 0.12±0.015s-1 calculated using the measured absorption cross-section, terrestrial solar flux for clear sky conditions and assuming a photo-dissociation yield of unity. A two-stream radiation transfer model was then used to determine the variation in photolysis rate with solar zenith angle (SZA, from which an analytic expression is derived for use in atmospheric models. Photolysis appears to be the dominant loss process for I2 during daytime, and hence an important source of iodine atoms in the lower atmosphere.

  19. Electron-impact resonant vibration excitation cross sections and rate coefficients for carbon monoxide

    International Nuclear Information System (INIS)

    Resonant vibrational and rotation–vibration excitation cross sections for electron–CO scattering are calculated in the 0–10 eV energy range for all 81 vibrational states of CO, assuming that the excitation occurs via the 2Π shape resonance. Static exchange plus polarization calculations performed using the R-matrix method are used to estimate resonance positions and widths as functions of internuclear separation. The effects of nuclear motion are considered using a local-complex-potential model. Good agreement is obtained with available experimental data on excitation from the vibrational ground state. Excitation rates and cross sections are provided as a function of the initial CO vibrational state for all ground state vibrational levels. (paper)

  20. Electron--impact resonant vibration excitation cross sections and rate coefficients for carbon monoxide

    CERN Document Server

    Laporta, V; Tennyson, J; Celiberto, R; 10.1088/0963-0252/21/4/045005

    2012-01-01

    Resonant vibrational and rotation-vibration excitation cross sections for electron-CO scattering are calculated in the 0-10 eV energy range for all 81 vibrational states of CO, assuming that the excitation occur via the 2{\\Pi} shape resonance. Static exchange plus polarization calculations performed using the R-matrix method are used to estimate resonance positions and widths as functions of internuclear separation. The effects of nuclear motion are considered using a local complex potential model. Good agreement is obtained with available experimental data on excitation from the vibrational ground state. Excitation rates and cross sections are provided as a functions of the initial CO vibrational state for all ground state vibrational levels.

  1. Cross-sectional survey of detectable rate of subclinical hypothyroidism in different people in China

    International Nuclear Information System (INIS)

    Objective: To investigate the detectable rates of subclinical hypothyroidism (SH) of children aged 8-10 years, adults aged 18-45 years, breast feeding women and pregnant women, and analyze the differences of the detectable rates in different people with different levels of urinary iodine concentrations and immune status in order to provide new indexes for prevention and treatment of iodine deficiency disorders. Methods: A cross-sectional survey was performed in four kinds of 1999 target people (633 children aged 8-10 years, 703 adults aged 18-45 years, 334 breast feeding women and 329 pregnant women) in six different areas in China from the April 2009 to April 2010. The morning blood samples and three urine samples selected randomly of different people were collected and the thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid microsome antibody (TMAb), thyroid globulin antibody (TGAb) in blood samples and iodine in urine samples were detected. Results: The detectable rates of subclinical hypothyroidism of children aged -10 years old, adults aged 18-45 years old, breast feeding women and pregnant women were 10.43% , 4.84% , 4.19% , and 3.95% , respectively. The detectable rate of SH in children group was significantly higher than that in adults group (P<0.01). There was no significant differences of the detectable rates of SH between children children whose urinary iodine were normal and children whose urinary iodine were elevated (P>0.05). The positive rates of TMAb and TGAb of people with SH were significantly higher than those of people with normal thyroid function (P<0.01). Conclusion: The detectable rate of SH of children aged 8-10 years is higher than those in other three groups, which indicates that the index of SH should be used in routine monitoring of iodine disorder control in children. (authors)

  2. Cesarean section rate in Iran, multidimensional approaches for behavioral change of providers: a qualitative study

    Directory of Open Access Journals (Sweden)

    Rashidian Arash

    2011-07-01

    Full Text Available Abstract Background The cesarean section rate has been steadily rising from 35% in 2000 to 40% in 2005 in Iran. The objective of this study was to identify barriers of reduce the cesarean section rate in Iran, as perceived by obstetricians and midwives as the main behavioral change target groups. Methods A qualitative study with purposive sampling was designed in which data were collected through in-depth interviews and document analyses. Hospitals were selected on the bases of being public and or private and their response to the ministry's C-section reduction interventions. The hospital director, obstetricians and midwives from each hospital were included in the study. The classification of barriers suggested by Grol and Wensing was used for the thematic analysis. Results After 26 in-depth interviews and document analyses, the barriers were identified as: financial, insurance and judicial problems at the economic and political context level; the type and ownership of hospitals, absence of an on call physician, absence of clear job-descriptions for obstetricians and midwives, too many interventions in the delivery process and shortage of human resources and facilities at the organizational context level; distrust and insufficient collaborations between obstetricians and midwives from macro to micro level at the social context level; attitudes toward complications of C-section, reduced capabilities of obstetricians, midwives and residents at the individual professional level; and finally, at the innovation level, vaginal delivery is time consuming, imposes high stress levels and is unpredictable. Conclusion Changing service providers' behavior is not possible through presentation of scientific evidence alone. A multi-level and multidisciplinary approach using behavior change theories is unavoidable. In future studies, the effect of the barriers should be determined to help policy makers recognize the most effective interventional package.

  3. 降低剖宫产策略%The strategies for reducing cesarean section rate

    Institute of Scientific and Technical Information of China (English)

    陈卓; 马润玫

    2012-01-01

    剖宫产的正确使用应该基于全民对母亲安全和改善卫生保健的主动性上,中国剖宫产率(cesarean section rate,CSR)的下降需要依托公众/医务人员和管理人员的教育、卫生行政部门的政策倾斜以及政府的资金和医疗保险支持等,以建设一个科学的产科管理和干预体系.

  4. Neutron Thermal Cross Sections, Westcott Factors, Resonance Integrals, Maxwellian Averaged Cross Sections and Astrophysical Reaction Rates Calculated from Major Evaluated Data Libraries

    OpenAIRE

    Pritychenko, B.; Mughabghab, S.F.

    2012-01-01

    We present calculations of neutron thermal cross sections, Westcott factors, resonance integrals, Maxwellian-averaged cross sections and astrophysical reaction rates for 843 ENDF materials using data from the major evaluated nuclear libraries and European activation file. Extensive analysis of newly-evaluated neutron reaction cross sections, neutron covariances, and improvements in data processing techniques motivated us to calculate nuclear industry and neutron physics quantities, produce s-...

  5. Effective absorption cross sections and photolysis rates of anthropogenic and biogenic secondary organic aerosols

    Science.gov (United States)

    Romonosky, Dian E.; Ali, Nujhat N.; Saiduddin, Mariyah N.; Wu, Michael; Lee, Hyun Ji (Julie); Aiona, Paige K.; Nizkorodov, Sergey A.

    2016-04-01

    Mass absorption coefficient (MAC) values were measured for secondary organic aerosol (SOA) samples produced by flow tube ozonolysis and smog chamber photooxidation of a wide range of volatile organic compounds (VOC), specifically: α-pinene, β-pinene, β-myrcene, d-limonene, farnesene, guaiacol, imidazole, isoprene, linalool, ocimene, p-xylene, 1-methylpyrrole, and 2-methylpyrrole. Both low-NOx and high-NOx conditions were employed during the chamber photooxidation experiments. MAC values were converted into effective molecular absorption cross sections assuming an average molecular weight of 300 g/mol for SOA compounds. The upper limits for the effective photolysis rates of SOA compounds were calculated by assuming unity photolysis quantum yields and convoluting the absorption cross sections with a time-dependent solar spectral flux. A more realistic estimate for the photolysis rates relying on the quantum yield of acetone was also obtained. The results show that condensed-phase photolysis of SOA compounds can potentially occur with effective lifetimes ranging from minutes to days, suggesting that photolysis is an efficient and largely overlooked mechanism of SOA aging.

  6. Increased cesarean section rate in Central Saudi Arabia: a change in practice or different maternal characteristics

    Directory of Open Access Journals (Sweden)

    Al-Kadri HM

    2015-07-01

    Full Text Available Hanan M Al-Kadri,1 Sultana A Al-Anazi,1 Hani M Tamim21Department of Obstetrics and Gynecology, King Abdulaziz Medical City, 2College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaBackground: Cesarean section (CS rate has shown creepy increase. We aimed in this work to identify factors contributing to increasing rate of CS in central Saudi Arabia.Methods: A retrospective cohort study was conducted at King Abdulaziz Medical City. Two groups of women were included (G1 and G2. G1 had delivered by CS during the year 2002 (CS rate 12%, and G2 had delivered by CS during the year 2009 (CS rate 20%. We compared the included women’s characteristics, neonates, CS indications, and complications. Data were analyzed using SPSS version 15 program. Odds ratios and confidence intervals were calculated to report precision of categorical data results. A P-value of ≤0.05 was considered significant.Results: A total of 198 women were included in G1 and 200 in G2. Both groups had comparable maternal and fetal characteristics; however, absence of antenatal care has resulted in 70% increase in CS deliveries for G2, P=0.008, OR =0.30, CI 0.12–0.76. Previous vaginal surgeries have contributed to tenfold increase in CS deliveries for G2, P=0.006, OR =10.37, CI 1.32–81.78. G2 had eight times increased CS deliveries than G1 due to intrauterine growth restriction, P=0.02, OR =8.21, CI 1.02–66.25, and 80% increased risk of CS was based on maternal demand, P=0.02, OR =0.20, CI 0.02–1.71. Decision taken by less-experienced staff was associated with 2.5-fold increase in CS deliveries for G2, P=0.002, OR =2.62, CI 1.39–4.93. There was a significant increase in CS deliveries under regional analgesia and shorter duration of hospital stay for G2, P=0.0001 and P=0.001, respectively. G2 women had 2.75-fold increase in neonatal intensive care unit admission, P=0.03, OR =2.75, CI 1.06–7.15.Conclusion: CS delivery rate

  7. Post Caesarean Sagittal Sinus Thrombosis after Spinal Anaesthesia: A Case Report

    OpenAIRE

    Gaurav Tomar; Neeraj Narang; TC Kriplani; Ashish Sethi

    2010-01-01

    Central venous thrombosis, although rare, is a recognized cause of puerperium stroke. We present a case of successfully managed sagittal sinus thrombosis (SST) developed in a parturient after Caesarean delivery under spinal anaesthesia.

  8. Measurement of (alpha,n) reaction cross sections of erbium isotopes for testing astrophysical rate predictions

    CERN Document Server

    Kiss, G G; Rauscher, T; Török, Zs; Csedreki, L; Fülöp, Zs; Gyürky, Gy; Halász, Z

    2015-01-01

    The $\\gamma$-process in core-collapse and/or type Ia supernova explosions is thought to explain the origin of the majority of the so-called $p$ nuclei (the 35 proton-rich isotopes between Se and Hg). Reaction rates for $\\gamma$-process reaction network studies have to be predicted using Hauser-Feshbach statistical model calculations. Recent investigations have shown problems in the prediction of $\\alpha$-widths at astrophysical energies which are an essential input for the statistical model. It has an impact on the reliability of abundance predictions in the upper mass range of the $p$ nuclei. With the measurement of the $^{164,166}$Er($\\alpha$,n)$^{167,169}$Yb reaction cross sections at energies close to the astrophysically relevant energy range we tested the recently suggested low energy modification of the $\\alpha$+nucleus optical potential in a mass region where $\\gamma$-process calculations exhibit an underproduction of the $p$ nuclei. Using the same optical potential for the $\\alpha$-width which was der...

  9. 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

  10. Systematic effects on cross-section data derived from reaction rates at a cold neutron beam

    Energy Technology Data Exchange (ETDEWEB)

    Žerovnik, Gašper, E-mail: gasper.zerovnik@ijs.si [Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana (Slovenia); European Commission, Joint Research Centre, Retieseweg 111, B-2440 Geel (Belgium); Becker, Björn [European Commission, Joint Research Centre, Retieseweg 111, B-2440 Geel (Belgium); Belgya, Tamás, E-mail: belgya.tamas@energia.mta.hu [Institute for Energy Security and Environmental Safety, Centre for Energy Research, Hungarian Academy of Sciences, 29-33 Konkoly-Thege Miklós Street, H-1121 Budapest (Hungary); Genreith, Christoph, E-mail: christoph.genreith@frm2.tum.de [Heinz Maier-Leibnitz Zentrum (MLZ), Technische Universität München, Lichtenbergstr. 1, D-85748 Garching (Germany); Harada, Hideo, E-mail: harada.hideo@jaea.go.jp [Japan Atomic Energy Agency, Tokai-mura, 319-1195 Ibaraki (Japan); Kopecky, Stefan, E-mail: stefan.kopecky@ec.europa.eu [European Commission, Joint Research Centre, Retieseweg 111, B-2440 Geel (Belgium); Radulović, Vladimir, E-mail: vladimir.radulovic@ijs.si [Jožef Stefan Institute, Jamova cesta 39, SI-1000 Ljubljana (Slovenia); CEA, DEN, DER, Instrumentation, Sensors and Dosimetry Laboratory, Cadarache, F-13108 St-Paul-Lez-Durance (France); Sano, Tadafumi, E-mail: t-sano@rri.kyoto-u.ac.jp [Research Reactor Institute, Kyoto University, Kumatori-cho, 590-0494 Osaka (Japan); Schillebeeckx, Peter, E-mail: peter.schillebeeckx@ec.europa.eu [European Commission, Joint Research Centre, Retieseweg 111, B-2440 Geel (Belgium); and others

    2015-11-01

    The methodology to derive cross-section data from measurements in a cold neutron beam was studied. Mostly, capture cross-sections at thermal energy are derived relative to a standard cross-section, e.g. the cross-section of the {sup 1}H(n,γ), {sup 14}N(n,γ), or {sup 197}Au(n,γ) reaction, and proportionality between the standard and the measured cross-section, evaluated at different energies in the sub-thermal region, is often assumed. Due to this assumption the derived capture cross-section at thermal energy can be biased by more than 10%. Evidently the bias depends on how much the energy dependence of the cross-section deviates from a direct proportionality with the inverse of the neutron speed. The effect is reduced in case the cross-section is not derived at thermal energy but at an energy close to the average energy of the cold neutron beam. Nevertheless, it is demonstrated that the bias can only be avoided in case the energy dependence of the cross-section is known and proper correction factors are applied. In some cases the results are also biased when the attenuation of the neutron beam within the sample is neglected in the analysis. Some of the cross-section data reported in the literature suffer from such bias effects. Hence, the results have to be corrected using the correction factors presented in this paper.

  11. 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.

    2015-01-01

    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. PMID:26409016

  12. Fine needle aspiration cytology diagnosis of caesarean scar endometriosis with histopathological correlation: a case report

    Directory of Open Access Journals (Sweden)

    Sandeep P. Kumar

    2015-06-01

    Full Text Available Endometriosis is defined as the presence of endometrial tissue outside the endometrium or myometrium. It occurs in 8-15% of women of reproductive age group with abdominal wall endometriosis accounting for only 0.5-1% of all pelvic endometriosis. We present a case of a 25 year old lady who presented with a mass in the anterior abdominal wall over a previous caesarean section scar. Endometriosis was diagnosed on Fine Needle Aspiration Cytology (FNAC based on the findings of monolayered sheets of endometrial cells, few spindle shaped stromal cells and hemosiderin laden macrophages in the background. Histopathological examination confirmed the cytological diagnosis. Endometriosis in scar tissue is a rare disease which might be difficult to diagnose and should always be considered in evaluation of painful abdominal masses in women. Fine needle aspiration cytology is economical, fast and accurate method to make the diagnosis of scar endometriosis and to plan better surgical approach. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 921-923

  13. Transfusion transmitted virus prevalence rate in IDU patients: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Soudbakhsh AR, Nami MA, Hadjiabdolbaghi M, Kazemi B

    2008-07-01

    Full Text Available "nBackground: Transfusion-Transmitted Virus (TTV is a nonenveloped, single-stranded and circular DNA virus belongs to circuviridae family genus Anellovirus, discovered by Nishizawa in 1997. As the usage of common syringes is the known and most common route of the virus transmission, and because of increasing population of Injection drug users (IDU we decided to study infection rate in IDU population of our Society. "nMethods: In a cross-sectional study at Infectious ward of Imam Khomeini hospital, 60 IDU patients were studied. Blood samples were dispatched to lab in citrated test tube for Genome Virus isolation operation, using boiling method, then PCR assay performed based on their available primers. Patient's information gathered by interview and questionnaire methods."n "nResults: All of our 60 patients were men and their age average was 35.30(SD±9.68 years old. 26(43.3% patients had positive TTV PCR and 24(92.30% of them had prison history. 23(88.50% of these 26 patients had positive HCV Ab, 17(65.40% had positive HIV Ab and 8(30.80% had positive HBS Ag. Of 60 study patients 48(80% had HCV Ab+, 43(71.70% HIV Ab+, 26(43% TTV PCR and 43(26.70% had HBS Ag+ Of 26 patients who had TTV, 34.60% of them had no contemporary sickness and 11.50% of them displayed clear sign of hepatitis (fever, abdominal pain, nausea, vomiting, RUQ tenderness and Icter. 34.60% of them had LFT more than Upper limit normal (45u/l. Time average of injection in 26 TTV patient was 9 years (SD±7.16 and the patient's age average was 36.35%(SD±9.2. "nConclusions: One of the most important route of TTV infection is use of common syringes, TTV infection transmission chance is less than HIV and HCV infection and is more than HBV. In regard to high prevalence of TTV infection in IDU population and because there is no comprehensive information about pathogenesis of this virus in addition to another way of transmission of the virus, the fecal-oral way, we must make

  14. Near conductive cooling rates in the upper-plutonic section of crust formed at the East Pacific Rise

    Science.gov (United States)

    Faak, Kathrin; Coogan, Laurence A.; Chakraborty, Sumit

    2015-08-01

    A new geospeedometer, based on diffusion modeling of Mg in plagioclase, is used to determine cooling rates of the upper section of the lower oceanic crust formed at fast-spreading mid-ocean ridges. The investigated natural sample suites include gabbroic rocks formed at three different locations along the fast-spreading East Pacific Rise. These samples cover a depth interval of 0-840 m below the sheeted dike/gabbro boundary and therefore allow the variation of cooling rate as a function of depth within the upper plutonic sequence to be determined. We demonstrate that the cooling rates we obtained are robust (reproducible and consistent across different vertical sections at fast spreading ridges) and decrease significantly with increasing sample depth (covering almost 4 orders of magnitude, ranging from ∼1 °C y-1 for the shallowest samples to 0.0003 °C y-1 for the deepest samples). Both the absolute cooling rates, and the rate of decrease of cooling rate with depth, are consistent with conductive thermal models. In contrast, the absolute cooling rates determined from the deeper samples (>300 m below DGB), and the large decrease in cooling rate with depth are inconsistent with thermal models that include substantial cooling by off-axis hydrothermal circulation within the upper plutonic section of the crust.

  15. Validation of Cross Sections with Criticality Experiment and Reaction Rates: the Neptunium Case

    CERN Document Server

    Leong, L S; Audouin, L; Berthier, B; Le Naour, C; Stéphan, C; Paradela, C; Tarrío, D; Duran, I

    2014-01-01

    The Np-237 neutron-induced fission cross section has been recently measured in a large energy range (from eV to GeV) at the n\\_TOF facility at CERN. When compared to previous measurements the n\\_TOF fission cross section appears to be higher by 5-7\\% beyond the fission threshold. To check the relevance of the n\\_TOF data, we considered a criticality experiment performed at Los Alamos with a 6 kg sphere of Np-237, surrounded by uranium highly enriched in U-235 so as to approach criticality with fast neutrons. The multiplication factor k(eff) of the calculation is in better agreement with the experiment when we replace the ENDF/B-VII. 0 evaluation of the Np-237 fission cross section by the n\\_TOF data. We also explored the hypothesis of deficiencies of the inelastic cross section in U-235 which has been invoked by some authors to explain the deviation of 750 pcm. The large modification needed to reduce the deviation seems to be incompatible with existing inelastic cross section measurements. Also we show that t...

  16. Interaction Cross Sections and Survival Rates for Proposed Solar System Member Planet Nine

    OpenAIRE

    Li, Gongjie; Adams, Fred C.

    2016-01-01

    Motivated by the report of a possible new planetary member of the Solar System, this work calculates cross sections for interactions between passing stars and this proposed Planet Nine. Evidence for the new planet is provided by the orbital alignment of Kuiper Belt objects, and other Solar System properties, which suggest a Neptune-mass object on an eccentric orbit with semimajor axis a_9~400-1500 AU. With such a wide orbit, Planet Nine has a large interaction cross section, and is susceptibl...

  17. Measurements of fission cross-sections and of neutron production rates

    International Nuclear Information System (INIS)

    a) Measurements of neutron induced fission cross-sections in the low energy region. The variation of the fission cross sections of several fissile isotopes has been measured and analysed, for neutron energies below 0,025 eV. The monochromator was a crystal spectrometer used in conjunction with a mechanical velocity selector removing higher order Bragg reflections. The fissile material was laid down on the plates of a fission chamber by painting technic. An ionization chamber, having its plates coated with thin 10B layers, was used as the neutron flux monitor. b) Measurement of the fission cross section of 235U. We intend to measure the variation of the neutron induced fission cross section of 235U over the neutron energy range from 1 keV by the time of flight method. The neutron source is the uranium target of a pulsed 28 MeV electron linear accelerator. The detector is a large fission chamber, with parallel plates, containing about 10 g of 235U (20 deposits of 25 cm diameter). The relative fission data were corrected for the neutron spectrum measured with a set of BF3 proportional counters. c) Mean number ν of neutrons emitted in neutron induced fission. We measured the value of ν for several fissile isotopes in the case of fission induced by 14 MeV neutrons. The 14 MeV neutrons were produced by D (t, n) α reaction by means of a 300 kV Cockcroft Walton generator. (author)

  18. Anesthesia for caesarean section in a gravida with peripartum cardiomyopathy combined with acute heart failure: a case report%围产期心肌病合并急性心力衰竭剖宫产麻醉处理1例

    Institute of Scientific and Technical Information of China (English)

    曾鸿; 李晓曦; 赵文秋; 冯新恒; 郭向阳

    2012-01-01

    SUMMARY Peripartum cardiomyopathy ( PPCM) is a rare but serious form of cardiac failure affecting women in the last month of pregnancy or early puerperium within six months. Clinical presentation of PPCM is similar to that of idiopathic dilated cardiomyopathy, and maternal mortality is high. An 18 year-old pri-migravida was admitted to our hospital at the end of forty-one weeks of gestation. She was diagnosed with PPCM complicated with heart failure. Preoperative optimization was done with a view to managing left ventricular failure. Continuous epidural anesthesia in the sitting position with lidocaine was used for cesare-an section. The baby was delivered successfully. Intravenous furosemide 20 mg, morphine 10 mg, cedi-lanid 0.4 mg were given. Nitroglycerin and milinone infusions continued throughout the surgery titrated to the hemodynamics. The patient received inotropic agents, dieresis, vasodilators and anticoagulants post-operatively. Both the mother and the baby were discharged safely 9 days after operation.

  19. 剖宫产率升高原因探讨%To investigate the reason of increasing cesarean section rate

    Institute of Scientific and Technical Information of China (English)

    孙美红

    2014-01-01

    To investigate the related factors of increasing cesarean section rate.We analyzed the reason combined with the total hospitalized childbirth and cesarean section rate increased like a ladder of upward in recent five years,it can be divided into the social factors and the iatrogenic factors.The social factors influence on the cesarean section rate should be worthy of attention,how to reduce the rate of cesarean section is shared responsibilities of the maternity workers and the whole society.%目的:探讨剖宫产率升高的相关因素。我院5年来产科住院分娩总数和剖宫产率呈阶梯式上升,其原因可分为社会性因素和医源性因素,社会性因素对剖宫产率的影响应值得重视,如何降低剖宫产率是产科工作者及全社会共同的责任。

  20. Electron-impact resonant vibration excitation cross sections and rate coefficients for carbon monoxide

    OpenAIRE

    Laporta, V.; Cassidy, C. M.; Tennyson, J.; Celiberto, R.

    2012-01-01

    Resonant vibrational and rotation-vibration excitation cross sections for electron-CO scattering are calculated in the 0-10 eV energy range for all 81 vibrational states of CO, assuming that the excitation occur via the 2{\\Pi} shape resonance. Static exchange plus polarization calculations performed using the R-matrix method are used to estimate resonance positions and widths as functions of internuclear separation. The effects of nuclear motion are considered using a local complex potential ...

  1. Interaction Cross Sections and Survival Rates for Proposed Solar System Member Planet Nine

    CERN Document Server

    Li, Gongjie

    2016-01-01

    Motivated by the report of a possible new planetary member of the Solar System, this work calculates cross sections for interactions between passing stars and this proposed Planet Nine. Evidence for the new planet is provided by the orbital alignment of Kuiper Belt objects, and other Solar System properties, which suggest a Neptune-mass object on an eccentric orbit with semimajor axis a_9~400-1500 AU. With such a wide orbit, Planet Nine has a large interaction cross section, and is susceptible to disruption by passing stars. Using a large ensemble of numerical simulations (several million), and Monte Carlo sampling, we calculate the cross sections for different classes of orbit-altering events: [A] scattering the planet into its proposed orbit from a smaller orbit, [B] ejecting it from the Solar System from its current orbit, [C] capturing the planet from another system, and [D] capturing a free-floating planet. Results are presented for a range of orbital elements with planetary mass m_9=10M_\\earth. Removing...

  2. Contrasting Cross-Sectional and Longitudinal Early School Leaver Rates in Canada

    Science.gov (United States)

    Timmons, Vianne; Ostridge, Randy

    2009-01-01

    Data analysis is critical to educational planning. Determining the number of school leavers is crucial for a school board when planning for interventions and supports. In researching the number of early school leavers in the province of Prince Edward Island, the method in which the data were reported affected the rates. Two critical considerations…

  3. Accuracy and precision of MR velocity mapping in measurement of stenotic cross-sectional area, flow rate, and pressure gradient

    DEFF Research Database (Denmark)

    Søndergaard, L; Ståhlberg, F; Thomsen, C; Stensgaard, A; Lindvig, K; Henriksen, O

    1993-01-01

    Reliability of magnetic resonance (MR) velocity mapping to assess severity of stenosis was assessed in vitro. Steady flow at different flow rates through five stenoses with a central orifice area ranging from 17 to 176 mm2 was measured with velocity mapping performed perpendicular to the stenotic...... jet. Besides determination of the stenotic cross-sectional area and flow rate, the pressure gradient was calculated with the modified Bernoulli equation and compared with manometer measurements. Cross-sectional areas were measured with an accuracy of > or = 76%, a precision of > or = 91%, and an error...... of < or = 19 mm2. Flow rates had an accuracy of > or = 72%, a precision of > or = 94%, and an error of < or = 1.4 L/min. The modification of the Bernoulli equation limited its reliability to stenoses with areas of 35-113 mm2. Pressure gradients were calculated with an accuracy of > or = 80%, a...

  4. Experimental and modeling study of thermal rate coefficients and cross sections for electron attachment to C(60).

    Science.gov (United States)

    Viggiano, Albert A; Friedman, Jeffrey F; Shuman, Nicholas S; Miller, Thomas M; Schaffer, Linda C; Troe, Jürgen

    2010-05-21

    Thermal electron attachment to C(60) has been studied by relative rate measurements in a flowing afterglow Langmuir probe apparatus. The rate coefficients of the attachment k(1) are shown to be close to 10(-6) cm(3) s(-1) with a small negative temperature coefficient. These results supersede measurements from the 1990s which led to much smaller values of k(1) with a large positive temperature coefficient suggesting an activation barrier. Theoretical modeling of k(1) in terms of generalized Vogt-Wannier capture theory shows that k(1) now looks more consistent with measurements of absolute attachment cross sections sigma(at) than before. The comparison of capture theory and experimental rate or cross section data leads to empirical correction factors, accounting for "intramolecular vibrational relaxation" or "electron-phonon coupling," which reduce k(1) below the capture results and which, on a partial wave-selected level, decrease with increasing electron energy. PMID:20499963

  5. Cross-section and rate coefficient calculation for electron impact excitation, ionisation and dissociation of H2 and OH molecules

    International Nuclear Information System (INIS)

    The weighted total cross-sections (WTCS) theory is used to calculate electron impact excitation, ionization and dissociation cross-sections and rate coefficients of OH, H2, OH+, H2+, OH- and H2- diatomic molecules in the temperature range 1500-15000 K. Calculations are performed for H2(X, B, C), OH(X, A, B), H2+(X), OH+(X, a, A, b, c), H2-(X) and OH-(X) electronic states for which Dunham coefficients are available. Rate coefficients are calculated from WTCS assuming Maxwellian energy distribution functions for electrons and heavy particles. One and 2 temperatures (θe and θg respectively for electron and heavy particles kinetic temperatures) results are presented and fitting parameters (a, b and c) are given for each reaction rate coefficient: k(θ) a(θb)exp(-c/θ). (authors)

  6. Increased coronary intervention rate among diabetic patients with poor glycaemic control: A cross-sectional study

    OpenAIRE

    Çetin, Süha; Öztürk, Mehmet Akif; Barındık, Nadir; İmren, Ersin; Peker, Yüksel

    2014-01-01

    The relationship between glycaemic control and coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) is controversial. In the current cross-sectional study, we addressed the relationship between Hemoglobin A1c (HbA1c) values and the need for revascularization among diabetic patients undergoing coronary angiography. A total of 301 consecutive patients with known T2DM (age 61.8±10.1 years, 46.2% women) requiring coronary angiography due to CAD symptoms were included. T2DM patients we...

  7. Transition Gibbs free energy level cross section and formulation of carrier SRH recombination rate

    International Nuclear Information System (INIS)

    The transition among multiple charging states of a semiconductor's localized intrinsic/impurity defects is considered as phase transitions, and the concept of transition Gibbs free energy level (TGFEL) is proposed. Dependence of the cross section of TGFEL on its charge state is discussed. Introduction of TGFEL to replace activation energy has fundamentally important consequences for semiconductor physics and devices. TGFEL involves entropy. What is to be included and not included in the entropy term consistently for all defect levels is an unresolved open question, related to correct interpretation of various experimental data associated with various defect levels. This work is a first step towards resolving this question. (semiconductor physics)

  8. THE RESUSPENSION RATE OF SEDIMENTS IN 32°N SECTION ON THE EAST CHINA SEA

    Institute of Scientific and Technical Information of China (English)

    孙治涛; 詹滨秋

    2002-01-01

    This research on the influence of sediment resuspension on the flux of materials in the margin of the East China Sea showed that the sediment resuspension rates, was 47.40%-79.18% in the surface layers, and 72.75%-96.96% inthe bottom layers.The research confirmed that the Changjiang River runoff and the eddy area upwelling flow near 125°E were two important factors affecting thesediment resuspension in summer; the transformation of DOC to POC through the flocculation in the transitional region (123°-124°E) was also confirmed by comparison of the resuspension rate. The sediment resuspension was shown to be influenced by the seasonal factor, especially in the surface layer.``

  9. Influence of Strain-rate Effects on the Analysis of Steel Sections under Blast Loads

    OpenAIRE

    KARLOS VASILEIOS; SOLOMOS George

    2014-01-01

    The response of structural steel components under explosive loading is numerically investigated. First the procedure for determining the pressure loads to be applied on a structure after an explosion is briefly described. The importance of the material model and its capability of including the high strain-rate effects in the numerical analysis is studied by comparing simulations by the FEM code EUROPLEXUS with published data of real blast experiments. These comparisons are made with respect t...

  10. 个性化指导提高剖宫产产妇极早期母乳喂养率的探讨%Personalized guidance to improve the rate of cesarean section very early maternal breastfeeding

    Institute of Scientific and Technical Information of China (English)

    严期争

    2015-01-01

    目的:探讨和研究对剖宫产产妇极早期进行个性化母乳喂养指导的方法,促进产妇尽早分泌乳汁,纠正缺乳现象,满足新生儿的营养需求,提高母乳喂养率。方法:选择200例剖宫产产妇作为研究对象,并将其分成两组,每组各100例。常规组实行常规护理,实施健康宣教,产妇无要求不予个性化指导。实验组安排专职护士,在剖宫产术后极早期给予早接触、早开奶、早吸吮。结果:常规组产妇虽然认识母乳喂养的重要性,但因卧位、疼痛、输液、导尿、监护等导致活动不便未真正做到早接触、早开奶、早吸吮,30min内母乳喂养率仅为12%。而实验组有专职护士指导,30min内母乳喂养率为88%。结论:通过专职护士对剖宫产产妇极早期进行个性化母乳喂养指导,不仅提高了母乳喂养率,还有利于建立融洽的护患关系,提高了产妇对护理服务的满意度,提升医院的形象。%ObjectiveDiscussion and research to personalized cesarean delivery very early maternal breastfeeding guide method, promote maternal lactate as soon as possible, increase the rate of breastfeeding.Methods Choose 200 cases of cesarean section as the research object, maternal and divided into two groups, 100 cases in each group. Regular group of routine nursing. Experimental arrangement nurse, in the very early to give the earlier they touch after cesarean section, early, early sucking milk.Results Regular group within 30 min maternal breastfeeding rate is only 12%. The experimental group the breastfeeding rate was 88% within 30 minutes.Conclusions Through professional nurses to caesarean section maternal breastfeeding individuation guidance very early, not only increase the breastfeeding rate, and to establish a harmonious relationship between nurses and patients, improve the maternal satisfaction to nursing service.

  11. Constructal optimization of discrete and continuous-variable cross-section conducting path based on entransy dissipation rate minimization

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Using constructal entransy dissipation rate minimization method based on discrete variable cross-section conducting path,constructal optimizations of elemental area with variable cross-section conducting path are performed,and the results are compared with the optimization results of elemental area with the constant cross-section conducting path.The comparison shows that the minimum mean temperature difference based on elemental area with variable cross-section conducting path increases and approaches a constant as the assembly’s order increases,but the minimum mean temperature difference based on elemental area with constant cross-section conducting path decreases and approaches a constant as the assembly’s order increases.The difference between them is caused by the different dimensionless mean temperature difference of the first order assembly.A universal constructal optimization method by self similar organization to improve heat transfer ability and its corresponding rule are proposed.With the constructal optimization method by self similar organization based on entransy dissipation rate minimization objective,the mean temperature difference approaches a constant as the assembly’s order increases.

  12. Tendencias de cesáreas en relación con factores no clínicos en un centro de educación para el parto en la Ciudad de México Trends in caesarean sections associated with non-clinical factors in a Birthing Educational Center in Mexico City

    Directory of Open Access Journals (Sweden)

    Lourdes Campero

    2007-04-01

    Full Text Available OBJETIVOS: Describir las tendencias de la operación cesárea (OC asociadas con factores no clínicos en mujeres que asistieron al Centro de Educación para el Parto (CEPAPAR en la Ciudad de México. MATERIAL Y MÉTODOS: Se analizó información de 992 nacimientos de 847 mujeres, ocurridos entre 1988 y 2000. Se utilizó el método de regresión lineal para identificar el comportamiento de factores no clínicos con respecto a la tendencia de OC. RESULTADOS: La incidencia global de OC fue de 32.8%, con 8% de incremento promedio anual. El porcentaje de OC se mantuvo por debajo de 30% hasta 1994; durante los siguientes años se incrementó hasta 40%. Al analizar la tendencia de OC en relación con factores no clínicos se encontró que, a lo largo del periodo 1988-2000, el aumento en la incidencia de la OC fue mayor en nacimientos sin instructora presente, entre mujeres primigestas y en hospitales grandes (con más de 50 camas. CONCLUSIONES: Los resultados muestran que el aumento en la incidencia de OC está asociado a factores no clínicos, como el tamaño del hospital y la presencia de una instructora. Un modelo de apoyo a mujeres, que cuente con asesoría, información y presencia de una instructora durante el trabajo de parto, puede contribuir a disminuir el riesgo de tener una OC innecesaria en poblaciones como la estudiada.OBJECTIVES: To describe the trends in caesarian sections (CS associated with non-clinical factors in women who attended a birthing educational facility, also known as 'Centro de Educación,' (CEPAPAR in Mexico City. METHODS: Data from 992 births of 847 women that occurred from 1988-2000 were analyzed using linear regression to identify the association between non-clinical factors and time-trends in CS. RESULTS: The overall incidence of CS was 32.8%, with an 8% average annual increase. Until 1994 the percentage of CS remained relatively steady at 30%, increasing to 40% in subsequent years. In analyzing trends in CS and their

  13. Determination of effective cross sections and production rates for tritium in the irradiation experiment TRIDEX

    International Nuclear Information System (INIS)

    In the framework of the development of a fusion reactor blanket the irradiation experiment TRIDEX (Tritium Recovery Irradiation DIDO Experiment) takes place at the Juelich Research Reactor FRJ-2 (DIDO). For this equipment the required neutronic calculations have been performed. The aim was the determination of the neutron spectrum and several therefrom derived integral parameters for the irradiation positions in interest. From the calculated effective cross sections for the formation of Tritium resulting from irradiated Lithium samples on one hand and from measured neutron flux densities on the other hand, all needed quantities of the Tritium production could be determined. The calculation of the neutron spectrum has been performed in a two-dimensional x-y-geometry. The neutron flux densities have been gained by gamma-spectrometric measurement of the activities in irradiated activation samples. (orig.)

  14. Upper limit on the cross section for reactor antineutrinos changing 22Na decay rates

    CERN Document Server

    de Meijer, R J

    2014-01-01

    In this paper we present results of a long-term observation of the decay of 22Na in the presence of a nuclear fission reactor. The measurements were made outside the containment wall of and underneath the Koeberg nuclear power plant near Cape Town, South Africa. Antineutrino fluxes ranged from ~5*10^11 to 1.6*10^13 cm^-2 s^-1 during this period. We show that the coincidence summing technique provides a sensitive tool to measure a change in the total decay constant as well as the branching ratio between EC and beta+ decay of 22Na to the first excited state in 22Ne. We observe a relative change in count rate between reactor-ON and reactor-OFF equal to (-0.51+/-0.11)*10^-4. After evaluating possible systematic uncertainties we conclude that the effect is either due to a hidden instrumental cause or due to an interaction between antineutrinos and the 22Na nucleus. An upper limit of ~0.03 barn has been deduced for observing any change in the decay rate of 22Na due to antineutrino interactions.

  15. The Impact of Caesarean Delivery on Paracetamol and Ketorolac Pharmacokinetics: A Paired Analysis

    Directory of Open Access Journals (Sweden)

    Aida Kulo

    2012-01-01

    Full Text Available Pharmacokinetics is a first, but essential step to improve population-tailored postoperative analgesia, also after Caesarean delivery. We therefore aimed to quantify the impact of caesarean delivery on the pharmacokinetics of intravenous (iv paracetamol (2 g, single dose and iv ketorolac tromethamine (30 mg, single dose in 2 cohorts eachof 8 women at caesarean delivery and to compare these findings with postpartum to quantify intrapatient changes. We documented a higher median paracetamol clearance at delivery when compared to 10–15 weeks postpartum (11.7 to 6.4 L/h⋅m2, P<0.01, even after correction for weight-related changes. Similar conclusions were drawn for ketorolac: median clearance was higher at delivery with a subsequent decrease (2.03 to 1.43 L/h⋅m2, P<0.05 in postpartum (17–23 weeks. These differences likely reflect pregnancy- and caesarean-delivery-related changes in drug disposition. Moreover, postpartum paracetamol clearance was significantly lower when compared to estimates published in healthy young volunteers (6.4  versus  9.6 L/h⋅m2, while this was not the case for ketorolac (1.43  versus  1.48 L/h⋅m2. This suggests that postpartum is another specific status in young women that merits focused, compound-specific pharmacokinetic evaluation.

  16. Capture cross-section and rate of the 14C(, )15C reaction from the Coulomb dissociation of 15C

    Indian Academy of Sciences (India)

    Shubhchintak; Neelam; R Chatterjee

    2014-10-01

    We calculate the Coulomb dissociation of 15C on a Pb target at 68 MeV/u incident beam energy within the fully quantum mechanical distorted wave Born approximation formalism of breakup reactions. The capture cross-section and the subsequent rate of the 14C(, )15C reaction are calculated from the photodisintegration of 15C, using the principle of detailed balance. Our theoretical model is free from the uncertainties associated with the multipole strength distributions of the projectile.

  17. Changes in the Cesarean Section Rate in Korea (1982-2012) and a Review of the Associated Factors

    OpenAIRE

    Chung, Sung-Hoon; Seol, Hyun-Joo; Choi, Yong-Sung; Oh, Soo-young; Kim, Ahm; Bae, Chong-Woo

    2014-01-01

    Although Cesarean section (CS) itself has contributed to the reduction in maternal and perinatal mortality, an undue rise in the CS rate (CSR) has been issued in Korea as well as globally. The CSR in Korea increased over the past two decades, but has remained at approximately 36% since 2006. Contributing factors associated with the CSR in Korea were an improvement in socio-economic status, a higher maternal age, a rise in multiple pregnancies, and maternal obesity. We found that countries wit...

  18. Infertility and preterm delivery, birthweight, and Caesarean section: a study within the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Basso, Olga; Baird, Donna D.

    2003-01-01

    , longitudinal studies enrolling couples irrespective of infertility treatment. METHODS: We used data from the Danish National Birth Cohort: 55 906 singleton live births from women who reported their waiting time to pregnancy (TTP) and other covariates in an interview during the 2nd trimester of pregnancy....... RESULTS: A TTP >1 year was associated with an increased risk of all outcomes studied, including preterm birth [odds ratios and 95% confidence intervals were 1.5 (1.2, 1.8) among primiparas and 1.9 (1.5, 2.4) among multiparas]. Odds ratios for preterm remained elevated after adjustment for covariates....... Among couples with a TTP >1 year, infertility treatment was associated with added risk only among multiparas. CONCLUSION: Infertile women are at higher risk of adverse birth outcomes even if they conceive without treatment. With >10% of babies born to infertile couples, it is important to consider this...

  19. LIVE CONJOINED TWIN BABIES DELIVERED BY CAESAREAN SECTION: A CASE REPORT

    OpenAIRE

    Biswas,, S.; Rout; Mukhopadhyay,

    2014-01-01

    Conjoined twins, commonly referred to as Siamese twins, are babies connected physically to each other. Depending upon the point of connection, there are different types of conjoined twins. A targeted sonographic examination at midpregnancy can diagnose the entity in most cases. Fetal prognosis depends on the period of gestation at delivery, birth weight, extent of organ sharing by the fetuses and possibility of surgical separation. Viable conjoined twins should be delivere...

  20. [Case report: patient with needle phobia for caesarean section - not quite as in a textbook …].

    Science.gov (United States)

    Hillermann, Thomas; Breitenstein, Chantal; Soll, Cristina

    2015-06-01

    In a 20-year old parturient general anesthesia is induced by inhalation and without venous access because of severe needle phobia. This article discusses risks associated with inhalational induction of anesthesia in this special situation. It deals with needle phobia, an anxiety disorder belonging to the group of blood-injury-injection phobia. This psychic illness can cause severe problems for the anaesthetic management in acute or in elective situations. PMID:26147408

  1. Effect of high-volume systematic local infiltration analgesia in Caesarean section

    DEFF Research Database (Denmark)

    Larsen, Katrine Rose; Kristensen, B B; Rasmussen, Marianne A.; Rasmussen, Y H; Weber, T; Kristensen, Bent; Kehlet, H

    2015-01-01

    endpoints were rescue analgesic, post-operative nausea and vomiting, time spent in the postanesthesia care unit (PACU) and time to first mobilisation. RESULTS: No difference in pain response between groups, but time until maximum pain score was prolonged in the ropivacaine 0.5% group compared with the...... found concerning time spent in the PACU, to first mobilisation or in number of women with nausea/vomiting (P ≥ 0.05). No complications related to ropivacaine were observed. CONCLUSIONS: Systematic infiltration with a high concentration, low volume compared with low concentration, high volume showed no...

  2. Estimation of unemployment rates using small area estimation model by combining time series and cross-sectional data

    Science.gov (United States)

    Muchlisoh, Siti; Kurnia, Anang; Notodiputro, Khairil Anwar; Mangku, I. Wayan

    2016-02-01

    Labor force surveys conducted over time by the rotating panel design have been carried out in many countries, including Indonesia. Labor force survey in Indonesia is regularly conducted by Statistics Indonesia (Badan Pusat Statistik-BPS) and has been known as the National Labor Force Survey (Sakernas). The main purpose of Sakernas is to obtain information about unemployment rates and its changes over time. Sakernas is a quarterly survey. The quarterly survey is designed only for estimating the parameters at the provincial level. The quarterly unemployment rate published by BPS (official statistics) is calculated based on only cross-sectional methods, despite the fact that the data is collected under rotating panel design. The study purpose to estimate a quarterly unemployment rate at the district level used small area estimation (SAE) model by combining time series and cross-sectional data. The study focused on the application and comparison between the Rao-Yu model and dynamic model in context estimating the unemployment rate based on a rotating panel survey. The goodness of fit of both models was almost similar. Both models produced an almost similar estimation and better than direct estimation, but the dynamic model was more capable than the Rao-Yu model to capture a heterogeneity across area, although it was reduced over time.

  3. Effect of pre operative heart rate on post spinal hypotension in obsteric patients

    International Nuclear Information System (INIS)

    The purpose of the study was to determine the association between of preoperative heart rate and post spinal hypotension in women undergoing cesarean section, Two hundred patients undergoing caesarean were included in the study selected on non probability convenience sampling technique, The patients were divided into two groups depending upon their pre operative heart rate. Spinal anesthesia was administered and number of patients developing hypotension was noted. Among 200 patients, who were included in the study; 112 were placed in group A and 88 were placed in group B depending on mean heart rate of 90 beats per minute or less or 91 beats per minute or more respectively. In group A 14 (11.86%) patients developed hypotension where as in group B 28 (31,82%) patients developed hypotension. Pre operative heart rate is significantly associated with post spinal hypotension in obstetric patients undergoing cesarean section. (author)

  4. Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal

    Directory of Open Access Journals (Sweden)

    Dino Irawan

    2013-12-01

    Full Text Available The incidence of post dural puncture headache (PDPH is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnant woman with physical status of American Society of Anesthesiologist (ASA II, range of age was 18 to 45 years old. This research was an observational study with cross-sectional design. The incidence of PDPH after the use of Quincke type needle no. 25 was 68.2%, while with Quincke type needle no. 27 was 31.8%, and no PDPH was found on the use of pencil point type needle no. 27. The numeric rating scale (NRS from PDPH on the use of Quincke type needle no. 25 was 3–7, while on Quincke type needle no. 27 was 2–6, and 0 in pencil point type needle no. 27. As the conclusion, the greatest incidence of PDPH in patients undergoing caesarean section, based on spinal needle type, occurs most with no. 25 Quincke type needles, and less with no. 27 and none with no. 27.

  5. Urinary Metals and Heart Rate Variability: A Cross-Sectional Study of Urban Adults in Wuhan, China

    Science.gov (United States)

    Feng, Wei; He, Xiaosheng; Chen, Mu; Deng, Siyun; Qiu, Gaokun; Li, Xiaoliang; Liu, Chuanyao; Li, Jun; Deng, Qifei; Huang, Suli; Wang, Tian; Dai, Xiayun; Yang, Binyao; Yuan, Jing; He, Meian; Zhang, Xiaomin; Chen, Weihong; Kan, Haidong

    2014-01-01

    Background Epidemiological studies have suggested an association between external estimates of exposure to metals in air particles and altered heart rate variability (HRV). However, studies on the association between internal assessments of metals exposure and HRV are limited. Objectives The purpose of this study was to examine the potential association between urinary metals and HRV among residents of an urban community in Wuhan, China. Methods We performed a cross-sectional analysis of 23 urinary metals and 5-min HRV indices (SDNN, standard deviation of normal-to-normal intervals; r-MSSD, root mean square of successive differences in adjacent normal-to-normal intervals; LF, low frequency; HF, high frequency; TP, total power) using baseline data on 2,004 adult residents of Wuhan. Results After adjusting for other metals, creatinine, and other covariates, natural log-transformed urine titanium concentration was positively associated with all HRV indices (all p 52), current smokers (vs. nonsmokers), body mass index Zhang X, Chen W, Kan H, Wu T. 2015. Urinary metals and heart rate variability: a cross-sectional study of urban adults in Wuhan, China. Environ Health Perspect 123:217–222; http://dx.doi.org/10.1289/ehp.1307563 PMID:25356836

  6. An efficient nonclassical quadrature for the calculation of nonresonant nuclear fusion reaction rate coefficients from cross section data

    Science.gov (United States)

    Shizgal, Bernie D.

    2016-08-01

    Nonclassical quadratures based on a new set of half-range polynomials, Tn(x) , orthogonal with respect to w(x) =e - x - b /√{ x } for x ∈ [ 0 , ∞) are employed in the efficient calculation of the nuclear fusion reaction rate coefficients from cross section data. The parameter b = B /√{kB T } in the weight function is temperature dependent and B is the Gamow factor. The polynomials Tn(x) satisfy a three term recurrence relation defined by two sets of recurrence coefficients, αn and βn. These recurrence coefficients define in turn the tridiagonal Jacobi matrix whose eigenvalues are the quadrature points and the weights are calculated from the first components of the eigenfunctions. For nonresonant nuclear reactions for which the astrophysical function can be expressed as a lower order polynomial in the relative energy, the convergence of the thermal average of the reactive cross section with this nonclassical quadrature is extremely rapid requiring in many cases 2-4 quadrature points. The results are compared with other libraries of nuclear reaction rate coefficient data reported in the literature.

  7. Resonant vibrational-excitation cross sections and rate constants for low-energy electron scattering by molecular oxygen

    CERN Document Server

    Laporta, V; Tennyson, J

    2016-01-01

    Resonant vibrational-excitation cross sections and rate constants for electron scattering by molecular oxygen are presented. Transitions between all 42 vibrational levels of O$_2(\\textrm{X}\\ ^3\\Sigma_g^- $) are considered. Molecular rotations are parameterized by the rotational quantum number $J$ which is considered in the range 1 to 151. The lowest four resonant states of O$_2^-$, $^2\\Pi_g$, $^2\\Pi_u$, $^4\\Sigma_u^-$ and $^2\\Sigma_u^-$, are taken into account. The calculations are performed using the fixed-nuclei R-matrix approach to determine the resonance positions and widths, and the boomerang model to characterize the nuclei motion. Two energy regions below and above 4~eV are investigated: the first one is characterized by sharp structures in the cross section, and the second by a broad resonance peaked at 10~eV. The computed cross sections are compared with theoretical and experimental results available in literature for both the energy regions, and are made available for use by modelers. The effect of ...

  8. Spontaneous coronary artery dissection in pregnancy requiring emergency caesarean delivery followed by coronary artery bypass grafting.

    Science.gov (United States)

    Weinberg, L; Ong, M; Tan, C O; McDonnell, N J; Lo, C; Chiam, E

    2013-03-01

    Spontaneous coronary artery dissection is a rare and often fatal condition of pregnancy. The long-term morbidity is unknown, but a small cohort of patients develop severe ventricular dysfunction as a consequence. We describe a 37-week gestation parturient who presented with cardiogenic shock secondary to spontaneous left main coronary artery dissection. Despite rapid diagnosis, stabilisation with an intra-aortic balloon pump and prompt transfer to a tertiary centre for emergency caesarean delivery and coronary artery bypass grafting, the patient developed a severe postoperative dilated ischaemic cardiomyopathy. There is little information about the long-term outcomes and the specific anaesthesia management of combined emergency caesarean delivery and cardiac surgery in pregnancy for spontaneous coronary artery dissection. Therefore, we outline our multidisciplinary management of this critically ill pregnant woman. PMID:23530793

  9. Gestational obesity as a determinant of general anesthesia technique for caesarean delivery: a case report.

    OpenAIRE

    Navarro Vargas, José Ricardo; Aldana Díaz, José Luis; Eslava Schamalbach, Javier H.

    2010-01-01

    Background. The incidence of obesity has undergone a dramatic increase around the world during the last few years. Such epidemic behavior has been associated with obstetric patient’s frequent presentation of different stages of obesity when undergoing anesthetic procedure. Obesity in pregnant women involves the risk of adverse maternal and fetal outcomes. Hypertension and preeclampsia, diabetes, fetal macrosomia, caesarean delivery, difficult airway management and neuroaxial techniques are mo...

  10. The Main Determinants of Under 5 Mortality Rate (U5MR in OECD Countries: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Ali Kazemi karyani

    2015-02-01

    Full Text Available Introduction: Child mortality indices are key element that reflects health Status of societies and inform policy makers to take suitable policies to reduce them. This study was performed to examine the main determinants of under-5 mortality rate (U5MR in OECD countries in two cross-sections, 2010 and 2013, and the results of them was compared. Material and Methods: This was a cross- sectional study. The data on U5MR,health expenditure, Gross National Income per capita (GNI, Physician and nurses’ density, Ratio of female to male primary, secondary and tertiary school enrollment was gathered from world health organization (WHO and World bank datasets. Pearson correlation and regression models was used for analyzing the data for years 2010 and 2013. Stata 11 was used for analyzing the data. Results: Pearson correlation was negative for all variable in 2010 and all variables, expect  Ratio of female to male secondary enrollment,  had negative correlation with U5MR. Regression analysis showed that, all variable, except Ratio of female to male primary enrollment had negative effect on U5MR in 2010. Also, GNI had negative effect on U5MR in 2010 and its coefficient was significant. The β-coefficient of healthcare expenditures was -0.964 and -0.746 in 2010 and 2013, respectively  and  was statistically significant just in 2010. Two of three variables in which included for women literacy had negative effect on U5MR in 2010 and all of them had negative effect in 2013. Conclusion: The study results showed that all variables, including health expenditures, gross national income per capita, and density of physicians and nurses and female literacy, had invers effect on under-five mortality rate in OECD countries.

  11. Interaction of rare gas metastable atoms. [Differential and total cross sections, elastic scattering, ionization, potential scattering, phase shifts, rate constants

    Energy Technology Data Exchange (ETDEWEB)

    Wang, A.Z.F.

    1977-11-01

    The physical and chemical properties of metastable rare gas atoms are discussed and summarized. This is followed by a detailed examination of the various possible pathways whereby the metastable's excess electronic energy can be dissipated. The phenomenon of chemi-ionization is given special emphasis, and a theoretical treatment based on the use of complex (optical) potential is presented. This is followed by a discussion on the unique advantages offered by elastic differential cross section measurements in the apprehension of the fundamental forces governing the ionization process. The methodology generally adopted to extract information about the interaction potential for scattering data is also systematically outlined. Two widely studied chemi-ionization systems are then closely examined in the light of accurate differential cross section measurements obtained in this work. The first system is He(2/sup 3/S) + Ar for which one can obtain an interaction potential which is in good harmony with the experimental results of other investigators. The validity of using the first-order semiclassical approximation for the phase shifts calculation in the presence of significant opacities is also discussed. The second reaction studied is He*+D/sub 2/ for which measurements were made on both spin states of the metastable helium. A self-consistent interaction potential is obtained for the triplet system, and reasons are given for not being able to do likewise for the singlet system. The anomalous hump proposed by a number of laboratories is analyzed. Total elastic and ionization cross sections as well as rate constants are calculated for the triplet case. Good agreement with experimental data is found. Finally, the construction and operation of a high power repetitively pulsed nitrogen laser pumped dye laser system is described in great details. Details for the construction and operation of a flashlamp pumped dye laser are likewise given.

  12. Acculturation and self-rated health among Arctic indigenous peoples: a population-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Eliassen Bent-Martin

    2012-11-01

    Full Text Available Abstract Background Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance. Methods The principal method in the Survey of Living Conditions in the Arctic (SLiCA was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people’s ethnic identity, and poorer spoken indigenous language ability (SILA. Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH. Results Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P Conclusions This study shows that aggregate acculturation is a strong risk factor for poorer SRH among the Kalaallit of Greenland and female Iñupiat of Alaska, but our cross-sectional study design does not allow any conclusion with regard to causality. Limitations with regard to wording, categorisations, assumed cultural differences in the conceptualisation of SRH, and confounding effects of health care use, SES and discrimination, make it difficult to appropriately assess how strong this effect is though.

  13. Estimation of the rate of tooth wear in permanent incisors: a cross-sectional digital radiographic study.

    Science.gov (United States)

    Ray, D S; Wiemann, A H; Patel, P B; Ding, X; Kryscio, R J; Miller, C S

    2015-06-01

    This study used conventional digital radiography to estimate the rate of tooth wear (TW) of maxillary and mandibular central incisors based on a cross-sectional study design. The crown length of 1239 permanent maxillary and mandibular central incisors from 346 persons (age groups: 10, 25, 40, 55 and 70 years ± 3) were measured by three calibrated dentists. Study teeth were intact incisally, had clearly visible incisal edges and cementoenamel junctions and had natural tooth antagonists. Measures were based on digital radiographic images (N = 666) archived in MiPACS within the electronic health record (axiUm(®)) from the College of Dentistry patient database. Incisor crown length decreased at a linear rate in both arches over the 60 years represented by the age groups. The average crown length for maxillary incisors in the youngest age group was 11.94 mm, which decreased by an average of 1.01 mm by median age 70. For mandibular incisors, the average crown length in the youngest age group was 9.58 mm, which decreased by an average of 1.46 mm in the oldest age group. Males and females showed similar rates of TW. Regardless of age, females demonstrated smaller mean crown height for maxillary incisors than males (P < 0.0001). Measures by the examiners demonstrated good agreement, with an interclass correlation coefficient of 0.869 and an average intra-examiner correlation of 99.5%, based on repeated measurements (n = 100). TW was estimated to average 1.01 mm for maxillary central incisors and 1.46 mm for mandibular central incisors by age 70 years. PMID:25756187

  14. Constructing river stage-discharge rating curves using remotely sensed river cross-sectional inundation areas and river bathymetry

    Science.gov (United States)

    Pan, Feifei; Wang, Cheng; Xi, Xiaohuan

    2016-09-01

    Remote sensing from satellites and airborne platforms provides valuable data for monitoring and gauging river discharge. One effective approach first estimates river stage from satellite-measured inundation area based on the inundation area-river stage relationship (IARSR), and then the estimated river stage is used to compute river discharge based on the stage-discharge rating (SDR) curve. However, this approach is difficult to implement because of a lack of data for constructing the SDR curves. This study proposes a new method to construct the SDR curves using remotely sensed river cross-sectional inundation areas and river bathymetry. The proposed method was tested over a river reach between two USGS gauging stations, i.e., Kingston Mines (KM) and Copperas Creek (CC) along the Illinois River. First a polygon over each of two cross sections was defined. A complete IARSR curve was constructed inside each polygon using digital elevation model (DEM) and river bathymetric data. The constructed IARSR curves were then used to estimate 47 river water surface elevations at each cross section based on 47 river inundation areas estimated from Landsat TM images collected during 1994-2002. The estimated water surface elevations were substituted into an objective function formed by the Bernoulli equation of gradually varied open channel flow. A nonlinear global optimization scheme was applied to solve the Manning's coefficient through minimizing the objective function value. Finally the SDR curve was constructed at the KM site using the solved Manning's coefficient, channel cross sectional geometry and the Manning's equation, and employed to estimate river discharges. The root mean square error (RMSE) in the estimated river discharges against the USGS measured river discharges is 112.4 m3/s. To consider the variation of the Manning's coefficient in the vertical direction, this study also suggested a power-law function to describe the vertical decline of the Manning

  15. ZZ UKCTR-1, Cross-Section Library for Neutron Flux and Neutron Reaction Rates in CTR Calculation

    International Nuclear Information System (INIS)

    1 - Description of problem or function: Format: ANISN, DOT, MORSE, SWANLAKE; Number of Groups: 46 energy group structure from 14.2 MeV to 1 MeV; Nuclides: Li-6, Li-7, O, Be, Pb, Nb, Fe, Ni, Cr, Zr, V, Ti, H, D, T, C, Al, B-10, B-11, Cu-63, Cu-65, F, Na, K, Mo. Origin: UKNDL; Weighting Spectrum: 1/(Sigma t (E).E) weighting is used for groups 1 to 44 with Maxwellian weighting for the two thermal groups. UKCTR1 is a data library of neutron cross sections for 25 materials in a 46 energy group structure from 14.2 MeV to 1 MeV. It is designed for calculation of neutron fluxes and reaction rates in controlled thermonuclear reactors. The energy group structure is fine at 14 MeV and there are two thermal groups; the lethargy interval width per energy group for decreasing energy is as follows: 0.014, 0.036, 2 x 0.15, 15 x 0.3, 25 x 0.5, 2.935 and 3.091. Reaction cross sections including partial inelastic data are provided for the following materials: Li-6, Li-7, O, Be, Pb, Nb, Fe, Ni, Cr, Zr, V, Ti, H, D, T, C, Al, B-10, B-11, Cu-63, Cu-65, F, Na, K, Mo. 1/(Sigma t (E).E) weighting is used for groups 1 to 44 with Maxwellian weighting for the two thermal groups. Anisotropy of scattering is represented by a P order up to 4 (usually 0 to 4). Data for hydrogen and deuterium both in water and heavy water and in the gaseous state is available. As a supplement, neutron kerma factors are included for each of the nuclides in the library as well as 98 activation cross sections of importance in fusion reactor work. (These 98 activation cross sections have been extracted from the bulk of the UKCTR-I library to be in a more convenient form for programs such as ANISN.) The kerma factors were computed using the code ENBAL2, a revised version of ENBAL, which calculates multigroup kerma factors directly from multigroup cross sections together with reaction Q-values. This approach allows neutron heating calculations to be performed consistently with the flux calculation. 2 - Method of

  16. Changes in the cesarean section rate in Korea (1982-2012) and a review of the associated factors.

    Science.gov (United States)

    Chung, Sung-Hoon; Seol, Hyun-Joo; Choi, Yong-Sung; Oh, Soo-Young; Kim, Ahm; Bae, Chong-Woo

    2014-10-01

    Although Cesarean section (CS) itself has contributed to the reduction in maternal and perinatal mortality, an undue rise in the CS rate (CSR) has been issued in Korea as well as globally. The CSR in Korea increased over the past two decades, but has remained at approximately 36% since 2006. Contributing factors associated with the CSR in Korea were an improvement in socio-economic status, a higher maternal age, a rise in multiple pregnancies, and maternal obesity. We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country. The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective. To optimize the CSR in Korea, efforts on lowering the maternal childbearing age or reducing maternal obesity are needed at individual level. And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary. PMID:25368486

  17. Cross sections and rate coefficients for inner-shell excitation of Li-like ions with 6 < Z < 42

    International Nuclear Information System (INIS)

    Excitation cross sections and rate coefficients by electron impact were calculated for the 1s22s-1s2s2p, 1s22s-1s2s2 and 1s22s-1s2p2 transitions of the Li-like ions (C IV, N V, O VI, Ne VIII, Mg X, Al XI, Si XII, S XIV, Ar XVI, Ca XVIII, Ti XX, Fe XXIV, Ni XXVI, Zn XXVIII, Ge XXX, Se XXXII, Kr XXXIIV and Mo XXXX) in the Coulomb-Born approximation with exchange including relativistic effects and configuration interaction. Level energies, mixing coefficients and transition wavelengths and probabilities were also computed. Calculations performed by the 1/Z perturbation theory and Coulomb-Born approximation are compared with the R-matrix method and the distorted-wave approximation were Z is the nuclear charge. Formulae obtained for the angular factors of n-electron atomic system allow one to generalize this method to an arbitrary system of highly charged ions. (orig.)

  18. [Non elective cesarean section: use of a color code to optimize management of obstetric emergencies].

    Science.gov (United States)

    Rudigoz, René-Charles; Huissoud, Cyril; Delecour, Lisa; Thevenet, Simone; Dupont, Corinne

    2014-06-01

    The medical team of the Croix Rousse teaching hospital maternity unit has developed, over the last ten years, a set of procedures designed to respond to various emergency situations necessitating Caesarean section. Using the Lucas classification, we have defined as precisely as possible the degree of urgency of Caesarian sections. We have established specific protocols for the implementation of urgent and very urgent Caesarean section and have chosen a simple means to convey the degree of urgency to all team members, namely a color code system (red, orange and green). We have set time goals from decision to delivery: 15 minutes for the red code and 30 minutes for the orange code. The results seem very positive: The frequency of urgent and very urgent Caesareans has fallen over time, from 6.1 % to 1.6% in 2013. The average time from decision to delivery is 11 minutes for code red Caesareans and 21 minutes for code orange Caesareans. These time goals are now achieved in 95% of cases. Organizational and anesthetic difficulties are the main causes of delays. The indications for red and orange code Caesarians are appropriate more than two times out of three. Perinatal outcomes are generally favorable, code red Caesarians being life-saving in 15% of cases. No increase in maternal complications has been observed. In sum: Each obstetric department should have its own protocols for handling urgent and very urgent Caesarean sections. Continuous monitoring of their implementation, relevance and results should be conducted Management of extreme urgency must be integrated into the management of patients with identified risks (scarred uterus and twin pregnancies for example), and also in structures without medical facilities (birthing centers). Obstetric teams must keep in mind that implementation of these protocols in no way dispenses with close monitoring of labour. PMID:26983190

  19. Application of cross-sectional time series modeling for the prediction of energy expenditure from heart rate and accelerometry.

    Science.gov (United States)

    Zakeri, Issa; Adolph, Anne L; Puyau, Maurice R; Vohra, Firoz A; Butte, Nancy F

    2008-06-01

    Accurate estimation of energy expenditure (EE) in children and adolescents is required for a better understanding of physiological, behavioral, and environmental factors affecting energy balance. Cross-sectional time series (CSTS) models, which account for correlation structure of repeated observations on the same individual, may be advantageous for prediction of EE. CSTS models for prediction of minute-by-minute EE and, hence, total EE (TEE) from heart rate (HR), physical activity (PA) measured by accelerometry, and observable subject variables were developed in 109 children and adolescents by use of Actiheart and 24-h room respiration calorimetry. CSTS models based on HR, PA, time-invariant covariates, and interactions were developed. These dynamic models involve lagged and lead values of HR and lagged values of PA for better description of the series of minute-by-minute EE. CSTS models with random intercepts and random slopes were investigated. For comparison, likelihood ratio tests were used. Log likelihood increased substantially when random slopes for HR and PA were added. The population-specific model uses HR and 1- and 2-min lagged and lead values of HR, HR(2), and PA and 1- and 2-min lagged values of PA, PA(2), age, age(2), sex, weight, height, minimum HR, sitting HR, HR x height, HR x weight, HR x age, PA x weight, and PA x sex interactions (P height, or body mass index. CSTS modeling provides a useful predictive model for EE and, hence, TEE in children and adolescents on the basis of HR and PA and other observable explanatory subject characteristics of age, sex, weight, and height. PMID:18403453

  20. Two-dimensional cross-section sensitivity and uncertainty analysis for tritium production rate in fusion-oriented integral experiments

    International Nuclear Information System (INIS)

    Several integral experiments on tritium breeding were jointly performed in connection with the U.S./JAERI Collaborative Program on Fusion Breeder Neutronics. Tritium production rates from /sup 6/Li (T/sub 6/) and /sup 7/Li(T/sub 7/) were measured at several locations in an Li/sub 2/O assembly embedded in the concrete wall of a 5- x 5- x 4.5-m room (reference experiment) in independent benchmark experiments with the Li/sub 2/O assembly located in a large room of negligible room-return neutrons. In the reference experiment, large discrepancies in T/sub 6/ were found at the front locations in the Li/sub 2/O assembly. At middle locations, the calculated-to-experimental (C/E) values for T/sub 6/ are -- 1.2 (U.S.) and -- l.1 (JAERI). The C/E values for T/sub 7/ are -- 1.18 (U.S.) and 1.05 (JAERI). To assess the contribution to the uncertainty is predicting T/sub 6/ and T/sub 7/ that results from the current uncertainties in the nuclear data base, an extensive two-dimensional cross-section sensitivity/uncertainty analysis was performed. For that purpose, the FORSS module, and the VIP and DOT 4.3 codes were used along with the PUFF-2 covariance code. Two systems were considered for the analysis: the benchmark system and the reference system. The models used simulate the geometrical details and source conditions for the experiments

  1. Using surface creep rate to infer fraction locked for sections of the San Andreas fault system in northern California from alignment array and GPS data

    Science.gov (United States)

    Lienkaemper, James J.; McFarland, Forrest S.; Simpson, Robert W.; Caskey, S. John

    2014-01-01

    Surface creep rate, observed along five branches of the dextral San Andreas fault system in northern California, varies considerably from one section to the next, indicating that so too may the depth at which the faults are locked. We model locking on 29 fault sections using each section’s mean long‐term creep rate and the consensus values of fault width and geologic slip rate. Surface creep rate observations from 111 short‐range alignment and trilateration arrays and 48 near‐fault, Global Positioning System station pairs are used to estimate depth of creep, assuming an elastic half‐space model and adjusting depth of creep iteratively by trial and error to match the creep observations along fault sections. Fault sections are delineated either by geometric discontinuities between them or by distinctly different creeping behaviors. We remove transient rate changes associated with five large (M≥5.5) regional earthquakes. Estimates of fraction locked, the ratio of moment accumulation rate to loading rate, on each section of the fault system provide a uniform means to inform source parameters relevant to seismic‐hazard assessment. From its mean creep rates, we infer the main branch (the San Andreas fault) ranges from only 20%±10% locked on its central creeping section to 99%–100% on the north coast. From mean accumulation rates, we infer that four urban faults appear to have accumulated enough seismic moment to produce major earthquakes: the northern Calaveras (M 6.8), Hayward (M 6.8), Rodgers Creek (M 7.1), and Green Valley (M 7.1). The latter three faults are nearing or past their mean recurrence interval.

  2. What does age-comparative self-rated health measure? : A cross-sectional study from the Northern Sweden MONICA Project

    OpenAIRE

    Waller, Göran; Janlert, Urban; Hamberg, Katarina; Forssén, Annika

    2016-01-01

    Aims: Self-rated health comprehensively accounts for many health domains. Using self-ratings and a knowledge of associations with health domains might help personnel in the health care sector to understand reports of ill health. The aim of this paper was to investigate associations between age-comparative self-rated health and disease, risk factors, emotions and psychosocial factors in a general population. Methods: We based our study on population-based cross-sectional surveys performed in 1...

  3. Self-rated health, work characteristics and health related behaviours among nurses in Greece: a cross sectional study

    OpenAIRE

    Dimoliatis Ioannis DK; Alamanos Yannis; Pappas Noula A

    2005-01-01

    Abstract Background Previous studies on self-rated health among nurses have indicated an association of low job satisfaction and stress in relation to poor self-rated health. The relationship between self rated health and the specific work characteristics and health related behaviours of nurses to our knowledge have not been adequately studied. Objective To investigate the health profile of nurses working in hospitals in North West Greece and to examine the associations between self rated hea...

  4. Lifestyle and self-rated health: a cross-sectional study of 3,601 citizens of Athens, Greece

    Directory of Open Access Journals (Sweden)

    Alexopoulos Evangelos C

    2011-08-01

    Full Text Available Abstract Background Self-rated health (SRH is a popular health measure determined by multiple factors. International literature is increasingly focusing on health-related behaviors such as smoking, dietary habits, physical activity, even religiosity. However, population-based studies taking into account multiple putative determinants of SRH in Greece are scarce. The aim of this study was to clarify possible determinants of SRH with an emphasis on the relationship between SRH and lifestyle variables in a large sample of urban citizens. Methods In this one-year cross-sectional study, a stratified random sample of 3,601 urban citizens was selected. Data were collected using an interview-based questionnaire about various demographic, socioeconomic, disease- and lifestyle related factors such as smoking, physical activity, dietary habits, sleep quality and religiosity. Multivariate logistic regression was used separately in three age groups [15-29 (N = 1,360, 30-49 (N = 1,122 and 50+ (N = 1,119 years old] in order to identify putative lifestyle and other determinants of SRH. Results Reporting of good SRH decreased with age (97.1%, 91.4% and 74.8%, respectively. Overall, possible confounders of the lifestyle-SRH relationship among age groups were sex, education, hospitalization during the last year, daily physical symptoms and disease status. Poor SRH was associated with less physical activity in the 15-29 years old (OR 2.22, 95%CI 1.14-4.33, with past or heavy smoking, along with no sleep satisfaction in the 30-49 years old (OR 3.23, 95%CI 1.35-7.74, OR 2.56, 95%CI 1.29-5.05, OR 1.79, 95%CI 1.1-2.92, respectively and with obesity and no sleep satisfaction in the 50+ years old individuals (OR 1.83, 95%CI 1.19-2.81, OR 2.54, 95%CI 1.83-3.54. Sleep dissatisfaction of the 50+ years old was the only variable associated with poor SRH at the 0.001 p level of significance (OR 2.45, 99%CI 1.59 to 3.76. Subgroup analyses of the 15-19 years old individuals also

  5. Vaginal birth after cesarean section (VBAC versus emergency repeat cesarean section at teaching hospitals in India: an ICMR task force study

    Directory of Open Access Journals (Sweden)

    B. S. Dhillon

    2014-06-01

    Results: A total of 155863 deliveries occurred during the study duration, there were 28.1% (n=43824 cesarean section and (10.1% (n=15664 were the number of previous cesarean section. In 84% (n=13151 had repeat cesarean delivery and 2513 (16% delivered vaginally. A trial of labor was planned in 4035 (25.8% women. The success rate of VBAC was 62.3% with 2513 women had successful vaginal delivery and 1522 (37.7% delivered by emergency repeat cesarean section. Major indication of emergency cesarean section was CPD (52.9%, foetal distress (25.8%, severe PIH/eclampsia (5.0%, previous 2 CS (0.7%, APH (1.4% and others (2.7%. In majority, surgical technique was conventional and in 3.7% the Misgav-Ladach technique was used. Scar dehiscence and surgical complications were observed in 5.4% and 4.0% of cases respectively. Blood transfusion was given in 7.0% and post-operative complications were seen in 6.8%. Perinatal and maternal mortality was 18.0/1000 and 257/100000 deliveries respectively. Conclusions: Safety in childbirth for women with prior cesarean is a major public health concern. Repeat caesarean section and planned vaginal birth after cesarean section are both associated with benefits and harms and correct management represents one of the most significant and challenging issues in obstetric practice. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 592-597

  6. Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study

    OpenAIRE

    ,

    2014-01-01

    Louise Kenny and colleagues conduct a population-based cohort study in Denmark to assess the likelihood of stillbirth, miscarriage, and ectopic pregnancy following cesarean section compared to women who gave birth by vaginal delivery.

  7. Post operatory analgesia in caesarean surgery. Analgesia posoperatoria en la operación cesárea.

    Directory of Open Access Journals (Sweden)

    María Antonia 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.

  8. Correlation between Success Rates of Cardiopulmonary Cerebral Resuscitation and the Educational Level of the Team Leader; A Cross-Sectional Study

    OpenAIRE

    Shahram Bolandparvaz; Hamid Mohajer; Mansoor Masjedi; Ehsan Mohammadhoseini; Leila Shayan

    2015-01-01

    Objectives: To determine the correlation between the success rates of the cardiopulmonary cerebral resuscitation (CPCR) and the team’s leader education and skill level in Shiraz, southern Iran. Method: This cross-sectional study was conducted during a 6-month period from October 2007 to March 2008 in Nemazee hospital of Shiraz. We included all the patients who underwent CPCR due to cardiopulmonary arrest in emergency room of Nemazee hospital during the study period. We recorded the rates o...

  9. Rates of Detection of Mood and Anxiety Disorders in Primary Care: A Descriptive, Cross-Sectional Study

    OpenAIRE

    Vermani, Monica; Marcus, Madalyn; Katzman, Martin A

    2011-01-01

    Objective: To determine the incidence of major depressive disorder, bipolar disorder, panic disorder, social anxiety disorder, and generalized anxiety disorder and to assess their detection rates in the Canadian primary care setting.

  10. Determination of proton-induced production cross sections and production rates of {sup 129}I from Te

    Energy Technology Data Exchange (ETDEWEB)

    Schnabel, C.; Lopez-Guitierrez, J.M.; Suter, M. [Eidgenoessische Technische Hochschule, Zurich (Switzerland); Synal, H.A. [Paul Scherrer Inst. (PSI), Villigen (Switzerland); Gloris, M.; Leya, I.; Michel, R. [Hannover Univ. (Germany); Herpers, U. [Koeln Univ. (Germany)

    1997-09-01

    In order to model the production of {sup 129}I in meteoroids, proton-induced production cross sections in the medium range of {sup 129}I from Te as well as production from meteoroid simulation experiments have been determined. {sup 129}I is a very important cosmogenic nuclide to study the constancy of cosmic radiation on long time scales. (author) 2 figs., 2 refs.

  11. Self-rated health, work characteristics and health related behaviours among nurses in Greece: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Dimoliatis Ioannis DK

    2005-12-01

    Full Text Available Abstract Background Previous studies on self-rated health among nurses have indicated an association of low job satisfaction and stress in relation to poor self-rated health. The relationship between self rated health and the specific work characteristics and health related behaviours of nurses to our knowledge have not been adequately studied. Objective To investigate the health profile of nurses working in hospitals in North West Greece and to examine the associations between self rated health (SRH and health related behaviours and work characteristics in this group of hospital employees. Methods A self-administered questionnaire was distributed to a random sample of 443 nurses working in all the hospitals in North West Greece. Regression analysis was used to examine the relationship of health related behaviours and work characteristics with self rated health among the nurses. Results A total of 353 responded to the questionnaire (response rate 80% of which 311 (88% were female and 42 (12% male. The mean age (standard deviation of the respondents was 36 years (5.6 and their mean years of working as nurses were 13.5 years (5.9. Almost half of the nurses' smoked, and about one third were overweight or obese. About 58% (206 of the nurses reported having poor health while 42% (147 reported having good health. Self-rated health was independently associated with gender, effort to avoid fatty foods and physical activity, according to multiple logistic regression analysis. Conclusion The population studied presented a relatively poor health profile, and a high proportion of poor SRH. Though female gender and effort to avoid fatty foods were associated with poor SRH, and exercise and white meat consumption with good SRH, specific work characteristics were not associated with SRH.

  12. Is the ratio of flow-mediated dilation and shear rate a statistically sound approach to normalization in cross-sectional studies on endothelial function?

    NARCIS (Netherlands)

    Atkinson, G.; Batterham, A.M.; Black, M.A.; Cable, N.T.; Hopkins, N.D.; Dawson, E.A.; Thijssen, D.H.J.; Jones, H.; Tinken, T.M.; Green, D.J.

    2009-01-01

    It has been deemed important to normalize flow-mediated dilation (FMD), a marker of endothelial function, for between-subject differences in the eliciting shear rate (SR) stimulus. Conventionally, FMD is divided by the area under the curve of the SR stimulus. In the context of a cross-sectional comp

  13. [Acute pancreas necrosis with biliary peritonitis in cesarean section].

    Science.gov (United States)

    Zoldos, L; Hincová, M

    1986-01-01

    The authors describe the case of a hemorrhagic pancreatitis with non-perforating biliary peritonitis. The abdomen symptomatology was hidden by the beginning contractions and due to the dystocia the delivery was finished by caesarean section. The presence of choleperitoneum required a surgical revision of the abdominal cavity which enabled to make the right diagnosis. This thesis deals with aetiology and mechanism of choleperitoneum inception during hemorrhagic pancreatitis. PMID:3788337

  14. Dynamic Patterns of Forces and Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Ana Paula Ribeiro

    Full Text Available The etiology of plantar fasciitis (PF has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage.Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the chronic stage of the injury in relation to healthy runners.Forty-five runners with unilateral PF (30 acute and 15 chronic and 30 healthy control runners were evaluated while running at 12 km/h for 40 meters wearing standardized running shoes and Pedar-X insoles. The contact area and time, maximum force, and force-time integral over the rearfoot, midfoot, and forefoot were recorded and the loading rate (20-80% of the first vertical peak was calculated. Groups were compared by ANOVAs (p<0.05.Maximum force and force-time integral over the rearfoot and the loading rate was higher in runners with PF (acute and chronic compared with controls (p<0.01. Runners with PF in the acute stage showed lower loading rate and maximum force over the rearfoot compared to runners in the chronic stage (p<0.01.Runners with PF showed different dynamic patterns of plantar loads during running over the rearfoot area depending on the injury stage (acute or chronic. In the acute stage of PF, runners presented lower loading rate and forces over the rearfoot, possibly due to dynamic mechanisms related to pain protection of the calcaneal area.

  15. 147Sm(n,α) cross section measurements from 3 eV to 500 keV: Implications for explosive nucleosynthesis reaction rates

    International Nuclear Information System (INIS)

    We have measured the 147Sm(n,α) cross section from 3 eV to 500 keV. These data were used to test nuclear statistical models which must be relied on to calculate the rates for as yet unmeasurable reactions occurring in explosive nucleosynthesis scenarios. It was found that our data are in reasonably good agreement with the reaction rate predicted by an older model but that the rates predicted by two very recent models are roughly a factor of 3 different from the data (in opposite directions). A detailed analysis indicates the strong dependence on the employed optical α potentials. These results, together with counting rate estimates for future experiments indicate that (n,α) measurements will be useful for improving reaction rate predictions across the global range of masses needed for explosive nucleosynthesis calculations

  16. A STUDY OF THE OUTCOME OF SUBSEQUENT PREGNANCY FOLLOWING PREVIOUS C ESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Suman

    2014-02-01

    Full Text Available With the world - wide rising trend of caesarean delivery (CD, modern obstetric practice deals with a new group of mothers carrying reproductive performance upon a scarred uterus with obvious risk in feto - maternal outcome. AIMS: (1 To analyse the maternal & neonatal outcome in post - caesarean pregnancy. (2 To evaluate the factors influencing outcome in such cases. Design : Observational analytical study. MATERIALS & METHODS: The present study was carried out over two years (2010 - 11 taking consecutive 100 p ost - caesarean cases as admitted on my admission days & delivered in BR Singh Hospital. Data collection was done by interview technique along with hospital records. ANALYSIS USED: Percentage analysis was most often done. Categorical variables were compared with chi - square test; P value was calculated with 2012 Graphpad Software. Relative risk (RR & Odd ratio (OR were calculated with 1993 - 2012 Medcalc Software bvba (Version 12.3.0. All statistical tests were evaluated at the 0.05 significance level. RESULT S: Post - caesarean pregnancy rate was 26.02%. Vaginal birth after caesarean (VBAC incidence was 22% whereas VBAC success on trial of labour was 55%. VBAC gave best morbidity outcome (18.18% & 27.27%. But failed VBAC cases result more significant maternal morbidity (RR=3.97, P=0.0037 & NICU admission was also found highest in failed VBAC cases (38.89%. Maternal and neonatal morbidity were significantly high when scar integrity was lost; also significantly co - related with elderly mothers (>35 yrs., un - boo ked cases & non - admitted cases undergone repeat CD. CONCLUSIONS: Post - caesarean cases need meticulous antenatal check - up & mandatory institutional delivery with proper selection of mode of confinement to have a better maternal & neonatal outcome

  17. Cross-sectional study of possible association between rapid eating and high body fat rates among female Japanese college students.

    Science.gov (United States)

    Yaguchi-Tanaka, Yuri; Kawagoshi, Yumiko; Sasaki, Satoshi; Fukao, Akira

    2013-01-01

    The incidence of excessive body fat among young Japanese females with a normal BMI, which is referred to as normal weight obesity (NWO), has recently increased. Some studies have associated eating rates with BMI. However, an association between body fat rate and dietary habits has not been proven. We compared differences in dietary habits between 72 female Japanese junior college students with normal (<30%; normal body fat ratio, NFR) and high (≥ 30%; excessive body fat ratio, EFR) proportions of body fat. Energy and the intake of many nutrients and foods did not significantly differ between the two groups, but the EFR group consumed significantly less saturated fatty acid, sugar and confectionery. Eating rapidly was significantly associated with body fat ratios. Our findings suggest that eating rapidly increases body fat ratios. PMID:23883696

  18. Relationship between heart rate recovery and inflammatory markers in patients with polycystic ovary syndrome: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Giallauria Francesco

    2009-02-01

    Full Text Available Abstract Background Polycystic ovary syndrome (PCOS is an endocrine disease closely related to several risk factors for cardiovascular disease. An abnormal heart rate recovery (HRR, an easily-obtained measure derived from exercise stress test and closely related to an increased risk for cardiovascular mortality, has been recently described in PCOS women. A subclinical increase of the inflammation markers has been also observed in the PCOS. This study was designed to study the relationships between HRR and inflammatory markers in PCOS women. Methods Two-hundred forty-three young PCOS patients without known risk factors for cardiovascular risk were enrolled. All patients underwent hormonal and metabolic profile, white blood cells (WBCs count and C-reactive protein (CRP. HRR was calculated as the difference between heart rate at peak exercise and heart rate at first minute of the cool-down period. Abnormal HRR was defined as ≤18 beats/min for standard exercise testing. Results Eighty-nine out of 243 patients presented abnormal HRR. Serum CRP (1.8 ± 0.7 vs. 1.1 ± 0.4 mg/dl, p 9 cells/l, p versus normal HRR. HRR was significantly associated with both CRP (r = -0.33, p p Conclusion Abnormal HRR and inflammatory markers are closely associated in PCOS women acting probably in concert to increase the cardiovascular risk profile of these patients.

  19. Impacts of phase continuity of care on postpartum pain,comfort and ma-ternal feeding success rate of cesarean section maternal%持续性阶段护理对剖宫产产妇产后疼痛、舒适度及母乳喂养成功率的影响

    Institute of Scientific and Technical Information of China (English)

    陈小芹; 陆小莉; 屈利洁

    2015-01-01

    (P<0.05). Conclusion Phase continuity of care can significantly reduce the postpartum pain,im prove the comfort and breastfeeding success rate of caesarean section maternal,so is worthy of promotion.

  20. Influence of mercury exposure on blood pressure, resting heart rate and heart rate variability in French Polynesians: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Valera Beatriz

    2011-11-01

    Full Text Available Abstract Background Populations which diet is rich in seafood are highly exposed to contaminants such as mercury, which could affect cardiovascular risk factors Objective To assess the associations between mercury and blood pressure (BP, resting heart rate (HR and HR variability (HRV among French Polynesians Methods Data were collected among 180 adults (≥ 18 years and 101 teenagers (12-17 years. HRV was measured using a two-hour ambulatory electrocardiogram (Holter and BP was measured using a standardized protocol. The association between mercury and HRV and BP parameters was studied using analysis of variance (ANOVA and analysis of covariance (ANCOVA Results Among teenagers, the high frequency (HF decreased between the 2nd and 3rd tertile (380 vs. 204 ms2, p = 0.03 and a similar pattern was observed for the square root of the mean squared differences of successive R-R intervals (rMSSD (43 vs. 30 ms, p = 0.005 after adjusting for confounders. In addition, the ratio low/high frequency (LF/HF increased between the 2nd and 3rd tertile (2.3 vs. 3.0, p = 0.04. Among adults, the standard deviation of R-R intervals (SDNN tended to decrease between the 1st and 2nd tertile (84 vs. 75 ms, p = 0.069 after adjusting for confounders. Furthermore, diastolic BP tended to increase between the 2nd and 3rd tertile (86 vs. 91 mm Hg, p = 0.09. No significant difference was observed in resting HR or pulse pressure (PP Conclusions Mercury was associated with decreased HRV among French Polynesian teenagers while no significant association was observed with resting HR, BP, or PP among teenagers or adults

  1. Factors that associated with TB patient admission rate and TB inpatient service cost: a cross-sectional study in China

    Institute of Scientific and Technical Information of China (English)

    Hongyan Hu; Jiaying Chen; Kaori D.Sato; Yang Zhou; Hui Jiang; Pingbo Wu; Hong Wang

    2016-01-01

    Background:China has recently adopted the "TB designated hospital model" to improve the quality of tuberculosis (TB) treatment and patient management.Considering that inpatient service often results in high patient financial burden,and therefore influences patient adherence to treatment,it is critical to better understand the TB patient admission rate and TB inpatient service cost,as well as their influential factors in this new model.Methods:Quantitative and qualitative studies were conducted in two cities,Hanzhong in Shaanxi Province and Zhenjiang in Jiangsu Province,in China.Quantitative data were obtained from a sample survey of 533 TB patients and TB inpatient records from 2010-2012 in six county designated hospitals.Qualitative information was obtained through interviews with key stakeholders (40 key informant interviews,14 focus group discussions) and reviews of health policy documents in study areas.Both univariate and multivariate statistical analyses were applied for the quantitative analysis,and the thematic framework approach was applied for the qualitative analysis.Results:The TB patient admission rates in Zhenjiang and Hanzhong were 54.8 and 55.9 %,respectively.Qualitative analyses revealed that financial incentives,misunderstanding of infectious disease control and failure of health insurance regulations were the key factors associated with the admission rates and medical costs.Quantitative analyses found differences in hospitalization rate existed among patients with different health insurance and patients from different counties.Average medical costs for TB inpatients in Jurong and Zhenba were 7,215 CNY and 4,644 CNY,which was higher than the 5,500 CNY and 3,800 CNY limits set by the New Rural Cooperative Medical System.No differences in medical cost or length of stay were found between patients with and without comorbidities in county-level hospitals.Conclusions:TB patient admission rates and inpatient service costs were relatively high

  2. Predicting cesarean section and uterine rupture among women attempting vaginal birth after prior cesarean section.

    Directory of Open Access Journals (Sweden)

    2005-09-01

    Full Text Available BACKGROUND: There is currently no validated method for antepartum prediction of the risk of failed vaginal birth after cesarean section and no information on the relationship between the risk of emergency cesarean delivery and the risk of uterine rupture. METHODS AND FINDINGS: We linked a national maternity hospital discharge database and a national registry of perinatal deaths. We studied 23,286 women with one prior cesarean delivery who attempted vaginal birth at or after 40-wk gestation. The population was randomly split into model development and validation groups. The factors associated with emergency cesarean section were maternal age (adjusted odds ratio [OR] = 1.22 per 5-y increase, 95% confidence interval [CI]: 1.16 to 1.28, maternal height (adjusted OR = 0.75 per 5-cm increase, 95% CI: 0.73 to 0.78, male fetus (adjusted OR = 1.18, 95% CI: 1.08 to 1.29, no previous vaginal birth (adjusted OR = 5.08, 95% CI: 4.52 to 5.72, prostaglandin induction of labor (adjusted OR = 1.42, 95% CI: 1.26 to 1.60, and birth at 41-wk (adjusted OR = 1.30, 95% CI: 1.18 to 1.42 or 42-wk (adjusted OR = 1.38, 95% CI: 1.17 to 1.62 gestation compared with 40-wk. In the validation group, 36% of the women had a low predicted risk of caesarean section (< 20% and 16.5% of women had a high predicted risk (> 40%; 10.9% and 47.7% of these women, respectively, actually had deliveries by caesarean section. The predicted risk of caesarean section was also associated with the risk of all uterine rupture (OR for a 5% increase in predicted risk = 1.22, 95% CI: 1.14 to 1.31 and uterine rupture associated with perinatal death (OR for a 5% increase in predicted risk = 1.32, 95% CI: 1.02 to 1.73. The observed incidence of uterine rupture was 2.0 per 1,000 among women at low risk of cesarean section and 9.1 per 1,000 among those at high risk (relative risk = 4.5, 95% CI: 2.6 to 8.1. We present the model in a simple-to-use format. CONCLUSIONS: We present, to our knowledge, the

  3. Predicting cesarean section and uterine rupture among women attempting vaginal birth after prior cesarean section.

    Directory of Open Access Journals (Sweden)

    Gordon C S Smith

    2005-09-01

    Full Text Available BACKGROUND: There is currently no validated method for antepartum prediction of the risk of failed vaginal birth after cesarean section and no information on the relationship between the risk of emergency cesarean delivery and the risk of uterine rupture. METHODS AND FINDINGS: We linked a national maternity hospital discharge database and a national registry of perinatal deaths. We studied 23,286 women with one prior cesarean delivery who attempted vaginal birth at or after 40-wk gestation. The population was randomly split into model development and validation groups. The factors associated with emergency cesarean section were maternal age (adjusted odds ratio [OR] = 1.22 per 5-y increase, 95% confidence interval [CI]: 1.16 to 1.28, maternal height (adjusted OR = 0.75 per 5-cm increase, 95% CI: 0.73 to 0.78, male fetus (adjusted OR = 1.18, 95% CI: 1.08 to 1.29, no previous vaginal birth (adjusted OR = 5.08, 95% CI: 4.52 to 5.72, prostaglandin induction of labor (adjusted OR = 1.42, 95% CI: 1.26 to 1.60, and birth at 41-wk (adjusted OR = 1.30, 95% CI: 1.18 to 1.42 or 42-wk (adjusted OR = 1.38, 95% CI: 1.17 to 1.62 gestation compared with 40-wk. In the validation group, 36% of the women had a low predicted risk of caesarean section ( 40%; 10.9% and 47.7% of these women, respectively, actually had deliveries by caesarean section. The predicted risk of caesarean section was also associated with the risk of all uterine rupture (OR for a 5% increase in predicted risk = 1.22, 95% CI: 1.14 to 1.31 and uterine rupture associated with perinatal death (OR for a 5% increase in predicted risk = 1.32, 95% CI: 1.02 to 1.73. The observed incidence of uterine rupture was 2.0 per 1,000 among women at low risk of cesarean section and 9.1 per 1,000 among those at high risk (relative risk = 4.5, 95% CI: 2.6 to 8.1. We present the model in a simple-to-use format. CONCLUSIONS: We present, to our knowledge, the first validated model for antepartum prediction of the

  4. Factors associated with self-rated health status in university students: a cross-sectional study in three European countries

    Directory of Open Access Journals (Sweden)

    Dudziak Urszula

    2008-06-01

    Full Text Available Abstract Background Self-rated health status (SRHS is a reliable and valid measure for assessing the subjective and objective health of individuals. Previous studies have either focused predominantly on the elderly or investigated only a narrow range of factors potentially associated with SRHS. In examining student populations, these past studies were limited to single countries. The objectives of this study were to assess which candidate variables were independently associated with SRHS in university students, to compare these variables by country and by gender, and to investigate which of the variables was most important as a rating frame for SRHS. Methods The data is from the Cross-National Student Health Survey, conducted in 2005 in universities in Germany, Bulgaria, and Poland (n = 2103; mean age = 20.7 years. SRHS was assessed with a single question using a five-point scale ranging from "excellent" to "poor". The study also measured a wide range of variables including: physical and psychological health, studying, social contacts/social support, and socio-demographic status. Results Psychosomatic complaints (considered an aspect of physical health and, adjusted for psychological health were the most important indicators in forming a rating frame for students' SRHS. There were few differences in the effects of variables associated with SRHS by gender (well-being: a measure of psychological health and the variables associated with SRHS by country (well-being and self-efficacy. The remaining variables showed homogenous effects for both genders and for all three countries. Conclusion The results suggest that SRHS can be reasonably used to compare students' health across countries. SRHS is affected by different physical, psychological and psychosomatic aspects of health; however, its strongest association is with psychosomatic complaints.

  5. Dynamic Patterns of Forces and Loading Rate in Runners with Unilateral Plantar Fasciitis: A Cross-Sectional Study

    OpenAIRE

    Ana Paula Ribeiro; Silvia Maria Amado João; Roberto Casanova Dinato; Vitor Daniel Tessutti; Isabel de Camargo Neves Sacco

    2015-01-01

    Aim/Hypothesis The etiology of plantar fasciitis (PF) has been related to several risk factors, but the magnitude of the plantar load is the most commonly described factor. Although PF is the third most-common injury in runners, only two studies have investigated this factor in runners, and their results are still inconclusive regarding the injury stage. Objective Analyze and compare the plantar loads and vertical loading rate during running of runners in the acute stage of PF to those in the...

  6. 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

    Full Text Available BACKGROUND: Hemodynamic disturbance and uteroplacental hypoperfusion can occur due to Aortocaval Compression (ACC in parturient which are further aggravated by SAB. Incidence of maternal hypotension due to cephalad spread of local anesthetic (LA in subarachnoid space and ACC by gravid uterus; both these factors influenced by parturient’s posture during and immediately after SAB, we tested the hypothesis that keeping parturient in sitting position for five minutes after SAB, likely limit the spread of LA, thus reduce the incidence of hypotension and Intraoperative ephedrine requirements. AIMS AND OBJECTIVES: to determine the effects of making parturient sit up for five minutes after SAB, that would have on sensory block height, incidence of hypotension and ephedrine requirements. Secondarily, to study duration of postoperative analgesia. MATERIALS AND METHODS; Single blinded randomized comparative study having 30 parturients in each group CS and CL were allocated to receive 2ml of hyperbaric bupivacaine with 0.4ml NS, Or 20 µgm fentanyl added to 2 ml hyperbaric bupivacaine group FS or FL, either in sitting group (made to sit for 5 min. post SAB before supine or in lying group, made supine immediately. The maximum level of sensory blockade achieved and monitoring of heart rate, noninvasive blood pressure, respiratory rate and oxygen saturation were done every 2 min for first 10 min then at 15 min interval for remainder of operation. Postoperatively, onset of pain was noted. STATISTICAL ANALYSIS: By using descriptive and inferential statistics using unpaired t-test, chi Square test, and Mann-Whitney U test. The Software used was SPSS 17.0 version and Graph Pad Prism 5.0. Analyzed data was expressed as mean ± SD for continuous variables and number (% for categorical variables. P value < 0.05 was considered statistically significant RESULTS: Sitting Groups had lower sensory block height than lying Groups; also required less ephedrine. Duration of

  7. Improving Adaptive Learning Rate of BP Neural Network for the Modelling of 3D Woven Composites Using the Golden Section Law

    Institute of Scientific and Technical Information of China (English)

    易洪雷; 丁辛

    2001-01-01

    Focused on various BP algorithms with variable learning rate based on network system error gradient, a modified learning strategy for training non-linear network models is developed with both the incremental and the decremental factors of network learning rate being adjusted adaptively and dynamically. The golden section law is put forward to build a relationship between the network training parameters, and a series of data from an existing model is used to train and test the network parameters. By means of the evaluation of network performance in respect to convergent speed and predicting precision, the effectiveness of the proposed learning strategy can be illustrated.

  8. Which factors are associated with higher rates of chronic kidney disease recording in primary care? A cross-sectional survey of GP practices.

    Science.gov (United States)

    Walker, Nicola; Bankart, John; Brunskill, Nigel; Baker, Richard

    2011-03-01

    The prevalence of chronic kidney disease (CKD) at stage 3-5 is estimated at 8.5% in the UK, but the recorded rate of CKD from Quality and Outcomes Framework (QOF) registers in 2007-2008 was 2.9%. This study aimed to identify practice or patient characteristics associated with recorded rates of CKD. Demographic and QOF data for 230 general practices were combined into a database for cross-sectional analysis. Regression analyses investigated factors associated with CKD recording; deprivation, location in Leicester city or Northamptonshire, and low recording of hypertension and stroke were associated with low CKD recording. PMID:21375906

  9. Factors associated with self and informant ratings of the quality of life of people with dementia living in care facilities: a cross sectional study.

    Directory of Open Access Journals (Sweden)

    Christopher Beer

    Full Text Available BACKGROUND: There is no consensus regarding the optimal approach to assessment of the quality of life of people with dementia. We undertook the present study to describe and determine the factors associated with ratings of the quality of life of a cohort of people with dementia living in a residential care facility. METHODOLOGY/PRINCIPAL FINDINGS: 351 people with dementia living in residential care facilities, and their staff and family informants participated in this cross sectional observational study. Quality of life was measured using self (Quality of Life in Alzheimer's Disease [QoL-AD] scale, and informant (QoL-AD and Alzheimer's Disease Related QoL Scale reports. 226 people (64% with dementia (median MMSE 17; 12-21 were able to self rate the QoL-AD scale and these subjects' ratings were compared to ratings by staff and family. Both staff and family informant ratings of the QoL-AD underestimated self ratings (mean difference -7.8, 95% CI -8.8, -6.7 for staff rated QoL-AD; and mean difference -7.2, 95% CI -8.5, -6.0 for family rated QoL-AD. Self ratings of QoL were lower among people who were restrained, had fallen or had pain. Informant ratings of the QoL of the participants with dementia were consistently and significantly lower for people with severe cognitive impairment, who had fallen, had presence of neuropsychiatric symptoms, or where care giver distress was present. Documented restraint, reported pain and neuropsychiatric symptoms were independently associated with lower self rating of the QoL-AD in multivariate models. Cognitive impairment, case conferencing, hospitalizations and neuropsychiatric symptoms were found to be independently associated with staff rated ADRQL. CONCLUSIONS: The majority of people with dementia living in residential care facilities can rate their own QoL. Informant ratings underestimate self ratings of QoL of people with dementia, and appear to be associated with factors which are not associated with self

  10. ECSSIT - Elective caesarean section Syntocinon infusion trial a multi-centre randomized controlled trial oxytocin Syntocinon % iu bolus and placebo infusion versus oxtocin 5 iu bolus and 40 iu infusion for the control of blood loss at elective caesarean section

    LENUS (Irish Health Repository)

    Sheehan, S

    2011-02-01

    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  11. Critical Evaluation of Chemical Reaction Rates and Collision Cross Sections of Importance in the Earth's Upper Atmosphere and the Atmospheres of Other Planets, Moons, and Comets

    Science.gov (United States)

    Huestis, David L.

    2006-01-01

    We propose to establish a long-term program of critical evaluation by domain experts of the rates and cross sections for atomic and molecular processes that are needed for understanding and modeling the atmospheres in the solar system. We envision data products resembling those of the JPL/NASA Panel for Data Evaluation and the similar efforts of the international combustion modeling community funded by US DoE and its European counterpart.

  12. Experimental and theoretical determination of cross sections and rate constants for charge transfer population of some excited Ag+, I+, and Cu+ levels

    Science.gov (United States)

    Temelkov, K. A.; Vuchkov, N. K.; Sabotinov, N. V.

    2007-04-01

    Cross-sections and rate constants for thermal energy charge transfer into some Ag+, I+, and Cu+ excited states are theoretically and experimentally obtained for a gas discharge in the He-CuBr, Ne-CuBr, He-AgI, and Ne-AgI mixtures. Besides the pumping process the formation of the inversion population is determined by the radiative transitions, which populate or depopulate the upper and lower laser levels.

  13. An anthropological analysis of the perspectives of Somali women in the West and their obstetric care providers on caesarean birth

    OpenAIRE

    Essén, Birgitta; Binder, Pauline; Johnsdotter, Sara

    2011-01-01

    We explored the perceptions of 39 Somali women and 62 obstetric care providers in London in relation to caesarean birth, as borne out of a paradox we recognised from evidence-based information about the Somali group. Socio-cultural factors potentially leading to adverse obstetric outcome were identified using in-depth and focus group interviews with semi-structured, open-ended questions. A cultural anthropology model, the emic/etic model, was used for analysis. Somali women expressed fear and...

  14. Adding different doses of intrathecal magnesium sulfate for spinal anesthesia in the cesarean section: A prospective double blind randomized trial

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2012-01-01

    Conclusions: In patients undergoing the caesarean section under hyperbaric bupivacaine spinal anesthesia, the addition of 50, 75, or 100 mg magnesium sulfate provides safe and effective anesthesia, but 75 mg of this drug was enough to lead a significant delay in the onset of both sensory and motor blockade, and prolonged the duration of sensory and motor blockade, without increasing major side effects.

  15. The stress, coping and parenting experiences of mothers who gave birth by unplanned Caesarean section / Samantha Lynne van Reenen

    OpenAIRE

    Van Reenen, Samantha Lynne

    2012-01-01

    Pregnancy and childbirth are important life experiences in a woman’s psychosocial and psychological development. For many women, vaginal birth is still considered an integral part of being a woman and becoming a mother. Furthermore, it is thought to promote maternal well-being through helping women to match their expectations to experiences. For these women, a failed natural birth can be a psychological, psychosocial, and existential challenge that can result in significant ...

  16. Surveillance of hospital-acquired infections in women having undergone caesarean section in the County of Aarhus

    DEFF Research Database (Denmark)

    Leth, Rita Andersen

      Cirka 10% af indlagte patienter på danske sygehuse får en infektion i forbindelse med indlæggelsen. Overvågning af disse hospitalserhvervede infektioner (HAI) efterfulgt af feedback til klinikere har tidligere vist at kunne reducere prævalensen af HAI med en tredjedel. En af forudsætningerne fo...

  17. Comparison of Obstetric Outcome in Terms of the Risk of Low Birth Weight, Preterm Delivery, Cesarean Section Rate and Anemia in Primigravid Adolescents and Older Primigravida

    International Nuclear Information System (INIS)

    Objective: To compare the obstetric outcome in terms of risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. Study Design: Cohort study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012. Methodology: Three hundred primigravid women presenting to department of obstetrics and gynecology of Sir Ganga Ram Hospital, Lahore, having live singleton pregnancy, including 150 adolescents (A/sup 2/ 19 years) and 150 adults (A/sup 3/ 20 years) were studied. Obstetric outcome in terms of gestational age at delivery, infant's birth weight, presence of anemia and cesarean section rate was compared between two groups. Results were analyzed using Statistical Package for Social Sciences (SPSS) version 16. Chi-square test was applied with 0.05 as level of significance. Results: The mean age of adolescent subjects was 17.3 + 1.5 years and of adults 25.6 + 3.4 years. Mean gestational age at delivery was similar in two groups (39.2 weeks and 39.4 weeks, p = 0.37). Adolescents were more likely to have a preterm delivery (11.2% vs. 4.9%, p = 0.04) and low birth weight infants (19.3% vs. 8.2%, p = 0.005) than adults. Adolescents were more likely to be anemic (46% vs. 32%, p = 0.01) than adults. However, cesarean section rate was not statistically different between two groups. Conclusion: This study showed that primiparous adolescents have significantly higher risk of adverse pregnancy outcomes such as preterm delivery, low birth weight infants and anemia as compared to adult primiparas. (author)

  18. Electron impact cross-sections and cooling rates for methane. [in thermal balance of electrons in atmospheres and ionospheres of planets and satellites in outer solar system

    Science.gov (United States)

    Gan, L.; Cravens, T. E.

    1992-01-01

    Energy transfer between electrons and methane gas by collisional processes plays an important role in the thermal balance of electrons in the atmospheres and ionospheres of planets and satellites in the outer solar system. The literature is reviewed for electron impact cross-sections for methane in this paper. Energy transfer rates are calculated for elastic and inelastic processes using a Maxwellian electron distribution. Vibrational, rotational, and electronic excitation and ionization are included. Results are presented for a wide range of electron temperatures and neutral temperatures.

  19. Self-rated quality of life of city-dwelling elderly people benefitting from social help: results of a cross-sectional study

    OpenAIRE

    Bryła, Marek; Burzyńska, Monika; Maniecka-Bryła, Irena

    2013-01-01

    Background The percentage of people aged 65 or older living in Poland is 13.6%, but 17.2% in Łódź. The aim of the study was to identify factors correlating with the self-rated quality of life of elderly inhabitants of cities applying for social help, on the basis of a cross-sectional study. Methods The study was conducted in Łódź, a large Polish city, between September 2011 and February 2012 in a group of people applying for help in the Municipal Social Welfare Centre. Four hundred and sixty-...

  20. ANAESTHESIA MANAGEMENT OF A TERM PREGNANT PATIENT W ITH GULLAIN BARRE SYNDROME POSTED FOR ELECTIVE CAESAREA N SECTION – A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Poornima

    2013-05-01

    Full Text Available ABSTRACT: Guillain Barre Syndrome (GBS is an acute, inflamm atory, demyelinating polyneuropathy that present with ascending, symmetr ical flaccid paralysis accompanied by sensory and autonomic involvement. GBS complicating pregnan cy is a rare event and the anaesthesia management of a parturient with GBS is not well def ined. We report anaesthesia management and its anaesthetic implications in term pregnant patie nt with GBS who was posted for elective caesarean section. In this case the caesarean secti on was successfully carried out under general anaesthesia.

  1. Meteor fluxes and visual magnitudes from EISCAT radar event rates: a comparison with cross-section based magnitude estimates and optical data

    Directory of Open Access Journals (Sweden)

    A. Pellinen-Wannberg

    Full Text Available Incoherent scatter radars (ISR are versatile instruments for continuous monitoring of ionisation processes in the Earth's atmosphere. EISCAT, The European Incoherent Scatter facility has proven effective also in meteor studies. The time resolution of the radar can be reduced to a few milliseconds, sufficient to resolve the passage of individual meteors through the narrow ISR beam. Methods for group and phase velocity determination of the meteoroids and the discrepancy between the results related to the target behaviour are presented. The radar cross sections of echoes associated with moving meteoroids ("meteor head echoes" are very small and increase with decreasing wavelength. The parent meteoroids are found to have visual magnitudes far below the detection limit of most optical observations. The equivalent visual magnitude limit of the smallest objects observed by EISCAT in the current experiments has been estimated by two different methods, both from the cross-section measurements and from the measured event rates. Both methods give a limit value of +10 for the smallest objects while the upper limit is +4. The lower limit of the visual magnitude for the collocated optical measurement system is +4. Thus the two detection systems observe two different meteor size ranges, with the radar almost reaching micrometeorite population. Meteor fluxes estimated from the event rates and the radar system parameters agree well with previous extrapolated values for this size range.

    Key words. Ionosphere (ionization mechanisms. Radio science (ionospheric physics. Space plasma physics (ionization processes

  2. Reduced Cardiovascular Capacity and Resting Metabolic Rate in Men with Prostate Cancer Undergoing Androgen Deprivation: A Comprehensive Cross-Sectional Investigation

    Directory of Open Access Journals (Sweden)

    Bradley A. Wall

    2015-01-01

    Full Text Available Objectives. To investigate if androgen deprivation therapy exposure is associated with additional risk factors for cardiovascular disease and metabolic treatment-related toxicities. Methods. One hundred and seven men (42–89 years with prostate cancer undergoing androgen deprivation therapy completed a maximal graded objective exercise test to determine maximal oxygen uptake, assessments for resting metabolic rate, body composition, blood pressure and arterial stiffness, and blood biomarker analysis. A cross-sectional analysis was undertaken to investigate the potential impact of therapy exposure with participants stratified into two groups according to duration of androgen deprivation therapy (<3 months and ≥3 months. Results. Maximal oxygen uptake (26.1 ± 6.0 mL/kg/min versus 23.2 ± 5.8 mL/kg/min, p=0.020 and resting metabolic rate (1795 ± 256 kcal/d versus 1647 ± 236 kcal/d, p=0.005 were significantly higher in those with shorter exposure to androgen deprivation. There were no differences between groups for peripheral and central blood pressure, arterial stiffness, or metabolic profile. Conclusion. Three months or longer exposure to androgen deprivation therapy was associated with reduced cardiorespiratory capacity and resting metabolic rate, but not in a range of blood biomarkers. These findings suggest that prolonged exposure to androgen deprivation therapy is associated with negative alterations in cardiovascular outcomes. Trial registry is: ACTRN12609000200280.

  3. Determinants of Self-Rated Health in a Representative Sample of a Rural Population: A Cross-Sectional Study in Greece

    Directory of Open Access Journals (Sweden)

    Christina Darviri

    2012-03-01

    Full Text Available Self-rated health (SRH is a health measure related to future health, mortality, healthcare services utilization and quality of life. Various sociodemographic, health and lifestyle determinants of SRH have been identified in different populations. The aim of this study is to extend SRH literature in the Greek population. This is a cross-sectional study conducted in rural communities between 2001 and 2003. Interviews eliciting basic demographic, health-related and lifestyle information (smoking, physical activity, diet, quality of sleep and religiosity were conducted. The sample consisted of 1,519 participants, representative of the rural population of Tripoli. Multinomial regression analysis was conducted to identify putative SRH determinants. Among the 1,519 participants, 489 (32.2%, 790 (52% and 237 (15.6% rated their health as “very good”, “good” and “poor” respectively. Female gender, older age, lower level of education and impaired health were all associated with worse SRH, accounting for 16.6% of SRH variance. Regular exercise, healthier diet, better sleep quality and better adherence to religious habits were related with better health ratings, after adjusting for sociodemographic and health-related factors. BMI and smoking did not reach significance while exercise and physical activity exhibited significant correlations but not consistently across SRH categories. Our results support previous findings indicating that people following a more proactive lifestyle pattern tend to rate their health better. The role of stress-related neuroendocrinologic mechanisms on SRH and health in general is also discussed.

  4. A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study

    OpenAIRE

    興津, 裕美

    2014-01-01

    博士(医学) 乙第2814号, 著者名:Hiromi Okitsu・Jitsuki Sawamura・Katsuji Nishimura・Yasuto Sato・Jun Ishigooka,タイトル:A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study,掲載誌:Open Journal of Psychiatry (2161-7325),巻・頁・年:4巻1号 p.68~74 (2014),著作権関連情報:Copyright © 2014 by authors and Scientific Research Publishing Inc.,DOI:10.4236/ojpsych.2014.41010...

  5. In vivo imaging flow cytometry based on laser scanning two-photon microscopy at kHz cross-sectional frame rate

    Science.gov (United States)

    Kong, Lingjie; Tang, Jianyong; Cui, Meng

    2016-03-01

    In vivo flow cytometry has found numerous applications in biology and pharmacology. However, conventional cytometry does not provide the detailed morphological information that is needed to fully determine the phenotype of individual circulating cells. Imaging cytometry, capable of visualizing the morphology and dynamics of the circulating cells at high spatiotemporal resolution, is highly desired. Current wide-field based image cytometers are limited in the imaging depth and provide only two-dimensional resolution. For deep tissue imaging, laser scanning two-photon fluorescence microscopy (TPM) is widely adopted. However, for applications in flow cytometry, the axial scanning speed of current TPMs is inadequate to provide high-speed cross-sectional imaging of vasculature. We have integrated an optical phase-locked ultrasound lens into a standard TPM and achieved microsecond-scale axial scanning. With a galvo scanner for transverse scanning, we achieved kHz cross-sectional frame rate. Here we report its applications for in vivo deformability cytometry and in vivo imaging flow cytometry, and demonstrate the capability of imaging dynamical morphologies of flowing cells, distinguishing cells and cellular clusters, and simultaneously quantifying different cell populations based on their fluorescent labels.

  6. First measurement of the cross section for the production of hadrons with high transverse momenta at COMPASS, and developments for particle tracking in high-rate experiments

    Energy Technology Data Exchange (ETDEWEB)

    Hoeppner, Christian C.

    2012-01-31

    In this dissertation, the first measurement of the luminosity for data from the COMPASS experiment is presented. The result is obtained by the direct measurement of the beam flux and the correction of all inefficiencies and dead times of the measurement. The normalized data set consists of about 30% of the COMPASS data recorded in 2004 and the effective integrated luminosity is 142.4 pb{sup -1} {+-} 10%, which is verified by the determination of the structure function F{sub 2} of the nucleon and its comparison to literature. Based on this result, the cross section for the quasi-real photoproduction of charged hadrons with high transverse momenta in muon-deuteron scattering at a center-of-mass energy of {radical}(s)=17.4 GeV is determined. The measurement of a hadron-production cross section in a thick solid-state target is quite challenging in comparison to collider measurements of such processes. The issue of secondary hadronic interactions in the target material is carefully studied and taken into account. The cross section is presented in bins of the pseudo-rapidity of the hadrons and separated by hadron charge. The results are discussed and compared to recent calculations of next-to-leading order perturbative Quantum Chromodynamics. This comparison serves as a test of the applicability of such calculations to the production of hadrons with high transverse momenta at COMPASS energies. The second part of this dissertation describes new developments for charged-particle tracking in high-rate experiments. The design of a new type of Time Projection Chamber (TPC), which employs GEM foils instead of proportional wires for gas amplification, is discussed. This technology opens up the possibility of using TPCs in experiments with trigger rates beyond about 1 kHz. Several important contributions to the GEM-TPC project are presented. Furthermore, a generic framework for track fitting in high-energy physics, called GENFIT, is introduced. This novel software is being used

  7. An Empirical Method Permitting Rapid Determination of the Area, Rate and Distribution of Water-Drop Impingement on an Airfoil of Arbitrary Section at Subsonic Speeds

    Science.gov (United States)

    Bergrun, N. R.

    1951-01-01

    An empirical method for the determination of the area, rate, and distribution of water-drop impingement on airfoils of arbitrary section is presented. The procedure represents an initial step toward the development of a method which is generally applicable in the design of thermal ice-prevention equipment for airplane wing and tail surfaces. Results given by the proposed empirical method are expected to be sufficiently accurate for the purpose of heated-wing design, and can be obtained from a few numerical computations once the velocity distribution over the airfoil has been determined. The empirical method presented for incompressible flow is based on results of extensive water-drop. trajectory computations for five airfoil cases which consisted of 15-percent-thick airfoils encompassing a moderate lift-coefficient range. The differential equations pertaining to the paths of the drops were solved by a differential analyzer. The method developed for incompressible flow is extended to the calculation of area and rate of impingement on straight wings in subsonic compressible flow to indicate the probable effects of compressibility for airfoils at low subsonic Mach numbers.

  8. Self-rated health status and subjective health complaints associated with health-promoting lifestyles among urban Chinese women: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Jingru Cheng

    Full Text Available This study aimed to investigate whether self-rated health status (SRH and subjective health complaints (SHC of urban Chinese women are associated with their health-promoting lifestyles (HPL.We conducted a cross-sectional study on 8142 eligible Chinese participants between 2012 and 2013. Demographic and SHC data were collected. Each subject completed the SRH questionnaire and the Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-II. Correlation and binary regression analyses were performed to examine the associations of SRH and SHC with HPL.Both SRH and HPL of urban Chinese women were moderate. The most common complaints were fatigue (1972, 24.2%, eye discomfort (1571, 19.3%, and insomnia (1542, 18.9%. Teachers, highly educated subjects and elderly women had lower SRH scores, while college students and married women had better HPL. All items of HPLP-II were positively correlated with SRH (r = 0.127-0.533, P = 0.000 and negatively correlated with SHC to a significant extent (odds ratio [OR] = 1.40-11.37.Aspects of HPL, particularly stress management and spiritual growth, are associated with higher SRH and lower SHC ratings among urban Chinese women. Physical activity and health responsibility are additionally related to reduced fatigue and nervousness. We believe that these findings will be instrumental in encouraging researchers and urban women to adopt better health-promoting lifestyles with different priorities in their daily lives.

  9. The Association Between Self-Rated Mental Health Status and Total Health Care Expenditure: A Cross-Sectional Analysis of a Nationally Representative Sample.

    Science.gov (United States)

    Nguyen, Muoi T; Chan, Winnie Y; Keeler, Courtney

    2015-09-01

    Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ tests and a 2-part model (logistics regression and generalized linear model regression for the first and second stages, respectively).Although predictive of any health expenditure, SRMH alone was not highly predictive of the dollar value of that health expenditure conditional on any spending. By comparison, the K6 measure was significantly and positively associated with the probability of any health expenditure as well as the dollar value of that spending. Taken together, both the K6 and SRMH measures suggest a positive relationship between poor mental health and the probability of any health expenditure and total expenditure conditional on any spending, even when adjusting for other confounding factors such as race/ethnicity, sex, age, educational attainment, insurance status, and some regional characteristics.Our results suggest that psychological distress and SRMH may represent potential pathways linking poor mental health to increased health care expenditure. Further research exploring the nuances of these relationships may aid researchers, practitioners, and policy makers in addressing issues of inflated health care expenditure in populations at risk for poor mental health. PMID:26334899

  10. The hospital anxiety and depression rating scale: A cross-sectional study of psychometrics and case finding abilities in general practice

    Directory of Open Access Journals (Sweden)

    Mykletun Arnstein

    2005-12-01

    Full Text Available Abstract Background General practitioners' (GPs diagnostic skills lead to underidentification of generalized anxiety disorders (GAD and major depressive episodes (MDE. Supplement of brief questionnaires could improve the diagnostic accuracy of GPs for these common mental disorders. The aims of this study were to examine the usefulness of The Hospital Anxiety and Depression Rating Scale (HADS for GPs by: 1 Examining its psychometrics in the GPs' setting; 2 Testing its case-finding properties compared to patient-rated GAD and MDE (DSM-IV; and 3 Comparing its case finding abilities to that of the GPs using Clinical Global Impression-Severity (CGI-S rating. Methods In a cross-sectional survey study 1,781 patients in three consecutive days in September 2001 attended 141 GPs geographically spread in Norway. Sensitivity, specificity, optimal cut off score, and Area under the curve (AUC for the HADS and the CGI-S were calculated with Generalized Anxiety Questionnaire (GAS-Q as reference standard for GAD, and Depression Screening Questionnaire (DSQ for MDE. Results The HADS-A had optimal cut off ≥8 (sensitivity 0.89, specificity 0.75, AUC 0.88 and 76% of patients were correctly classified in relation to GAD. The HADS-D had by optimal cut off ≥8 (sensitivity 0.80 and specificity 0.88 AUC 0.93 and 87% of the patients were correctly classified in relation to MDE. Proportions of the total correctly classified at the CGI-S optimal cut-off ≥3 were 83% of patients for GAD and 81% for MDE. Conclusion The results indicate that addition of the patients' HADS scores to GPs' information could improve their diagnostic accuracy of GAD and MDE.

  11. Maternal and fetal arterial blood gas data during general anaesthesia for caesarean delivery of preterm twin lambs.

    Science.gov (United States)

    Musk, G C; Kemp, M W

    2016-06-01

    Much remains to be understood with regards the effects of prolonged anaesthesia on maternal and fetal haemodynamics and oxygenation. With the aim of improving anaesthetic management of pregnant sheep undergoing recovery surgery under anaesthesia, paired maternal and fetal arterial blood samples were collected during caesarean delivery of twin preterm lambs to document the blood gas status of the ewe and fetus. Twenty-one Merino twin pregnant ewes at 126 (±1) days of gestation were anaesthetized for caesarean delivery of their fetuses. Arterial blood samples were collected from the radial artery of the ewe and umbilical artery of the fetus at the point of delivery. There was a significant difference between maternal PaCO2 and end-tidal CO2 and alveolar and arterial PaO2, indicating ventilation perfusion mismatch. Interestingly, the ewes were anaemic but the fetuses were not. These data underscore the need to undertake further work to determine the optimal anaesthetic regimen for twin pregnant ewes at different gestational ages in a biomedical research setting. PMID:26219550

  12. Desigualdade social nas taxas de cesariana em primíparas no Rio Grande do Sul Social inequalities in cesarean section rates in primiparae, Southern Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Fontoura Freitas

    2005-10-01

    Full Text Available OBJETIVO: Investigar o efeito das desigualdades sociais nas taxas de cesariana em primíparas, com gravidez única e parto hospitalar. MÉTODOS: Estudo realizado no Estado do Rio Grande do Sul em 1996, 1998 e 2000. Foram utilizados dados do Sistema de Informação de Nascidos Vivos no cálculo das taxas anuais e das razões de chance de cesariana (RC brutas e ajustadas para condições sociais (escolaridade e idade maternas, etnia/cor da pele e macro-regional de saúde, duração da gestação e número de consultas pré-natal. RESULTADOS: A taxa de cesarianas foi de 45%, e acima de 37% para todas as macro-regionais. As taxas aumentaram entre: mulheres de etnia indígena e negra, mulheres com mais de 30 anos, residentes nas macro-regiões Metropolitana, Vales e Serra, e com mais de seis consultas no pré-natal. Razões brutas e ajustadas indicaram taxas negativamente associadas para todas as categorias de etnia/cor, quando comparadas à cor branca da pele do recém-nascido, em especial para etnia indígena (RCaj=0,43; IC 95%: 0,31-0,59, positivamente associadas à escolaridade (RCaj=3,52; IC 95%: 3,11-3,99 e idade maternas mais elevadas (RCaj=6,87; IC 95%: 5,90-8,00, e maior número de consultas pré-natal (RCaj=2,16; IC 95%: 1,99-2,35. Os efeitos de idade e escolaridade mostraram estar parcialmente mediados pelo maior número de consultas pré-natal nas mulheres com idade e escolaridade mais elevadas. As taxas variaram entre as macro-regionais, sendo maiores na região da Serra, economicamente mais rica. CONCLUSÕES: Altas taxas de cesariana no sul do Brasil constituem problema de saúde pública e estão associadas a fatores sociais, econômicos e culturais, os quais podem levar ao mau-uso da tecnologia médica na atenção ao parto.OBJECTIVE: To investigate the effect of social inequalities in cesarean section rates among primiparae having single pregnancy and delivering in maternity hospitals. METHODS: The study was carried out in Southern

  13. Are doctors and nurses associated with coverage of essential health services in developing countries? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    de Pinho Helen

    2009-03-01

    Full Text Available Abstract Background There is broad policy consensus that a shortage of doctors and nurses is a key constraint to increasing utilization of essential health services important for achieving the health Millennium Development Goals. However there is limited research on the quantitative links between health workers and service coverage rates. We examined the relationship between doctor and nurse concentrations and utilization rates of five essential health services in developing countries. Methods We performed cross-national analyses of low- and middle-income countries by means of ordinary least squares regression with coverage rates of antenatal care, attended delivery, caesarean section, measles immunization, tuberculosis case diagnosis and care for acute respiratory infection as outcomes. Doctor, nurse and aggregate health worker (sum of doctors and nurses concentrations were the main explanatory variables. Results Nurses were associated with utilization of skilled birth attendants (P = 0.02 and doctors were associated with measles immunization rates (P = 0.01 in separate adjusted analyses. Aggregate health workers were associated with the utilization of skilled birth attendants (P Conclusion A range of health system and population-level factors aside from health workers influences coverage of health services in developing countries. However, it is also plausible that health workers who are neither doctors nor nurses, such as clinical officers and community health workers, may be providing a substantial proportion of health services. The human resources for health research agenda should be expanded beyond doctors and nurses.

  14. FEMA DFIRM Cross Sections

    Data.gov (United States)

    Minnesota Department of Natural Resources — FEMA Cross Sections are required for any Digital Flood Insurance Rate Map database where cross sections are shown on the Flood Insurance Rate Map (FIRM). Normally...

  15. Factors associated with good self-rated health of non-disabled elderly living alone in Japan: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Saito Masahisa

    2007-10-01

    Full Text Available Abstract Background Self-rated health (SRH is reported as a reliable predictor of disability and mortality in the aged population and has been studied worldwide to enhance the quality of life of the elderly. Nowadays, the elderly living alone, a particular population at great risk of suffering physical and mental health problems, is increasing rapidly in Japan and could potentially make up the majority of the aged population. However, few data are available pertaining to SRH of this population. Given the fact that sufficient healthcare is provided to the disabled elderly whereas there is little support for non-disabled elderly, we designed this population-based survey to investigate SRH of non-disabled elderly living alone and to identify the factors associated with good SRH with the purpose of aiding health promotion for the elderly. Methods A cross-sectional study was conducted in a metropolitan suburb in Japan. Questionnaires pertaining to SRH and physical conditions, lifestyle factors, psychological status, and social activities, were distributed in October 2005 to individuals aged ≥ 65 years and living alone. Response rate was 75.1%. Among these respondents, a total of 600 male and 2587 female respondents were identified as non-disabled elderly living alone and became our subjects. Multivariate logistic regression was used to identify the factors associated with good SRH and sex-specific effect was tested by stepwise logistic regression. Results Good SRH was reported by 69.8% of men and 73.8% of women. Multivariate logistic regression analysis showed that good SRH correlated with, in odds ratio sequence, "can go out alone to distant places", no depression, no weight loss, absence of self-rated chronic disease, good chewing ability, and good visual ability in men; whereas with "can go out alone to distant places", absence of self-rated chronic disease, no weight loss, no depression, no risk of falling, independent IADL, good chewing

  16. Prevalence and diagnosis rate of intra-abdominal hypertension in critically ill adult patients: A single-center cross-sectional study

    Institute of Scientific and Technical Information of China (English)

    Hua-Yu Zhang; Dong Liu; Hao Tang; Shi-Jin Sun; Shan-Mu Ai; Wen-Qun Yang; Dong-Po Jiang

    2015-01-01

    Purpose: To investigate the prevalence and diagnosis rate of intra-abdominal hypertension (IAH) in a mixed-population intensive care unit (ICU), and to investigate the knowledge of ICU staff regarding the guidelines published by the World Society of Abdominal Compartment Syndrome (WSACS) in 2013.Methods: A one-day cross-sectional study based on the WSACS 2013 guidelines was conducted in the general ICU of a tertiary teaching hospital in Chongqing, China.The included patients were divided into intravesical pressure (IVP) measured group and IVP unmeasured group.The epidemiologic data were recorded, and potential IAH risk factors (RFs) were collected based on the guidelines.IVP measurements were conducted by investigators every 4 h and the result was compared to that measured by the ICU staff to evaluate the diagnosis rate.Besides, a questionnaire was used to investigate the understanding of the guidelines among ICU staff.Results: Thirty-two patients were included, 14 in the IVP measured group and 18 in the IVP unmeasured group.The prevalence of IAH during the survey was 15.63% (5/32), 35.71% (5/14) in IVP measured group.Only one case of IAH had been diagnosed by the ICU physician and the diagnosis rate was as low as 20.00%.Logistic regression analysis showed that sequential organ failure assessment (SOFA) score was an independent RF for IAH (OR: 1.532, 95% CI: 1.029-2.282, p =0.036.Fourteen doctors and 5 nurses were investigated and the response rate was 67.86%.The average scores of the doctors and nurses were 27.14 ± 20.16 and 16.00 ± 8.94 respectively.None of them had studied the WSACS 2013 guidelines thoroughly.Conclusion: Patients with a higher SOFA score has a higher incidence of IAH.The IAH prevalence in 14 ICU patients with indwelling catheter was 35.71%.Strengthening the wide and rational use of WSACS guideline is important to improve the diagnosis of IAH.

  17. Assessing Rates of Inadequate Feeding Practices Among Children 12-24 months: Results from a Cross-Sectional Survey in Myanmar.

    Science.gov (United States)

    Thet, May Me; Richards, Leah-Mari; Sudhinaraset, May; Paw, Naw Eh Thi; Diamond-Smith, Nadia

    2016-08-01

    Objectives To ensure proper nutrition and optimal health outcomes, it is critical that infants are exclusively breastfed (0-6 months) and then receive adequate feeding from 6-23 months (breastfeeding and frequent feedings of complementary foods). Despite policies and guidelines on adequate feeding in Myanmar, past research has found low rates of adequately fed infants 0-11 months and little is known about the adequacy of feeding practices for children 12-23 months. The aim of this study is to understand the feeding practices of children aged 0-24 months in Myanmar and maternal characteristics associated with adequate feeding practices. Methods This study examines the rates of adequately fed infants and young children (0-23 months) in hard-to-reach townships in Myanmar from a cross-sectional, multistage cluster survey. Survey data on nutritional practices were collected from 489 mothers. Data were analyzed using multivariate regressions. Results We found that 41.8 % of infants under 6 months were exclusively breastfed, 63.2 % of those aged 6-11 months were adequately fed, and 10.3 % of 12-23 month-olds were adequately fed. In multivariate regressions we found that antenatal care visits [1-4 visits, AOR = 6.59 (p 4 visits, AOR = 6.63 (p breastfeeding for under 6 month old infants. Having >4 antenatal care visits [AOR = 9.97 (p < 0.05)] was associated with adequate feeding for 6-11 months old infants. Conclusions Future nutritional interventions and policies should focus on improving messaging about adequate feeding practices, especially for 12-23 months olds. PMID:27003151

  18. Estudo clínico e cardiorrespiratório em cadelas gestantes com parto normal ou submetidas à cesariana sob anestesia inalatória com sevofluorano Clinical and cardiorespiratory study in bitches under normal parturition or underwent to cesarean section using inalatory anesthesia with sevoflurane

    Directory of Open Access Journals (Sweden)

    D.T. Gabas

    2006-08-01

    Full Text Available Estudaram-se as alterações hemodinâmicas e respiratórias em cadelas, decorrentes do parto normal e da cesariana, utilizando-se sevofluorano como agente de manutenção anestésica. Foram acompanhados seis partos normais e seis cesarianas, sendo as últimas realizadas sob anestesia geral utilizando-se acepromazina, propofol e sevofluorano. Durante o parto normal, ao nascimento de cada filhote, as gestantes foram monitoradas (temperatura retal, pressão arterial não-invasiva, freqüências respiratória e cardíaca, tempo de reperfusão capilar e gasometria. Durante a cesariana foram avaliadas as mesmas características citadas para o parto normal, acrescentando-se a temperatura esofágica e a pressão arterial invasiva, ao longo de todo o período anestésico, além da qualidade da recuperação anestésica. Os valores das variáveis: freqüência cardíaca, pressão arterial, freqüência respiratória, tempo de reperfusão capilar e o pH do sangue arterial no grupo submetido à cesariana foram menores que os das cadelas de partos normais, evidenciando a relativa depressão cardiorrespiratória produzida pelo procedimento anestésico. O protocolo anestésico empregado não comprometeu a viabilidade e a saúde das parturientes e dos filhotes e é seguro em cadelas gestantes, podendo ser utilizado nas operações cesarianas.Haemodynamic and respiratory changes in 12 bitches, being six of natural birth and six caesarean using sevoflurane as an anaesthetic maintenance agent, were studied. The caesarean sections were performed using general anaesthesia, employing acepromazine maleate, propofol and sevoflurane. During natural birth, as each puppy was being delivered, the bitches were evaluated (rectal temperature, non-invasive arterial blood pressure respiratory and cardiac rate, capillary time reperfusion and blood gas values. During the caesarean, the same parameters mentioned for the natural birth were measured, in addition to the esophagus

  19. 3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: A cross-sectional quality-of-life survey

    Energy Technology Data Exchange (ETDEWEB)

    Vordermark, Dirk [Univ. of Wuerzburg (DE). Dept. of Radiation Oncology] (and others)

    2006-09-15

    The effects of two modalities of dose-escalated radiotherapy on health-related quality of life (HRQOL) were compared. Forty-one consecutive patients were treated with a 3-D conformal (3-DC) boost to 74 Gy, and 43 with high-dose rate (HDR) brachytherapy boost (2x9 Gy), following 3-D conformal treatment to 46 Gy. Median age was 70 years in both groups, median initial PSA was 7.9 {mu}g/l in 3-DC boost patients and 8.1 {mu}g/l in HDR boost patients. Stage was 7 in 52% and 47%, respectively. HRQOL was assessed cross-sectionally using EORTC QLQ-C30 and organ-specific PR25 modules 3-32 (median 19) and 4-25 (median 14) months after treatment, respectively. Questionnaires were completed by 93% and 97% of patients, respectively. Diarrhea and insomnia scores were significantly increased in both groups. In the PR25 module, scores of 3-DC boost and HDR boost patients for urinary, bowel and treatment-related symptoms were similar. Among responders, 34% of 3-DC boost patients and 86% of HDR boost patients had severe erectile problems. Dose escalation in prostate cancer by either 3-DC boost to 74 Gy or HDR brachytherapy boost appears to result in similar HRQOL profiles.

  20. 3-D conformal treatment of prostate cancer to 74 Gy vs. high-dose-rate brachytherapy boost: A cross-sectional quality-of-life survey

    International Nuclear Information System (INIS)

    The effects of two modalities of dose-escalated radiotherapy on health-related quality of life (HRQOL) were compared. Forty-one consecutive patients were treated with a 3-D conformal (3-DC) boost to 74 Gy, and 43 with high-dose rate (HDR) brachytherapy boost (2x9 Gy), following 3-D conformal treatment to 46 Gy. Median age was 70 years in both groups, median initial PSA was 7.9 μg/l in 3-DC boost patients and 8.1 μg/l in HDR boost patients. Stage was 7 in 52% and 47%, respectively. HRQOL was assessed cross-sectionally using EORTC QLQ-C30 and organ-specific PR25 modules 3-32 (median 19) and 4-25 (median 14) months after treatment, respectively. Questionnaires were completed by 93% and 97% of patients, respectively. Diarrhea and insomnia scores were significantly increased in both groups. In the PR25 module, scores of 3-DC boost and HDR boost patients for urinary, bowel and treatment-related symptoms were similar. Among responders, 34% of 3-DC boost patients and 86% of HDR boost patients had severe erectile problems. Dose escalation in prostate cancer by either 3-DC boost to 74 Gy or HDR brachytherapy boost appears to result in similar HRQOL profiles

  1. Investigation on the comprehensive intervention measures to reduce cesarean section rate%探讨降低剖宫产率的综合干预措施

    Institute of Scientific and Technical Information of China (English)

    孟柳

    2016-01-01

    目的:分析综合干预措施降低剖宫产率的效果。方法选取在焦作市妇幼保健院分娩的孕妇共316例为研究对象,随机分为观察组和对照组,每组158例,孕12~18周时建卡,对照组进行常规定期孕检和健康知识指导,观察组进行综合干预措施,包括:孕期知识讲座、定期孕检、孕期心理指导、孕期锻炼、产程指导等。对比分析两组的剖宫产影响因素、剖宫产率以及妊娠相关并发症情况。结果在剖宫产影响因素方面,孕方要求剖宫产、产程异常、胎儿窘迫、及妊娠相关并发症所占比例方面对比差异有统计学意义(P0.05),观察组剖宫产率为32.3%(51/158),对照组剖宫产率为63.3%(100/158),两组对比差异有统计学意义(P0. 05). The observation group of cesarean delivery rate was 32. 3% (51/158), the control group the cesarean delivery rate was 63. 3%(100/158), and they are significantly different (P<0. 05). Conclusions For maternal by prenatal comprehensive inter-vention measures, strictly regulate antenatal examination, pregnancy knowledge lecture psychological guidance, exercise during pregnancy and labor guidance can effectively reduce the cesarean section rate, and can also effectively reduce the complications related to pregnancy, so it is worthy of clinical popularization and application.

  2. Flood Insurance Rate Maps and Base Flood Elevations, FIRM, DFIRM, BFE - FLOODPLAINS_CROSSSECTION_DFIRM_IDNR_IN: DFIRM Floodplain Cross section Lines for 86 of 92 Counties in Indiana (Indiana Department of Natural Resources, 1:12,000, Line Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This line layer represents cross sections (XS) created from FEMA Flood Rate Insurance Maps (FIRM). These lines represent the locations of channel surveys performed...

  3. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    Science.gov (United States)

    DeMuro, Jp; Hanna, Af; Chalas, E; Cunha, Ba

    2012-01-01

    We report a case of a previously healthy woman after an uneventful caesarean section who developed polymicrobial necrotizing fasciitis. She was given a non-steroidal anti-inflamatory drug (NSAID) after her delivery. Her post-delivery course was complicated by septic shock, and required multiple debridements before abdominal reconstruction. This case describes the increased risk of necrotizing fasciitis with NSAID use. Unusual were the organisms causing the polymicrobial necrotizing fasciitis: Staphylococcus aureus, Enterobacter agglomerans, Acinetobacter baumannii, and two strains of Enterobacter cloacae. PMID:24960796

  4. Birth in Brazil: national survey into labour and birth

    OpenAIRE

    do Carmo Leal Maria; da Silva Antônio Augusto; Dias Marcos Augusto; da Gama Silvana Granado; Rattner Daphne; Moreira Maria; Filha Mariza Miranda; Domingues RosaMariaSoaresMadeira; Pereira Ana Paula; Torres Jacqueline; Bittencourt Sonia Duarte; D’orsi Eleonora; Cunha Antonio JLA; Leite Alvaro Jorge; Cavalcante Rejane

    2012-01-01

    Abstract Background Caesarean section rates in Brazil have been steadily increasing. In 2009, for the first time, the number of children born by this type of procedure was greater than the number of vaginal births. Caesarean section is associated with a series of adverse effects on the women and newborn, and recent evidence suggests that the increasing rates of prematurity and low birth weight in Brazil are associated to the increasing rates of Caesarean section and labour induction. Methods ...

  5. Caesarean Delivery and Postpartum Maternal Mortality: A Population-Based Case Control Study in Brazil

    Science.gov (United States)

    Esteves-Pereira, Ana Paula; Deneux-Tharaux, Catherine; Nakamura-Pereira, Marcos; Saucedo, Monica; Bouvier-Colle, Marie-Hélène; Leal, Maria do Carmo

    2016-01-01

    Background Cesarean delivery rates continue to increase worldwide and reached 57% in Brazil in 2014. Although the safety of this surgery has improved in the last decades, this trend is a concern because it carries potential risks to women’s health and may be a modifiable risk factor of maternal mortality. This paper aims to investigate the risk of postpartum maternal death directly associated with cesarean delivery in comparison to vaginal delivery in Brazil. Methods This was a population-based case—control study performed in eight Brazilian states. To control for indication bias, deaths due to antenatal morbidity were excluded. We included 73 cases of postpartum maternal deaths from 2009–2012. Controls were selected from the Birth in Brazil Study, a 2011 nationwide survey including 9,221 postpartum women. We examined the association of cesarean section and postpartum maternal death by multivariate logistic regression, adjusting for confounders. Results After controlling for indication bias and confounders, the risk of postpartum maternal death was almost three-fold higher with cesarean than vaginal delivery (OR 2.87, 95% CI 1.63–5.06), mainly due to deaths from postpartum hemorrhage and complications of anesthesia. Conclusion Cesarean delivery is an independent risk factor of postpartum maternal death. Clinicians and patients should consider this fact in balancing the benefits and risks of the procedure. PMID:27073870

  6. "Human immunodeficiency virus serostatus disclosure-Rate, reactions, and discrimination": A cross-sectional study at a rural tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Umesh S Joge

    2013-01-01

    Full Text Available Background: From the moment scientists identified Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS, social responses of fear, denial, stigma, and discrimination have accompanied the epidemic. Aims: To assess the rate of disclosure of HIV serostatus, reactions by the HIV/AIDS patients and their spouse, and discrimination faced by the patients. Methods: The present cross-sectional study was conducted at Antiretroviral Therapy (ART center of a rural tertiary care hospital, situated in Marathawada region of Maharashtra state from November 2008 to October 2010. Totally, 801 HIV-positive patients coming to ART center for treatment were included after ensuring confidentiality and taking informed consent. A preformed questionnaire was used to enquire about reaction after diagnosis, disclosure, and discrimination faced by the patients. The data analyzed using descriptive statistics and Chi-square test. Results: The most common immediate reaction by the HIV patients after getting diagnosed as seropositive was fear (593, 74.03% followed by depression (385, 48.06% and suicidal thoughts (98, 12.25%. Out of 801 patients, 769 (96% had spouse and of these maximum number of patients (653, 84.92% had disclosed HIV status to their spouses. Most common immediate reaction by spouse after disclosure was crime (324, 42.13% followed by horror (294, 38.23% and anger (237, 36.29%. Maximum number of patients were discriminated by friends (120, 71.01% followed by discrimination at workplace (49, 67.12%, by neighbors (32, 56.14%, and by relatives (53, 43.80%. Conclusion: Male positives were granted greater acceptance, care, and support by their spouses. More percentage of females discriminated by neighbors, relatives, and friends and at workplace which might be due to factors like customs, morals, and taboos.

  7. Self-rated health showed a consistent association with serum HDL-cholesterol in the cross-sectional Oslo Health Study

    Directory of Open Access Journals (Sweden)

    Sissel E. Tomten, Arne T. Høstmark

    2007-01-01

    Full Text Available Objective: To examine the association between serum HDL-cholesterol concentration (HDL-C and self rated health (SRH in several age groups of men and women. Study design and setting: The study had a cross-sectional design and included 18,770 men and women of the Oslo Health Study aged 30; 40 and 45; 69-60; 75-76 years. Results: In both sexes and all age groups, SRH (3 categories: poor, good, very good was positively correlated with HDL-C. Logistic regression analysis on dichotomized values of SRH (i.e. poor vs. good health in each age group of men and women showed that increasing HDL-C values were associated with increasing odds for reporting good health; the odds ratio (OR was highest in young men, and was generally lower in women than in men. Odds ratios in the 4 age groups of men were 4.94 (2.63-9.29, 2.25 (1.63-3.09, 2.12 (1.58-2.86, 1.87 (1.37-2.54; and in women: 3.58 (2.46-5.21, 2.81 (2.23-3.53, 2.28 (1.84-2.82, 1.61 (1.31-1.99. In the whole material, 1 mmol/L increase in HDL-C increased the odds for reporting good health by 2.27 (2.06-2.50; p<0.001, when adjusting for sex, age group, time since food intake and use of cholesterol lowering drugs. Chronic diseases, pain, psychological distress, smoking, alcohol, length of education, and dietary items did not have any major influence on the pattern of the HDL-C vs. SRH association. Conclusion: There was a consistent positive association between HDL-C and SRH, in both men and women in four different age groups, with the strongest association in young people.

  8. The goitre rate, its association with reproductive failure, and the knowledge of iodine deficiency disorders (IDD among women in Ethiopia: Cross-section community based study

    Directory of Open Access Journals (Sweden)

    Berhane Yemane

    2007-11-01

    Full Text Available Abstract Background Iodine deficiency is severe public health problem in Ethiopia. Although urinary iodine excretion level (UIE is a better indicator for IDD the goitre rate is commonly used to mark the public health significance. The range of ill effect of IDD is however beyond goitre in Ethiopia. In this study the prevalence of goitre and its association with reproductive failure, and the knowledge of women on Iodine Deficiency were investigated. Methods A cross-section community based study was conducted during February to May 2005 in 10998 women in child bearing age of 15 to 49 years. To assess the state of iodine deficiency in Ethiopia, a multistage "Proportional to Population Size" (PPS sampling methods was used, and WHO/UNICEF/ICCIDD recommended method for goitre classification. Results Total goitre prevalence (weighted was 35.8% (95% CI 34.5–37.1, 24.3% palpable and 11.5% visible goitre. This demonstrates that more than 6 million women were affected by goitre. Goitre prevalence in four regional states namely Southern Nation Nationalities and People (SNNP, Oromia, Bebshandul-Gumuz and Tigray was greater than 30%, an indication of severe iodine deficiency. In the rest of the regions except Gambella, the IDD situation was mild to moderate. According to WHO/UNICEF/ICCIDD this is a lucid indication that IDD is a major public health problem in Ethiopia. Women with goitre experience more pregnancy failure (X2 = 16.5, p 2 = 67.52; p Conclusion Ethiopia is at risk of iodine deficiency disorders. The findings presented in this report emphasis on a sustainable iodine intervention program targeted at population particularly reproductive age women. Nutrition education along with Universal Salt Iodization program and iodized oil capsule distribution in some peripheries where iodine deficiency is severe is urgently required.

  9. Autonomic dysfunction in mild cognitive impairment: evidence from power spectral analysis of heart rate variability in a cross-sectional case-control study.

    Directory of Open Access Journals (Sweden)

    Paola Nicolini

    Full Text Available Mild cognitive impairment (MCI is set to become a major health problem with the exponential ageing of the world's population. The association between MCI and autonomic dysfunction, supported by indirect evidence and rich with clinical implications in terms of progression to dementia and increased risk of mortality and falls, has never been specifically demonstrated.To conduct a comprehensive assessment of autonomic function in subjects with MCI by means of power spectral analysis (PSA of heart rate variability (HRV at rest and during provocative manoeuvres.This cross-sectional study involved 80 older outpatients (aged ≥ 65 consecutively referred to a geriatric unit and diagnosed with MCI or normal cognition (controls based on neuropsychological testing. PSA was performed on 5-minute electrocardiographic recordings under three conditions--supine rest with free breathing (baseline, supine rest with paced breathing at 12 breaths/minute (parasympathetic stimulation, and active standing (orthosympathetic stimulation--with particular focus on the changes from baseline to stimulation of indices of sympathovagal balance: normalized low frequency (LFn and high frequency (HFn powers and the LF/HF ratio. Blood pressure (BP was measured at baseline and during standing. Given its exploratory nature in a clinical population the study included subjects on medications with a potential to affect HRV.There were no significant differences in HRV indices between the two groups at baseline. MCI subjects exhibited smaller physiological changes in all three HRV indices during active standing, consistently with a dysfunction of the orthosympathetic system. Systolic BP after 10 minutes of standing was lower in MCI subjects, suggesting dysautonomia-related orthostatic BP dysregulation.Our study is novel in providing evidence of autonomic dysfunction in MCI. This is associated with orthostatic BP dysregulation and the ongoing follow-up of the study population will

  10. 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.

  11. Electron-Ion Recombination Rate Coefficients and Photoionization Cross Sections for Astrophysically Abundant Elements. VII. Relativistic calculations for O VI and O VII for UV and X-ray modeling

    CERN Document Server

    Nahar, S N; Nahar, Sultana N.; Pradhan, Anil K.

    2003-01-01

    Aimed at ionization balance and spectral analysis of UV and X-ray sources, we present self-consistent sets of photoionization cross sections, recombination cross sections, and rate coefficients for Li-like O VI and He-like O VII. Relativistic fine structure is considered through the Breit-Pauli R-matrix (BPRM) method in the close coupling approximation, implementing the unified treatment for total electron-ion recombination subsuming both radiative and di-electronic recombination processes. Self-consistency is ensured by using an identical wavefunction expansion for the inverse processes of photoionization and photo-recombination. Radiation damping of resonances, important for H-like and He-like core ions, is included. Compared to previous LS coupling results without radiative decay of low-n (<= 10) resonances, the presents results show significant reduction in O VI recombination rates at high temperatures. In addition to the total rates, level-specific photoionization cross sections and recombination rate...

  12. Effect on survey response rate of hand written versus printed signature on a covering letter: randomised controlled trial [ISRCTN67566265

    Directory of Open Access Journals (Sweden)

    Ayers Sarah

    2005-08-01

    Full Text Available Abstract Background It is important that response rates to postal surveys are as high as possible to ensure that the results are representative and to maximise statistical power. Previous research has suggested that any personalisation of approach helps to improve the response rate. This experiment tested whether personalising questionnaires by hand signing the covering letter improved the response rate compared with a non-personalised group where the investigator's signature on the covering letter was scanned into the document and printed. Methods Randomised controlled trial. Questionnaires about surgical techniques of caesarean section were mailed to 3,799 Members and Fellows of the Royal College of Obstetricians and Gynaecologists resident in the UK. Individuals were randomly allocated to receive a covering letter with either a computer printed signature or a hand written signature. Two reminders were sent to non-respondents. The outcome measures were the proportion of questionnaires returned and their time to return. Results The response rate was 79.1% (1506/1905 in the hand-signed group and 78.4% (1484/1894 in the scanned and printed signature group. There was no detectable difference between the groups in response rate or time taken to respond. Conclusion No advantage was detected to hand signing the covering letter accompanying a postal questionnaire to health professionals.

  13. Pregnancy risk assessment monitoring system in Ireland: methods and response rates

    LENUS (Irish Health Repository)

    O’Keeffe, Linda M.

    2014-06-01

    To describe response rates and characteristics associated with response to the Pregnancy Risk Assessment Monitoring System study in Ireland (PRAMS Ireland). Using hospital discharge records of live births at a large, urban, obstetric hospital, a sampling frame of approximately 2,400 mother-infant pairs were used to alternately sample 1,200 women. Mothers’ information including name, address, parity, age and infant characteristics such as sex and gestational age at delivery were extracted from records. Modes of contact included an invitation letter with option to opt out of the study, three mail surveys, a reminder letter and text message reminder for remaining non-respondents. Sixty-one per cent of women responded to the PRAMS Ireland survey over a 133 day response period. Women aged <30, single women, multiparous women and women with a preterm delivery were less likely to respond. Women participating in PRAMS Ireland were similar to the national birth profile in 2011 which had a mean age of 32, were 40 % primiparous, 33 % single or never married and had a 28 % caesarean section rate. Survey and protocol changes are required to increase response rates above recommended Centers for Disease Control and Prevention (CDC) thresholds of 65 % within the recommended 90 day data collection cycle. Additional efforts such as stratification and over-sampling are required to increase representativeness among hard to reach groups such as younger, single and multiparous women before expanding the project to an ongoing, national surveillance system in Ireland.

  14. Determinants of self-rated health in old age: A population-based, cross-sectional study using the International Classification of Functioning

    Directory of Open Access Journals (Sweden)

    Stenlund Hans

    2011-08-01

    Full Text Available Abstract Background Self-rated health (SRH is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas. Methods The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF. Results Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p p = 0.040, household physical activity (adjOR = 1.01, p = 0.016, and older age (adjOR = 1.09, p = 0.006; but decreased with more depressive symptoms (adjOR = 0.79, p Conclusions The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due

  15. Neutron Thermal Cross Sections, Westcott Factors, Resonance Integrals, Maxwellian Averaged Cross Sections and Astrophysical Reaction Rates Calculated from the ENDF/B-VII.1, JEFF-3.1.2, JENDL-4.0, ROSFOND-2010, CENDL-3.1 and EAF-2010 Evaluated Data Libraries

    Science.gov (United States)

    Pritychenko, B.; Mughabghab, S. F.

    2012-12-01

    We present calculations of neutron thermal cross sections, Westcott factors, resonance integrals, Maxwellian-averaged cross sections and astrophysical reaction rates for 843 ENDF materials using data from the major evaluated nuclear libraries and European activation file. Extensive analysis of newly-evaluated neutron reaction cross sections, neutron covariances, and improvements in data processing techniques motivated us to calculate nuclear industry and neutron physics quantities, produce s-process Maxwellian-averaged cross sections and astrophysical reaction rates, systematically calculate uncertainties, and provide additional insights on currently available neutron-induced reaction data. Nuclear reaction calculations are discussed and new results are presented. Due to space limitations, the present paper contains only calculated Maxwellian-averaged cross sections and their uncertainties. The complete data sets for all results are published in the Brookhaven National Laboratory report.

  16. Electron-Ion Recombination Rate Coefficients and Photoionization Cross Sections for Astrophysically Abundant Elements. VII. Relativistic calculations for O VI and O VII for UV and X-ray modeling

    OpenAIRE

    Nahar, Sultana N.; Pradhan, Anil K.

    2003-01-01

    Aimed at ionization balance and spectral analysis of UV and X-ray sources, we present self-consistent sets of photoionization cross sections, recombination cross sections, and rate coefficients for Li-like O VI and He-like O VII. Relativistic fine structure is considered through the Breit-Pauli R-matrix (BPRM) method in the close coupling approximation, implementing the unified treatment for total electron-ion recombination subsuming both radiative and di-electronic recombination processes. S...

  17. Clinical Study of Transverse Incision Outside the Peritoneum Caesarean Technique%横切口腹膜外剖宫产的临床研究

    Institute of Scientific and Technical Information of China (English)

    蔡宇

    2009-01-01

    目的 探讨横切口腹膜外剖宫产术的临床价值.方法 对55例因孕足月行剖宫产术的患者随机分成两组,研究者35例采用腹部横切口腹膜外子宫下段剖宫产术,对照组20例采用传统经腹子宫下段剖宫产术.结果 横切口腹膜外剖宫产术操作简单,组织损伤小,手术时间短,出血量少,术后疼痛轻,恢复快,住院时间短,皮肤外表美观等优点.结论 横切口腹膜外剖宫产术优于传统的经腹子宫下段剖宫产术.%Objective:Explore the clinical value of the transverse cutting outside the peritoneum caesarean technique.Method: The 55 examples of the full-term pregnant women are randomly divided into two groups. The research group of 35 uses the abdomen transverse cutting on the lower womb outside the peritoneum while the comparison group of 20 uses the traditional cesarean technique.Results: The advantages of transverse cutting outside the peritoneum caesarean technique are many: it is a simple procedure that causes slight tissue damage and requires less operation time. Patients undergo less pain, less hemorrhage, speedier recovery, shorter hospitalization, and the scar has a more aesthetical appearance.Conclusion: The transverse cutting outside the peritoneum caesarean technique is superior to the traditional caesarean technique.

  18. Inverted Takotsubo-Like Left Ventricular Dysfunction with Pulmonary Oedema Developed after Caesarean Delivery Complicated by Massive Haemorrhage in a Severe Preeclamptic Parturient with a Prolonged Painful Labour

    OpenAIRE

    Hyejin Jeong; Seongheon Lee; Cheolwon Jeong; Jongun Lee; Seongtae Jeong; Sungsu Chung; Kyungyeon Yoo

    2011-01-01

    Inverted takotsubo cardiomyopathy (TTC), a variant of stress-induced cardiomyopathy, features transient myocardial dysfunction characterized by a hyperdynamic left ventricular apex and akinesia of the base. Herein, we describe a 38-year-old primigravida with severe preeclampsia who had active labour for 4 h followed by an emergency caesarean delivery. She developed postpartum haemorrhage due to uterine atony complicated by pulmonary oedema, which was managed with large-volume infusion and hys...

  19. Organizational justice is related to heart rate variability in white-collar workers, but not in blue-collar workers - findings from a cross-sectional study

    NARCIS (Netherlands)

    R.M. Herr; J.A. Bosch; A.E.M. van Vianen; M.N. Jarczok; J.F. Thayer; J. Li; B. Schmidt; J.E. Fischer; A. Loerbroks

    2015-01-01

    Background: Perceived injustice at work predicts coronary heart disease. Vagal dysregulation represents a potential psychobiological pathway. Purpose: We examined associations between organizational justice and heart rate variability (HRV) indicators. Grounded in social exchange and psychological co

  20. Comparison of the Schwartz and CKD-EPI Equations for Estimating Glomerular Filtration Rate in Children, Adolescents, and Adults: A Retrospective Cross-Sectional Study

    OpenAIRE

    Luciano Selistre; Muriel Rabilloud; Pierre Cochat; Vandréa de Souza; Jean Iwaz; Sandrine Lemoine; Françoise Beyerle; Carlos E Poli-de-Figueiredo; Laurence Dubourg

    2016-01-01

    Editors' Summary Background Throughout life, our kidneys filter waste products (from food and from the normal breakdown of tissues) and excess water from our blood to make urine. If our kidneys stop working for any reason, the rate at which they filter the blood (the glomerular filtration rate, or GFR) decreases, and dangerous amounts of creatinine and other waste products build up in the blood. Kidneys can stop working suddenly, but in chronic kidney disease (CKD), a condition that affects m...

  1. Differential associations between actual and expected GP practice prescribing rates for statins, ACE inhibitors, and beta-blockers: a cross-sectional study in England

    OpenAIRE

    Ward, Paul R; Noyce, Peter R; St Leger, Antony S

    2005-01-01

    Aim To explore the relationship between actual and expected general medical practitioner (GP) practice prescribing rates for statins, angiotensin converting enzyme (ACE) inhibitors, and beta-blockers. Background There is a growing body of literature highlighting inequities in GP practice prescribing rates for many drug therapies. The equity of prescribing is of central importance in the area of therapeutics since it explores the interface between those patients who should and those who actual...

  2. Theoretical vibrational-excitation cross sections and rate coefficients for electron-impact resonant collisions involving rovibrationally excited N2 and NO molecules

    CERN Document Server

    Laporta, V; Wadehra, J M

    2012-01-01

    Electron-impact vi->vf vibrational excitations cross sections, involving rovibrationally excited N_{2}(v_{i}, J) and NO(v_{i}, J) molecules (fixed J), are calculated for collisions occurring through the nitrogen resonant electronic state N_{2}^{-} (X ^{2}\\Pi_{g}), and the three resonant states of nitric oxide NO^{-}(^{3}\\Sigma^{-},^{1} \\Delta,^{1} \\Sigma^{+}). Complete sets of cross sections have been obtained for all possible transitions involving 68 vibrational levels of N2(X ^{1}\\Sigma^{+}_{g}) and 55 levels of NO(X ^{2}\\Pi), for the incident electron energy between 0.1 and 10 eV. In order to study the rotational motion in the resonant processes, cross sections have been also computed for rotationally elastic transitions characterized by the rotational quantum number J running from 0 through 150. The calculations are performed within the framework of the local complex potential model, by using potentials energies and widths optimized in order to reproduce the experimental cross sections available in litera...

  3. Measurements of heavy-ion anisotropy and dose rates in the Russian section of the International Space Station with the Sileye-3/Alteino detector

    International Nuclear Information System (INIS)

    In this work we present data on linear energy transfer (LET), dose and dose equivalent rates from different locations of the Russian part of the International Space Station (ISS) measured by the Sileye-3/Alteino detector. Data were taken as part of the ESA ALTCRISS project from late 2005 through 2007. The LET rate data shows a heavy-ion (LET >50 keV/μm) anisotropy. From the heavy-ion LET rate in the Zvezda service module we find ISS y-hat (Starboard) and z-hat (Nadir) to be about 10–15 times higher than in x-hat (Forward). The situation is similar for dose and dose equivalent rates, ranging from 25–40 μGy d−1 in x-hat to about 75 μGy d−1 in z-hat , whereas for the dose equivalent the rate peaks in y-hat with around 470 μSv d−1. The heavy-ion anisotropy confirms what has been reported by the ALTEA collaboration. Measurements using two sets of passive detectors, DLR-TLDs and PADLES (TLD+CR-39), have also been performed in conjunction with Alteino measurements, both shielded and unshielded. The passive detectors register a dose rate about 3–5 times as high as Alteino, 260–280 μGy d−1 for PADLES and 200–260 μGy d−1 for DLR-TLDs. For the dose equivalent PADLES measurements ranges from 560–740 μSv d−1. (paper)

  4. Z $\\rightarrow$ $\\tau\\tau$ Cross Section Measurement and Liquid-Argon Calorimeter Performance at High Rates at the ATLAS Experiment

    CERN Document Server

    Seifert, Frank

    In this study, a measurement of the production cross section of Standard Model $Z$ bosons in proton-proton collisions in the decay channel $Z\\rightarrow\\tau\\tau$ is performed with data of 1.34$\\,\\mathrm{fb^{-1}}$ - 1.55$\\,\\mathrm{fb^{-1}}$ recorded by the ATLAS experiment at the LHC at a center-of-mass energy of $\\sqrt{s}=7\\,\\mathrm{TeV}$. An event selection of the data is applied in order to obtain a sample enriched with $Z\\rightarrow\\tau\\tau$ events. After background estimations using data and Monte Carlo (MC) simulations, the fiducial cross sections in the sub-channels $Z\\rightarrow\\tau\\tau\\rightarrow e\\tau_h + 3\

  5. Relationship of urinary endothelin-1 with estimated glomerular filtration rate in autosomal dominant polycystic kidney disease: a pilot cross-sectional analysis

    OpenAIRE

    Raina, Rupesh; Lou, Linda; Berger, Bruce; Vogt, Beth; Do, Angelique Sao-Mai; Cunningham, Robert; Vasavada, Pauravi; Herrmann, Karin; Dell, Katherine; Simonson, Michael

    2016-01-01

    Background The pathogenesis of progressive renal insufficiency in autosomal dominant polycystic kidney disease (ADPKD) is unclear. Evidence from experimental models of ADPKD suggests that elevated endothelin-1 (ET-1) drives cyst growth, renal fibrosis and loss of renal function, but whether ET-1 is elevated in humans with ADPKD is uncertain. Methods In a cross-sectional study of ADPKD we measured urinary ET-1, a surrogate for ET-1 in kidney cortex, in spot collections corrected for creatinine...

  6. Electron attachment line shapes, cross sections, and rate constants at ultralow energies in CF3SO3H, (CF3SO2)2O, and CF3I

    Science.gov (United States)

    Alajajian, S. H.; Man, K.-F.; Chutjian, A.

    1991-01-01

    Electron attachment cross sections are reported in the energy range 0-160 meV, and at resolutions of 6.0-6.5 meV (FWHM) for the molecules CF3SO3H (triflic acid), (CF3SO2)2O (triflic anhydride), and CF3I (methyl iodide). Use is made of the Kr photoionization method. Attachment line shapes are deconvoluted from the spectral slit (electron energy) function, and are converted to cross sections by normalization to thermal attachment rate constants at 300 K. Rate constants as a function of mean electron energy are calculated from the cross sections using a Maxwellian electron energy distribution function. Present data are compared with flowing-afterglow, Langmuir-probe results in triflic acid and anhydride, and with high-Rydberg ionization results in CF3I.

  7. Measurement of the Inclusive Electron Cross-Section from Heavy Flavour Decays and of the Bottom Production Rate with the ATLAS Experiment

    CERN Document Server

    Mora Herrera, Maria Clemencia Rosario; Wu, Xin

    This thesis presents a measurement of the inclusive electron production cross-section from heavy-flavour decays with the ATLAS experiment at the LHC. A dataset of proton-proton collisions at a center-of-mass energy of 7 TeV with a total integrated luminosity of 1.28 +- 0.04 pb-1 is used for this measurement. Signal electrons, arising predominantly from semi-leptonic decays of charm and bottom hadrons, are extracted using a binned maximum likelihood method. A combination of particle identification techniques is used to discriminate against the dominant backgrounds of hadron fakes and photon conversions. Taking into account trigger, reconstruction and identification efficiencies, the extracted inclusive electron spectrum is unfolded into a differential cross-section as a function of the electron transverse momentum. A good agreement is found with theoretical predictions and with an ATLAS measurement using muons in the final state. The integrated cross-section for electrons originating from heavy- flavour decay...

  8. Effects of a simple or a complex starter microbiota on intestinal microbiota composition in caesarean derived piglets.

    Science.gov (United States)

    Jansman, A J M; Zhang, J; Koopmans, S J; Dekker, R A; Smidt, H

    2012-12-01

    The present study was designed to develop a model in piglets that allows the investigation of the effects of postnatal association with a simple or a complex microbiota on gut health and development. Thirty piglets from 2 sows were obtained by caesarean delivery (day 0) and were equally divided over 2 treatment groups housed in separate clean, nonsterile rooms. All piglets received orally a simple microbiota consisting of Lactobacillus amylovorus, Clostridium glycolicum, and Parabacteroides spp. on days 1, 2, and 3 after birth. On day 3 and 4 the piglets received either a complex microbiota by providing them with a fecal inoculant of an adult sow [complex association (CA)] or a placebo inoculant [simple association (SA)]. Fecal microbiota composition, as determined by denaturing gradient gel electrophoresis and by pig intestinal tract chip (PITChip) analysis of 16S rRNA genes (days 3, 5, 7, 14, and 28), was less diverse in the SA group compared to the CA group. A difference in fecal microbiota composition between treatments persisted until the end of the study. It was concluded that the composition of microbiota in feces of cesarean delivery-derived piglets is influenced by bacterial association in the first days after birth. Differences in fecal microbiota composition between piglets exposed to a simple or complex inoculum at early age persisted for at least 3 wk. PMID:23365401

  9. Healthy Zero Energy Buildings (HZEB) Program - Cross-Sectional Study of Contaminant Levels, Source, Strengths, and Ventilation Rates in Retail Stores

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Wanyu R.; Sidheswaran, Meera; Cohn, Sebastian; Sullivan, Douglas P.; Fisk, William

    2014-02-01

    This field study measured ventilation rates and indoor air quality parameters in 21 visits to retail stores in California. The data was collected to guide the development of new, science-based commercial building ventilation rate standards that balance the dual objectives of increasing energy efficiency and maintaining acceptable indoor air quality. Data collection occurred between September 2011 and March 2013. Three types of stores participated in this study: grocery stores, furniture/hardware stores, and apparel stores. Ventilation rates and indoor air contaminant concentrations were measured on a weekday, typically between 9 am and 6 pm. Ventilation rates measured using a tracer gas decay method exceeded the minimum requirement of California’s Title 24 Standard in all but one store. Even though there was adequate ventilation according to Title 24, concentrations of formaldehyde, acetaldehyde, and acrolein exceeded the most stringent chronic health guidelines. Other indoor air contaminants measured included carbon dioxide (CO{sub 2}), carbon monoxide (CO), ozone (O{sub 3}), and particulate matter (PM). Concentrations of CO{sub 2} were kept low by adequate ventilation, and were assumed low also because the sampling occurred on a weekday when retail stores were less busy. CO concentrations were also low. The indoor-outdoor ratios of O{sub 3} showed that the first-order loss rate may vary by store trade types and also by ventilation mode (mechanical versus natural). Analysis of fine and ultrafine PM measurements showed that a substantial portion of the particle mass in grocery stores with cooking-related emissions was in particles less than 0.3 μm. Stores without cooking as an indoor source had PM size distributions that were more similar indoors and outdoors. The whole-building emission rates of volatile organic compounds (VOCs) and PM were estimated from the measured ventilation rates and indoor and outdoor contaminant concentrations. Mass balance models were

  10. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients

    OpenAIRE

    Xiu-Bin Tao; Li-Hua Qian; Yan Li; Qun Wu; Jing-Jing Ruan; Dong-Zhen Cai; Hui Peng

    2014-01-01

    A single-day hospital-acquired infections (HAIs) point prevalence study was conducted in a tertiary care hospital in China. The overall prevalence rate of HAIs was 3.53% (95% confidence interval 2.80–4.26%) among 2434 inpatients surveyed. Respiratory system infection was the most common type of HAI (49.43%), followed by surgical site infection (22.99%). The pathogen detection results for 50 patients showed Pseudomonas aeruginosa to account for 24.00% of isolates, followed by Klebsiella pneumo...

  11. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients

    Directory of Open Access Journals (Sweden)

    Xiu-Bin Tao

    2014-10-01

    Full Text Available A single-day hospital-acquired infections (HAIs point prevalence study was conducted in a tertiary care hospital in China. The overall prevalence rate of HAIs was 3.53% (95% confidence interval 2.80–4.26% among 2434 inpatients surveyed. Respiratory system infection was the most common type of HAI (49.43%, followed by surgical site infection (22.99%. The pathogen detection results for 50 patients showed Pseudomonas aeruginosa to account for 24.00% of isolates, followed by Klebsiella pneumoniae (14.00% and Escherichia coli (14.00%.

  12. QCC Application in Improving Breast Feeding Rate of Cesarean Section%品管圈活动在提高剖宫产产妇母乳喂养率中的应用

    Institute of Scientific and Technical Information of China (English)

    张锦霞; 刘丽芳

    2015-01-01

    目的:探讨品管圈活动对提高剖宫产产妇母乳喂养率的效果。方法:在品管圈活动前先对科室的剖宫产产妇的母乳喂养率进行统计。由10名护士自愿组成一个品管圈,成立质量控制品管圈,确立提高剖宫产产妇母乳喂养率为活动主题,对活动前科室的剖宫产产妇母乳喂养现状进行调查,找出母乳喂养不足或未进行母乳喂养的原因,制定和落实整改措施。结果:通过开展品管圈活动,剖宫产产妇的母乳喂养率较实施品管圈活动前有提高,比较差异有统计学意义(P<0.05)。结论:开展品管圈活动提高了剖宫产产妇的母乳喂养率,提高了产妇满意度,同时也提高了圈员的团队合作精神和质量管理能力。%Objective:To investigate the effect of QCC activities in improving breast feeding rate of cesarean section.Method:The management circle activities in before the hospital cesarean section maternal breastfeeding rate statistics,by 10 nurses voluntarily formed a quality control circle,the establishment of quality control circle,the establishment of increasing cesarean section rate of breastfeeding as the theme,the activity before sections of the cesarean section maternal breast milk feeding status of the investigation,find out the reasons of insufficient breastfeeding breastfeeding,formulate and implement rectification measures.Result:The circle activities of cesarean section rate of breast feeding was improved QCC ago through the development of quality management,by comparison with statistical significance(P<0.05).Conclusion:The QCC increases cesarean section rate of breast feeding and increased maternal satisfaction,but also improve the team cooperation spirit and quality management capability of the ring member.

  13. Quantification by image analysis on thin sections of lessivage and bioturbation rates in soils in response to land use change and recycling of organic residues

    Science.gov (United States)

    Sauzet, Ophélie; Montagne, David; Cammas, Cécilia; Gilliot, Jean Marc

    2014-05-01

    Land agricultural management has strongly influenced soil evolution during the so-called anthropocene and agricultural practices have to be now assessed according to their influence on soil processes. However, there is a lack of quantitative data about agricultural effect on soil processes and their dynamics especially at generational time scale (10-100 years). Lessivage (i.e. clay translocation) and bioturbation by burrowing animals (mesofauna and macrofauna) are two major pedologic processes in temperate climate. They are of crucial importance as they imply the clay size fraction. This study aims at characterizing the dynamics of these processes and quantifying their intensity after (i) a change in land use and (ii) the introduction of a widespread agricultural practice i.e. organic amendments spreading. In our investigation, we built an anthropo-chrono-sequence of three Luvisols located on a plateau in Feucherolles (Yvelines, France). The first one is under a deciduous forest and the second one is under conventional agricultural management both with no change in land-use for the past two centuries. The last one is a cultivated Luvisol with regular manure spreading since 1998. Undisturbed soil samples were collected in each horizon of the three Luvisols and large thin sections (57 cm2) prepared according to the method of Guilloré (1985). Clay illuviation features and macropores of biological origin (>100 µm) were quantified by image analysis on the thin sections to evaluate the intensity of lessivage and bioturbation respectively. Size and shape of the macroporosity were used to quantify the activity of mesofauna and of endogeic and anecic worms. In case of cultivation, we can note a global increase of macroporosity and clay coatings abundance. The greater macroporosity observed on cultivated profiles was undoubtedly due to endogeic and anecic worm activities. Moreover, whereas macroporosity is preferentially located on soil surface under forest, it is better

  14. The impact of area residential property values on self-rated health: A cross-sectional comparative study of Seattle and Paris.

    Science.gov (United States)

    Jiao, Junfeng; Drewnowski, Adam; Moudon, Anne Vernez; Aggarwal, Anju; Oppert, Jean-Michel; Charreire, Helene; Chaix, Basile

    2016-12-01

    This study analyzed the impact of area residential property values, an objective measure of socioeconomic status (SES), on self-rated health (SRH) in Seattle, Washington and Paris, France. This study brings forth a valuable comparison of SRH between cities that have contrasting urban forms, population compositions, residential segregation, food systems and transportation modes. The SOS (Seattle Obesity Study) was based on a representative sample of 1394 adult residents of Seattle and King County in the United States. The RECORD Study (Residential Environment and Coronary Heart Disease) was based on 7131 adult residents of Paris and its suburbs in France. Socio-demographics, SRH and body weights were obtained from telephone surveys (SOS) and in-person interviews (RECORD). All home addresses were geocoded using ArcGIS 9.3.1 (ESRI, Redlands, CA). Residential property values were obtained from tax records (Seattle) and from real estate sales (Paris). Binary logistic regression models were used to test the associations among demographic and SES variables and SRH. Higher area property values significantly associated with better SRH, adjusting for age, gender, individual education, incomes, and BMI. The associations were significant for both cities. A one-unit increase in body mass index (BMI) was more detrimental to SRH in Seattle than in Paris. In both cities, higher area residential property values were related to a significantly lower obesity risk and better SRH. Ranked residential property values can be useful for health and weight studies, including those involving social inequalities and cross-country comparisons. PMID:27413663

  15. Borderline intellectual functioning is associated with poor social functioning, increased rates of psychiatric diagnosis and drug use--a cross sectional population based study.

    Science.gov (United States)

    Gigi, Karny; Werbeloff, Nomi; Goldberg, Shira; Portuguese, Shirly; Reichenberg, Abraham; Fruchter, Eyal; Weiser, Mark

    2014-11-01

    Borderline intellectual functioning is defined by the DSM IV as an IQ range that is between one to two standard deviations below the mean (71IQachievement. Using data from the Israeli military, we retrieved the social and clinical characteristics of 76,962 adolescents with borderline intellectual functioning and compared their social functioning, psychiatric diagnoses and drug abuse with those of 96,580 adolescents with average IQ (± 0.25 SD from population mean). The results demonstrated that the borderline intellectual functioning group had higher rates of poor social functioning compared to the control group (OR=1.9, 95% CI=1.85-1.94). Individuals with borderline intellectual functioning were 2.37 times more likely to have a psychiatric diagnosis (95% CI=2.30-2.45) and 1.2 times more likely to use drugs (95% CI=1.07-0.35) than those with average IQ. These results suggest that adolescents with borderline intellectual functioning are more likely to suffer from psychiatric disorders, poor social functioning and drug abuse than those with average intelligence, and that borderline intellectual functioning is a marker of vulnerability to these poor outcomes. PMID:25224107

  16. Association of lecithin-cholesterol acyltransferase activity measured as a serum cholesterol esterification rate and low-density lipoprotein heterogeneity with cardiovascular risk: a cross-sectional study.

    Science.gov (United States)

    Tani, Shigemasa; Takahashi, Atsuhiko; Nagao, Ken; Hirayama, Atsushi

    2016-06-01

    The cholesterol-esterifying enzyme, lecithin-cholesterol acyltransferase (LCAT), is believed to play a key role in reverse cholesterol transport. However, recent investigations have demonstrated that higher LCAT activity levels increase the formation of triglyceride (TG)-rich lipoproteins (TRLs) and atherogenesis. We hypothesized that higher LCAT activity measured as a serum cholesterol esterification rate by the endogenous substrate method might increase the formation of TRLs and thereby alter low-density lipoprotein (LDL) heterogeneity. The estimated LDL particle size [relative LDL migration (LDL-Rm)] was measured by polyacrylamide gel electrophoresis with the LipoPhor system (Joko, Tokyo, Japan) in 538 consecutive patients with at least risk factor for atherosclerosis. Multivariate regression analysis after adjustments for traditional risk factors identified elevated TRL-related marker (TG, remnant-like particle cholesterol, apolipoprotein C-II, and apolipoprotein C-III) levels as independent predictors of smaller-sized LDL particle size, both in the overall subject population and in the subset of patients with serum LDL cholesterol levels of <100 mg/dL. Area under the receiver operating characteristic curve of the LCAT activity (0.79; sensitivity 60 %; specificity 84.8 %) was observed for the evaluation of the indicators of an LDL-Rm value of ≥0.40, which suggests the presence of large amounts of small-dense LDL. The results lend support to the hypothesis that increased LCAT activity may be associated with increased formation of TRLs, leading to a reduction in LDL particle size. Therefore, to reduce the risk of atherosclerotic cardiovascular disease, it may be of importance to pay attention not only to a quantitative change in the serum LDL-C, but also to the LCAT activity which is possibly associated with LDL heterogeneity. PMID:25894629

  17. Modelling strategic interventions in a population with a total fertility rate of 8.3: a cross-sectional study of Idjwi Island, DRC

    Directory of Open Access Journals (Sweden)

    Thomson Dana R

    2012-11-01

    Full Text Available Abstract Background Idjwi, an island of approximately 220,000 people, is located in eastern DRC and functions semi-autonomously under the governance of two kings (mwamis. At more than 8 live births per woman, Idjwi has one of the highest total fertility rates (TFRs in the world. Rapid population growth has led to widespread environmental degradation and food insecurity. Meanwhile family planning services are largely unavailable. Methods At the invitation of local leaders, we conducted a representative survey of 2,078 households in accordance with MEASURE DHS protocols, and performed ethnographic interviews and focus groups with key informants and vulnerable subpopulations. Modelling proximate determinates of fertility, we evaluated how the introduction of contraceptives and/or extended periods of breastfeeding could reduce the TFR. Results Over half of all women reported an unmet need for spacing or limiting births, and nearly 70% named a specific modern method of contraception they would prefer to use; pills (25.4% and injectables (26.5% were most desired. We predicted that an increased length of breastfeeding (from 10 to 21 months or an increase in contraceptive prevalence (from 1% to 30%, or a combination of both could reduce TFR on Idjwi to 6, the average desired number of children. Increasing contraceptive prevalence to 15% could reduce unmet need for contraception by 8%. Conclusions To meet women’s need and desire for fertility control, we recommend adding family planning services at health centers with NGO support, pursuing a community health worker program, promoting extended breastfeeding, and implementing programs to end sexual- and gender-based violence toward women.

  18. Geographical Differences in the Population-Based Cross-Sectional Growth Curve and Age at Peak Height Velocity with respect to the Prevalence Rate of Overweight in Japanese Children

    Directory of Open Access Journals (Sweden)

    Masana Yokoya

    2014-01-01

    Full Text Available The School Health Examination Survey is a nationwide examination carried out annually in Japan, and the results are entered into a prefectural-level physical measurement database. We used this database to determine the geographical differences in a population-based cross-sectional growth curve and investigated the association between age at peak height velocity (PHV and the prevalence rate of overweight in children among Japanese prefectures. Mean prefectural-level age at PHV was estimated by the cubic spline-fitting procedure using cross-sectional whole-year prefectural mean height data (5–17 years, 2006–2013, and 8-year (2006–2013 means of the standardized prevalence rates of overweight children and other anatomical data (8-year standardized weight and height were recalculated. Mean prefectural age at PHV was more strongly correlated with the mean prefectural prevalence rate of overweight (age 5–8 years than with other weights or heights in both sexes. On the basis of these findings and their confirmation by multiple regression analysis, the prevalence rate of overweight was selected as a primary factor to explain the geographical difference in age at PHV. These findings suggest that childhood overweight is a dominant factor responsible for the observed geographical differences in onset of puberty in Japan.

  19. Comparison of cross-sectional renal function measurements in African Americans with hypertensive nephrosclerosis and of primary formulas to estimate glomerular filtration rate.

    Science.gov (United States)

    Lewis, J; Agodoa, L; Cheek, D; Greene, T; Middleton, J; O'Connor, D; Ojo, A; Phillips, R; Sika, M; Wright, J

    2001-10-01

    Renal function measurements were obtained in 1,703 African Americans with presumed hypertensive nephrosclerosis who were screened for entry into the African-American Study of Hypertension and Kidney Disease (AASK). We examined the effect of race on relationships involving renal variables by comparing African Americans enrolled into the AASK with non-African Americans enrolled into the Modification of Diet in Renal Disease (MDRD) study. We examined the effect of gender on renal variables by comparing African American men and women. We compared various methods for estimating glomerular filtration rate (GFR) with iodine 125-labeled ((125)I)-iothalamate GFR. AASK data were also used to derive a new formula for estimating GFR in African Americans. After adjusting for age, sex, and baseline GFR, African American patients on the AASK study were heavier and had larger body surface areas and body mass indices than either MDRD African Americans or non-African Americans. African Americans had greater serum creatinine levels and urinary creatinine excretions for any given level of GFR. Mean GFR was greater in African American men than African American women (59.7 versus 51.7 mL/min/1.73 m(2)), although serum creatinine levels were also greater in men (1.91 versus 1.73 mg/dL). Seventy-eight percent of women with serum creatinine levels between 1.2 and 1.5 mg/dL had GFRs less than 65 mL/min/1.73 m(2). For African Americans in the AASK, GFR was overestimated by the 24-hour creatinine clearance and underestimated by the Cockcroft-Gault formula. A prediction formula developed in the MDRD study more accurately predicted GFR in AASK patients than these measurements. AASK data were also used to derive a new five-term formula for estimating GFR that was slightly more accurate in the African Americans in the AASK than the MDRD formula (median percentage of error, 12.4% for the MDRD formula versus 12.1% for the AASK formula). Important differences exist in renal variables between African

  20. 昂丹司琼在剖宫产术后镇痛中的应用%Ondansetron for Patient Controlled Intravenous Analgesia after Caesarean Section

    Institute of Scientific and Technical Information of China (English)

    倪正强

    2008-01-01

    目的:观察中枢性镇吐药昂丹司琼在剖宫产术后镇痛中预防恶心、呕吐的效果.方法:选择行剖宫产术者120例,术后使用自控静脉镇痛,并随机分为3组,每组40例.A组镇痛泵中加入昂丹司琼8 mg.手术结束前静脉注射昂丹司琼4 mg;B组镇痛泵中加入昂丹司琼8 mg;C组镇痛泵中加入氟哌利多5 mg.记录各组术后恶心、呕吐发生例数以及应用止吐药的例数.结果:A组恶心2例,呕吐1例;B组恶心4例,呕吐2例;C组恶心8例,呕吐4例,3组间恶心、呕吐发生率比较差异均有统计学意义(P<0.05).结论:应用昂丹司琼能减少术后镇痛所致恶心、呕吐的发生率,且手术结束前静脉注射昂丹司琼对降低恶心、呕吐的发生效果更加明显,值得临床推广.

  1. Reduce scar Uterine Cesarean Section rate of Postpartum Hemorrhage again Clinical Interventions%降低瘢痕子宫再次剖宫产产后出血率的临床干预措施

    Institute of Scientific and Technical Information of China (English)

    王秀清

    2014-01-01

    Objective To study the effective reduce scar uterine cesarean section rate of postpartum hemorrhage again clinical interventions .Methods We were cho-sen for scar uterine cesarean section again multipara,200,in the control group of 100 women for routine care,intervention group of 100 women at the same time of routine nursing care,to take targeted clinical intervention.Compared two groups of maternal postpartum hemorrhage rate.Results The intervention group the postpartum hemor-rhage rate was 4%;Control postpartum hemorrhage rate was 15%.Intervention group postpartum hemorrhage rate is far lower than the control group ,there was an obvious statistical significance difference(P<0.05).Conclusion Take effective clinical intervention measures,strengthen the preoperative,intraoperative and postpartum nursing intervention,which can effectively reduce the scar uterine cesarean section rate of postpartum hemorrhage again .%目的:探讨有效降低瘢痕子宫再次剖宫产产后出血率的临床干预措施。方法选本院收治的因瘢痕子宫再次剖宫产的经产妇200名,对照组100名产妇接受常规护理,干预组100名产妇在常规护理的同时,采取有针对性的临床干预。对比两组产妇产后出血率。结果干预组产后出血率为4%;对照组产后出血率占15%。干预组产后出血率远低于对照组,差异明显有统计学意义(P<0.05)。结论采取有力的临床干预措施,加强术前、术中以及产后的干预护理,可有效降低瘢痕子宫再次剖宫产产后出血率。

  2. 我院2010~2014年剖宫产指征前6位因素综合分析%A Comprehensive Analysis of The First Sixth Factors of Cesarean Section in Our Hospital From 2010 to 2014

    Institute of Scientific and Technical Information of China (English)

    王俊蓉

    2015-01-01

    目的:探讨近几年我院剖宫产率及剖宫产指征的变化情况,寻找安全有效的降低剖宫产率的方法。方法对2010~2014年在本院分娩的孕产妇临床资料进行回顾性分析。结果剖宫产率逐年下降,新生儿窒息率差异无统计学意义。计划生育政策因素导致的疤痕子宫剖宫产成为第一剖宫产因素。结论加强围生期保健的宣教,重点控制胎儿体重;严格掌握第一产剖宫产指征;对孕妇给予导乐、分娩镇痛等人文关怀,提高产科质量,从而降低剖宫产率。%ObjectiveTo investigate the changes of recent years, our hospital cesarean section rate and indications of cesarean section, look for a safe and efective method of reducing the rate of cesarean section. MethodsFor 2010 to 2014 in our hospital delivery of maternal clinical data were retrospectively analyzed.Results Declining rate of caesarean section, neonatal asphyxia was no significant diference. Uterine scar cesarean birth control policy factors leading to become the first cesarean factor.ConclusionStrengthening perinatal health education, focusing on fetal weight control; strict control of the first stage of cesarean section,pregnant women give doula, childbirth analgesic humane care, improve the quality of obstetric, thereby reducing the rate of cesarean section.

  3. Calculations of Maxwellian-averaged Cross Sections and Astrophysical Reaction Rates Using the ENDF/B-VII.0, JEFF-3.1, JENDL-3.3 and ENDF/B-VI.8 Evaluated Nuclear Reaction Data Libraries

    OpenAIRE

    Pritychenko, B.; Mughaghab, S. F.; Sonzogni, A. A.

    2009-01-01

    We calculated the Maxwellian-averaged cross sections (MACS) and astrophysical reaction rates of the stellar nucleosynthesis reactions (n,$\\gamma$), (n,fission), (n,p), (n,$\\alpha$) and (n,2n) using the ENDF/B-VII.0-, JEFF-3.1-, JENDL-3.3-, and ENDF/B-VI.8-evaluated nuclear-data libraries. Four major nuclear reaction libraries were processed under the same conditions for Maxwellian temperatures ({\\it kT}) ranging from 1 keV to 1 MeV. We compare our current calculations of the {\\it s}-process n...

  4. Cesarean Sections

    Science.gov (United States)

    ... arise with the mother and/or baby during pregnancy or labor. An emergency C-section might be required if: labor stops ... of possible problems with the placenta during future pregnancies. In the case of emergency C-sections, the benefits usually far outweigh the ...

  5. OUTCOME OF CHILDREN AT 1-2 YEARS AND MATERNAL MORB IDITY AFTER CESAREAN SECTION VS VAGINAL BIRTH FOR BREECH PRESENTATION AT OR NEAR TERM

    Directory of Open Access Journals (Sweden)

    Jyoti Ramesh

    2013-02-01

    Full Text Available ABSTRACT: Back ground: In 2000 an international multicentric randomized co ntrol trial of planned vaginal delivery vs planned elective caesarea n section for uncomplicated term breech presentation confirmed that perinatal mortality and s erious neonatal morbidity were significantly lower in planned caesarean group. Seco ndary analysis of Term Breech Trial showed that prelabour caesarean and caesarean during early labour were associated with lowest adverse perinatal outcome due to labour or de livery and that vaginal delivery had the highest risk of adverse outcome AIMS: The purpose of this study is to determine the outco me of children at 1-2 years and maternal morbidity after caesarean section vs. vaginal birth for breech presentation at or near term. SETTINGS AND DESIGN: Prospective observational study from 1 st January 2008-30 th June 2009( 18 months at Institute of Maternal & Child Health , Govt. Medical College Kozhikode. METHODS AND MATERIAL: Outcome of 45 assisted breech deliveries during this period analyzed from case rec ords. 90 Cesarean deliveries during the same period randomly selected as control. STATISTICAL ANALYSIS USED: Data analyzed using SPSS version 16.0.Chi square test was used to compare the outcome. A p value <0.05 was considered to indicate statistical significance. RESULTS : Vaginal delivery group- Five minute Apgar <7 (p=0.019, NICU admission (p=0.00001(RR 4.71 , 95% CI 2.33 to 9.91,Neonatal morbidity (p=0.012RR 2.627,95% CI 1.216 to 5.678 , Prolonged hospitalisation (p=0.005 RR = 2.962 ,95% CI 1.354 to 6.478 statistically signific ant in vaginal delivery group .Caesarean Section group-Elective 30(33.3% Emergency 60(66.6% Neonatal complication( p=0.03 RR=2.57 ,95% CI 1.06 to 6.2, NICU admission ( p=0.01 3 RR=2.86 ,95% CI 1.21 to 6.76. were statistically significant in elective section grou p Maternal morbidity was not associated with type of CS p=0.2 RR = 1.39 ,95% CI 0.447 to 4.307. However the perinatal mortality was

  6. 产妇剖宫产率及剖宫产术手术指征变化趋势分析%Analysis on change trend of cesarean section rate and operative indications

    Institute of Scientific and Technical Information of China (English)

    程虹; 周爱梅; 符爱贞

    2015-01-01

    [Objective] To compare the change trend of cesarean section rate and operative indications,provide a scientific basis for promoting natural childbirth and optimizing birth outcomes.[Methods] The data of 26 465 parturient women in Haikou Women and Children Hospital from January 2010 to September 2014 were analyzed by retrospective method,and the chi square trend test was used to compare the change trend of cesarean section rate with time [Results] 26 465 parturient women aged 17-47 years old and 27 137 newborn were enrolled in this study,and the average age of parturient women was (29.7±4.9) years old.The cesarean section rate decreased from 37.0% in 2010 to 33.5% in 2012,rebounded to 35.5% in 2013,dropped again to 31.8% in 2014,and the cesarean section rate decreased in 5 years (P<0.01),while rate of vaginal delivery showed a rising trend (P<0.01).The first operative indication for cesarean section was sociological factor in 2010 and 2011,accounting for 18.2% and 17.1% respectively.The sociological factor dropped to the 3rd place in operative indications for cesarean section in 2012,accounting for 10.8%,and then dropped to 8th place in 2013 and 9th place in 2014,which the constituent ratio was 5.0% and 3.8% respectively.The operative indication of advanced maternal age raised from 9th place in 2010 and 2011,which accounted for 5.2% and 4.2% respectively,to 6th place in 2012 with the constituent ratio of 8.9%,and then raised to 4th place in 2013 and 2nd place in 2014,which the constituent ratio was 1 1.1% and 12.8% respectively.[Conclusion] Since 2010,the cesarean section rate in the hospital has showed a downward trend,but remained at a high level.The influence from sociological factor on cesarean section has reduced,while the influence from advanced maternal age is increasing.%目的 比较剖宫产率及剖宫产手术指征的变化趋势,为促进自然分娩、优化分娩结局提供科学依据.方法

  7. Cross Sections

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — The National Flood Hazard Layer (NFHL) data incorporates all Digital Flood Insurance Rate Map(DFIRM) databases published by FEMA, and any Letters Of Map Revision...

  8. Inverted Takotsubo-Like Left Ventricular Dysfunction with Pulmonary Oedema Developed after Caesarean Delivery Complicated by Massive Haemorrhage in a Severe Preeclamptic Parturient with a Prolonged Painful Labour

    Directory of Open Access Journals (Sweden)

    Hyejin Jeong

    2011-01-01

    Full Text Available Inverted takotsubo cardiomyopathy (TTC, a variant of stress-induced cardiomyopathy, features transient myocardial dysfunction characterized by a hyperdynamic left ventricular apex and akinesia of the base. Herein, we describe a 38-year-old primigravida with severe preeclampsia who had active labour for 4 h followed by an emergency caesarean delivery. She developed postpartum haemorrhage due to uterine atony complicated by pulmonary oedema, which was managed with large-volume infusion and hysterectomy. Her haemodynamic instability was associated with cardiac biomarkers indicative of diffuse myocardial injury and echocardiographic findings of an “inverted” TTC. The patient was almost fully recovered one month later. Our case shows that a reversible inverted TTC may result from a prolonged painful labour. TTC should be listed in the differential diagnosis of the patient presenting with pulmonary oedema of unknown origin, especially in patients with severe preeclampsia.

  9. The H + HeH(+) → He + H2(+) reaction from the ultra-cold regime to the three-body breakup: exact quantum mechanical integral cross sections and rate constants.

    Science.gov (United States)

    De Fazio, Dario

    2014-06-21

    In this work, we present a quantum mechanical scattering study of the title reaction from 1 mK to 2000 K. Total integral cross sections and thermal rate constants are compared with previous theoretical and experimental data and with simpler theoretical models to understand the range of validity of the approximations used in the previous studies. The obtained quantum reactive observables have been found to be nearly insensitive to the roto-vibrational energy of the reactants at high temperatures. More sensitive to the reactant's roto-vibrational energy are the data in the cold and ultra-cold regimes. The implications of the new data presented here in the early universe scenario are also discussed and analyzed. PMID:24810283

  10. Repercussão da monitorização fetal intraparto sobre os índices de operação cesariana Impact of intrapartum fetal monitoring on cesarean section rates

    Directory of Open Access Journals (Sweden)

    Edson N. Morais

    1998-03-01

    Full Text Available A monitorização fetal eletrônica (MFE tem sido o método mais amplamente utilizado para a vigilância fetal direta, especialmente durante o trabalho de parto. Na tentativa de elucidar o efeito da MFE sobre os índices de cesárea (IC, um estudo retrospectivo foi realizado no Hospital Universitário de Santa Maria (HUSM. Estudamos dois grupos de pacientes perfazendo um total de 2.114 gestantes: um grupo (n=517 com MFE e outro (n=1.597 com ausculta intermitente (AI. No grupo MFE observamos um IC de 38,0%, contra 27,2% do grupo AI. Para todas as pacientes, o IC foi de 29,9%. O sofrimento fetal agudo foi a indicação mais comum de cesárea no grupo MFE (40,6%, ao passo que a cesárea prévia foi a terceira causa (10,1%. No grupo AI, o sofrimento fetal foi a terceira causa de cesárea (14,3%, ao passo que a cesárea prévia foi a indicação mais comum (32,4%. Baseados no presente estudo, acreditamos que a MFE não tem efeito, por si só, sobre as taxas de cesárea, se considerados todos os nascimentos no HUSM. Com uma educação adequada dos obstetras e uma correta interpretação dos traçados, a MFE não aumenta os índices de cesárea, ao contrário permite mais acuracidade na descrição das condições fetais intraparto.Electronic fetal heart rate monitoring (EFM is the most widely used method of direct fetal surveillance especially during labor. In an attempt to elucidate the effect of EFM on cesarean section (CS rates, a retrospective study was performed at the University Hospital of Santa Maria (HUSM. We studied two groups of patients, consisting of 2114 pregnant women: EFM group (n=517 and intermittent auscultation (IA group (n=1597. In the EFM group we observed 38.0% of CS vs. 27.2% in the IA group. For all patients, the CS rate was 29.9%. Fetal distress was the most common indication for CS in the EFM group (40.6%, while previous CS was the third cause (10.1%. On the IA group, fetal distress was the third cause in CS (14.3%, while

  11. Kejadian Post Dural Puncture Headache dan Nilai Numeric Rating Scale Pascaseksio Sesarea dengan Anestesi Spinal

    OpenAIRE

    Dino Irawan; Doddy Tavianto; Eri Surahman

    2013-01-01

    The incidence of post dural puncture headache (PDPH) is associated with the size of duramater diameter puncture caused by the puncture itself. There are two factors related to this problem, the size of the needle and the shape of the needle’s-end. The purpose of this study was to obtain an overview of incidence of PDPH in patients undergoing caesarean section with regional spinal anesthesia in Dr. Hasan Sadikin Hospital Bandung in January–April 2010. This research was conducted on 115 pregnan...

  12. GENERALIZED PERITONITIS WITH UTERINE INCISION NECROSIS WITH DEHISCENCE FOLLOWING CESAREAN SECTION PRESE N TING AS GENITOURINARY FISTULA: A UNIQUE COMPLICATION

    Directory of Open Access Journals (Sweden)

    Madhuri

    2014-01-01

    Full Text Available Generalized peritonitis following lower segment caesarean section with uterine incision necrosis and dehiscence presenting as genitourinary fistula is very unusual. Herein we report a case of 28 years old woman who was received in emergency hours as a referred case from a private nursing home with history of caesarean section done 11 days back for premature rupture of membranes and pregnancy induced hypertension. She came w ith complaints of continuous watery discharge per vaginum , high grade fever with chills and rigor , nausea , vomiting , breathlessness , severe diffuse abdominal pain and distension of abdomen since last 4 - 5 days. Here acute abdomen series was done. The urologist ruled out genitourinary fistula. CECT of abdomen was done. She was diagnosed to be a case of generalized peritonitis following ca esarean section with necrosis and dehiscence of suture line of uterus through which ascitic fluid was being drained into vagina. Consequently , patient underwent laparotomy. Gentle adhesiolysis with supra cervical hysterectomy was done. Thorough drainage an d irrigation of pelvi - abdominal cavity was done. Post - operative period was uneventful

  13. Patients with depressive disorder, their co-morbidity, visiting rate and disability in relation to self-evaluation of physical and mental health: a cross-sectional study in family practice

    Directory of Open Access Journals (Sweden)

    Maaroos Heidi-Ingrid

    2009-06-01

    Full Text Available Abstract Background High prevalence of depression among primary care patients has increased the need for more research in this field. The objectives of our study were to analyse how depressed patients evaluate their health; which co-morbid diseases are associated with depression; how depression influences the patients' consultation rate in family practice (FP; how disability is associated with depression; and how depression influences the patients' working ability. Methods A cross-sectional study, part of the PREDICT study. The study group was formed of 1094 consecutive patients from 23 FPs across Estonia, aged 18–75 years, attending a FP to consult the family doctor (FD. Occurrence of major depression during six months was estimated using the Depression Section of the Composite International Diagnostic Interview. The medical records of all patients were analysed concerning co-morbid diseases, number of visits to the FD, and disability. Every patient filled in questionnaires to assess health-related risk factors for depression, and the SF-12 Health Survey to assess functioning and the perception of health. Results Depression was found in 230 (21% of the patients. Depressed patients reported less accomplishment owing to emotional problems (OR 1.80; 95% CI 1.18–2.72, being less careful as usual (OR 1.81; 95% CI 1.26–2.60, and having pain that extremely interfered with their normal work (OR 2.50; 95% CI 1.33–4.70 in comparison with non-depressed patients. Also depressed patients were more days on sick-leave (OR 1.00; 95% CI 1.00–1.01 than non-depressed patients. However, analysis of the medical records did not indicate that depressed patients consulted the FD more or had more co-morbid diagnoses than the non-depressed patients. Conclusion Depressed patients may have low self-reported functioning due to emotional problems, pain, and their working ability may have decreased; however, the patients of both groups have an equal number of co

  14. Response rates and selection problems, with emphasis on mental health variables and DNA sampling, in large population-based, cross-sectional and longitudinal studies of adolescents in Norway

    Directory of Open Access Journals (Sweden)

    Lien Lars

    2010-10-01

    Full Text Available Abstract Background Selection bias is a threat to the internal validity of epidemiological studies. In light of a growing number of studies which aim to provide DNA, as well as a considerable number of invitees who declined to participate, we discuss response rates, predictors of lost to follow-up and failure to provide DNA, and the presence of possible selection bias, based on five samples of adolescents. Methods We included nearly 7,000 adolescents from two longitudinal studies of 18/19 year olds with two corresponding cross-sectional baseline studies at age 15/16 (10th graders, and one cross-sectional study of 13th graders (18/19 years old. DNA was sampled from the cheek mucosa of 18/19 year olds. Predictors of lost to follow-up and failure to provide DNA were studied by Poisson regression. Selection bias in the follow-up at age 18/19 was estimated through investigation of prevalence ratios (PRs between selected exposures (physical activity, smoking and outcome variables (general health, mental distress, externalizing problems measured at baseline. Results Out of 5,750 who participated at age 15/16, we lost 42% at follow-up at age 18/19. The percentage of participants who gave their consent to DNA provision was as high as the percentage that consented to a linkage of data with other health registers and surveys, approximately 90%. Significant predictors of lost to follow-up and failure to provide DNA samples in the present genetic epidemiological study were: male gender; non-western ethnicity; postal survey compared with school-based; low educational plans; low education and income of father; low perceived family economy; unmarried parents; poor self-reported health; externalized symptoms and smoking, with some differences in subgroups of ethnicity and gender. The association measures (PRs were quite similar among participants and all invitees, with some minor discrepancies in subgroups of non-western boys and girls. Conclusions Lost to

  15. Analysis of the delivery mode of secondary pregnancy after cesarean section%剖宫产术后再次妊娠分娩方式分析

    Institute of Scientific and Technical Information of China (English)

    吴玉芳

    2014-01-01

    Objective To analyse the feasibility of vaginal birth after cesarean(VBAC).Methods 54 cases who successed through vaginal delivery after cesarean section(the VBAC group) were retrospectively analyzed.Contrasted the VBAC group with 54 primiparas who successed through vaginal delivery in the same time(the VBOP group).And contrasted the VBAC group with 54 cases of repeated caesarean section in the same time(the RCS group).Results There was no significant difference between the VBAC group and the VBOP group in time of birth process,hemorrhage of intrapartum and neonatal asphyxia(P>0.05).And there was significant difference between the VBAC group and the RCS group in hemorrhage of intrapartum,puerperal infection,The average hospitalization days(P<0.05).Conclusion For secondary pregnancy after cesarean section,on the premise of mastering the contraindications and indications,should be given an opportunitie of vaginal delivery,In order to improve the success rate of vaginal birth after cesarean delivery,reduce the rate of cesarean section,and improve the quality of obstetrics.%目的:分析剖宫产术后再次妊娠经阴道分娩(Vaginal Birth After Cesarean,VBAC)的可行性。方法:回顾性分析剖宫产术后再次妊娠经阴道试产成功的产妇54例(VBAC组)。随机抽取同期经阴道试产成功的初产妇54例(Vaginal Birth Of Primipara, VBOP组)与VBAC组进行对照,又随机抽取同期剖宫产术后再次剖宫产者54例(Repeated Caesarean Section,RCS组)与VBAC组进行对照。结果:VBAC组与VBOP组在产程时间、产时出血量及新生儿窒息发生率等比较上差异无统计学意义(P>0.05)。VBAC组与RCS组在产时出血量、平均住院时间、产褥期感染等比较上差异有统计学意义(P<0.05)。结论:对于剖宫产术后再次妊娠的产妇,在掌握好禁忌证和适应证的前提下,应给予试产的机会,以提高剖宫产术后阴道分娩的成

  16. Utilization of delivery care among rural women in china: does the health insurance make a difference? a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wang Duolao

    2010-11-01

    Full Text Available Abstract Background Since 2003, the New Cooperative Medical Scheme (NCMS has been implemented throughout rural China, usually covering delivery services in its benefit package. The objective of this study was to compare the difference of utilization of delivery services, expenditures, and local women's perceived affordability between women with and without reimbursement from NCMS. Methods A cross-sectional survey was carried out in two rural counties in Shaanxi province, China, during December 2008-March 2009. Women giving birth from April 2008 to March 2009 were interviewed by a structured questionnaire to collect information on utilization of delivery services. Multivariable analyses were used to compare the differences in outcomes between women with and without reimbursement from NCMS. Results Of the total 1613 women interviewed, 747(46.3% got reimbursement to cover their expenditure on delivery care (NCMS group and 866(53.7% paid delivery services entirely out of their own pocket (Non-NCMS group. Compared with the Non-NCMS group, the NCMS group had significantly more women who delivered at hospital. The rate of Caesarean section (CS, proportion of women seeking higher level services, and length of hospitalization were similar between the two groups. The total hospital costs for delivery services in the NCMS group was significantly smaller and after being reimbursed, the out-of-pocket payment in the NCMS group was less than a half of that in the Non-NCMS group. Fewer women in the NCMS group than in the Non-NCMS group considered their payment for delivery services expensive. Conclusions There was no evidence of overuse delivery services among the women reimbursed by NCMS. Total hospital costs and women's costs for delivery services were found lower in the NCMS group, subsequently alleviation on women's perceived financial affordability.

  17. 剖宫产与体外授精技术在小鼠生物净化中的应用%Application of Caesarean and in vitro Fertilization for Bio-cleansing in Mice

    Institute of Scientific and Technical Information of China (English)

    朱莲; 孔彭成; 王美珊; 陈学进; 蒋满喜; 崔立

    2013-01-01

    Objective Caesarean and in vitro fertilization were used to rederive the contaminated SPF mouse colonies.Methods The contaminated mice with normal reproductive capacity were hysterectomized according to the vaginal plugs and abdomen palpatiion after natural mating.The fetus was removed from the uterus when labor and the pups were suckled by foster mothers.The foster nursing and the survival rates of the pups were observed.The in vitro fertilization and embryos transfer was used to the mouse strains whose reproductive capacity was poor or breeding failure.Both sperm and the eggs were incubated in the HTF medium,and 3.5 days embryos were transferred to the uterus of SPF recipient mice.Results All the re-derived mice through both methods reached the standard of SPF animals.Conclusions For the mice which did not meet the SPF standard but pathogens on them could not vertically transmit; the two methods can effectively improve their microbial level.%目的 采用剖宫取胎和体外受精对微生物级别达不到SPF级的小鼠进行生物净化.方法 对于具有正常繁殖能力的小鼠品系,通过对阴道栓的检查和触诊确定剖宫产取胎时间,采用子宫摘除手术对小鼠进行剖宫产,取出仔鼠用SPF级受体母鼠代乳,观察代乳情况及代乳仔鼠成活率;对于繁殖力较差或者丧失繁殖能力的品系,采取辅助生殖的方式,采集小鼠精子和卵子,在HTF液中受精,培养3.5 d后的胚胎移植到SPF级受体母鼠子宫内,待产仔.结果 两种方式净化的小鼠断奶后进行微生物检测,均达到SPF级.结论 对微生物级别达不到SPF级但不含垂直传播病原体的小鼠,采用两种方式可有效提高小鼠的微生物等级.

  18. Retrospective cross-sectional review of survival rates in critically ill children admitted to a combined paediatric/neonatal intensive care unit in Johannesburg, South Africa, 2013–2015

    Science.gov (United States)

    Ballot, Daynia E; Davies, Victor A; Cooper, Peter A; Chirwa, Tobias; Argent, Andrew; Mer, Mervyn

    2016-01-01

    Objective Report on survival to discharge of children in a combined paediatric/neonatal intensive care unit (PNICU). Design and setting Retrospective cross-sectional record review. Participants All children (medical and surgical patients) admitted to PNICU between 1 January 2013 and 30 June 2015. Outcome measures Primary outcome—survival to discharge. Secondary outcomes—disease profiles and predictors of mortality in different age categories. Results There were 1454 admissions, 182 missing records, leaving 1272 admissions for review. Overall mortality rate was 25.7% (327/1272). Mortality rate was 41.4% (121/292) (95% CI 35.8% to 47.1%) for very low birthweight (VLBW) babies, 26.6% (120/451) (95% CI 22.5% to 30.5%) for bigger babies and 16.2% (86/529) (95% CI 13.1% to 19.3%) for paediatric patients. Risk factors for a reduced chance of survival to discharge in paediatric patients included postcardiac arrest (OR 0.21, 95% CI 0.09 to 0.49), inotropic support (OR 0.085, 95% CI 0.04 to 0.17), hypernatraemia (OR 0.16, 95% CI 0.04 to 0.6), bacterial sepsis (OR 0.32, 95% CI 0.16 to 0.65) and lower respiratory tract infection (OR 0.54, 95% CI 0.30 to 0.97). Major birth defects (OR 0.44, 95% CI 0.26 to 0.74), persistent pulmonary hypertension of the new born (OR 0.44, 95% CI 0.21 to 0.91), metabolic acidosis (OR 0.23, 95% CI 0.12 to 0.74), inotropic support (OR 0.23, 95% CI 0.12 to 0.45) and congenital heart defects (OR 0.29, 95% CI 0.13 to 0.62) predicted decreased survival in bigger babies. Birth weight (OR 0.997, 95% CI 0.995 to 0.999), birth outside the hospital (OR 0.21, 95% CI 0.05 to 0.84), HIV exposure (OR 0.54, 95% CI 0.30 to 0.99), resuscitation at birth (OR 0.49, 95% CI 0.25 to 0.94), metabolic acidosis (OR 0.25, 95% CI 0.10 to 0.60) and necrotising enterocolitis (OR 0.23, 95% CI 0.12 to 0.46) predicted poor survival in VLBW babies. Conclusions Ongoing mortality review is essential to improve provision of paediatric critical care. PMID:27259525

  19. Cross Sections and Lorentz Violation

    OpenAIRE

    Colladay, Don; Kostelecky, Alan

    2001-01-01

    The derivation of cross sections and decay rates in the Lorentz-violating standard-model extension is discussed. General features of the physics are described, and some conceptual and calculational issues are addressed. As an illustrative example, the cross section for the specific process of electron-positron pair annihilation into two photons is obtained.

  20. ANAESTHETIC CONSIDERATIONS FOR THE HIV POSITIVE PARTURIENT

    OpenAIRE

    Oluwabukola, Adesina; Adesina, Oladokun

    2009-01-01

    The HIV epidemic in children parallels that among women on account of perinatal transmission. A combination of antiretroviral therapy and elective caesarean section reduces the rate of vertical transmission to

  1. Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study

    OpenAIRE

    Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H; Bonotti, Ana María; Izbizky, Gustavo H.; Ferrary, Marta; Viergue, Nora; Vigil, Silvia I.; Zalazar Denett, Gabriela; Belizán, José M

    2016-01-01

    Background Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women’s preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. Methods A prospective cohort study was conducted in two pub...

  2. Tracer kinetic studies of the low density lipoprotein metabolism in the fetal rat: An example for estimation of flux rates in the nonsteady state

    International Nuclear Information System (INIS)

    To get insight into the low density lipoprotein (LDL)-apoB flux in the rat fetus near term and in the early postnatal period, homologous apoE-free 125I-labeled LDL was injected into the umbilical vein of the rat fetus immediately after Caesarean section. Since the serum LDL-apoB spontaneously declined after birth, a time-dependent two-pool model was used to calculate the flux rates in the neonate from the specific activities of LDL-apoB up to 15 h post partum. An approximate value of LDL-apoB flux in the fetus at birth was obtained by extrapolation of the kinetic data to the time of injection of the tracer. The data revealed that the turnover of LDL-apoB in the fetus (18.6 micrograms LDL-apoB/h per g body weight) exceeded that in the adult rat (0.4 microgram/h per g body weight) by at least one order of magnitude. Even 15 h after delivery, the LDL-apoB influx amounted to 2.5 micrograms/h per g body weight. The fractional catabolic rate of LDL-apoB in the fetus at term (0.39, h-1) slightly exceeded that in the adult animal (0.15, h-1) and reached the adult level within the first 3 h after birth and remained constant thereafter. In the rat fetus, LDL-apoB flux greatly exceeds that of VLDL-apoB. The data support the view of a direct synthesis and secretion of LDL, most probably by the fetal membranes

  3. COMPARATIVE STUDY OF HYPERBARIC BUPIVACAINE AND PLAIN ROPIVACAINE WITH FENTANYL AS AN ADJUVANT FOR SPINAL ANAESTHESIA IN CEASAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Vindhya

    2014-07-01

    Full Text Available : Spinal anaesthesia is very popular for cesarean section and currently both hyperbaric and plain solutions of local anaesthesia along with opioids are used. Difference in the baricity can affect the intrathecal distribution of local anaesthetics. AIM: We compared the effects of intrathecal hyperbaric (heavy 0.5% bupivacaine and isobaric (plain 0.75%ropivacaine combined with 25micro grams fentanyl regarding the degree of sensory and motor block, quality of intraoperative anaesthesia, side effects and post-operative analgesia in patients undergoing cesarean section by doing a randomized controlled study. MATERIALS AND METHODS: Sixty women undergoing caesarean section were randomized into two groups, Group BF (n=30, group RF (n= 30. Group BF received 10 mg (2 ml of 0.5% hyperbaric bupivacaine with 25µgs of preservative free fentanyl and Group RF received 15mgs (2ml 0.75% plain Ropivacaine (isobaric with 25µgs of fentanyl for spinal anaesthesia. In case of insufficient blocks both the groups were supplemented with analgesic dose of ketamine. RESULTS: No difference was observed in onset time, highest level and recovery of sensory block. Recovery of motor block was slightly prolonged in RF group. The incidence of insufficient block requiring ketamine supplementation and duration of postoperative analgesia was same in both groups. The side effects were also similar in both the groups except for hypotension lower systolic pressure in BF group. The neonatal outcome was unaffected. CONCLUSION: In this study we did not find any difference in the two groups despite difference in density suggesting that the spread of spinal solution is not dependent on density in patients undergoing caesarean section.

  4. Analytical study of indications of cesarean section

    Directory of Open Access Journals (Sweden)

    Janki M. Pandya

    2015-10-01

    Conclusions: Reduction of number of primary cesarean sections and successful VBAC trials are recommended to keep the rate of cesarean sections to the possible minimum level. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1460-1463

  5. National ART Success Rates

    Science.gov (United States)

    ... ART and Birth Defects ART and Autism 2013 Assisted Reproductive Technology National Summary Report Recommend on Facebook Tweet Share ... live-birth rate? [PDF - 1.37MB] Section 2: ART Cycles using fresh nondonor eggs or embryos What ...

  6. Modeling Strategic Interventions in a Population With a Total Fertility Rate of 8.3: A Cross-Sectional Study of Idjwi Island, DRC - With Appendix Detailing Patterns of Poverty and Disease Among the Bany'Idjwi People

    OpenAIRE

    Hadley, Michael B

    2015-01-01

    Idjwi Island, DRC, has a total fertility rate of 8.3, one of the highest in the world. Rapid population growth has led to widespread environmental degradation and food insecurity. Meanwhile family planning services are largely unavailable. We conducted a representative survey of 2,078 households measuring standard reproductive health indicators. We also interviewed local women, community leaders, and clinicians about access to reproductive services. In the survey, over half of all women repor...

  7. High satisfaction rating by users of private-for-profit healthcare providers-evidence from a cross-sectional survey among inpatients of a private tertiary level hospital of north India

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar

    2012-01-01

    Full Text Available Background: Evaluation of outcomes can help improve the quality of provision of services within a healthcare setting. There is limited report on patient satisfaction in private-sector in India although they provide three-quarters of healthcare services. Aim: The study was designed to report the level of satisfaction among inpatients of a private tertiary care hospital in India. Materials and Methods: A total of 102 participants were recruited and their socio-demographic, health-seeking behavior, and satisfaction rating on various aspects of healthcare were elicited. A five item Likert scale was used to obtain the satisfaction rating. Data analysis was done with the help of Stata version-9. Proportions for the discrete variables and means with Standard Deviation for the continuous variables were obtained. Results: All the participants were urban and from upper-middle or upper socio-economic strata. The participants reported a high level of overall satisfaction (93% as well as high satisfaction with physicians (95%, the doctor′s interpersonal skills (99%, nursing-care (93%, general services (94%, and pharmacy (88.1%. Conclusion: There was a high level of satisfaction reported by the participants at this tertiary level hospital. This might reflect the actual good quality services being provided by the provider or the nonannoying response, which cannot be ruled out.

  8. Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Francesca Gatti

    2014-01-01

    Full Text Available The optimal treatment of a severe hemodynamic instability from shock to cardiac arrest in late term pregnant women is subject to ongoing studies. However, there is an increasing evidence that early “separation” between the mother and the foetus may increase the restoration of the hemodynamic status and, in the cardiac arrest setting, it may raise the likelihood of a return of spontaneous circulation (ROSC in the mother. This treatment, called Perimortem Cesarean Section (PMCS, is now termed as Resuscitative Hysterotomy (RH to better address the issue of an early Cesarean section (C-section. This strategy is in contrast with the traditional treatment of cardiac arrest characterized by the maintenance of cardiopulmonary resuscitation (CPR maneuvers without any emergent surgical intervention. We report the case of a prehospital perimortem delivery by Caesarean (C section of a foetus at 36 weeks of gestation after the mother’s traumatic cardiac arrest. Despite the negative outcome of the mother, the choice of performing a RH seems to represent up to date the most appropriate intervention to improve the outcome in both mother and foetus.

  9. Cross sections for nuclear astrophysics

    International Nuclear Information System (INIS)

    General properties of low-energy cross sections and of reaction rates are presented. We describe different models used in nuclear astrophysics: microscopic models, the potential model, and the R-matrix method. Two important reactions, 7Be(p,γ)8B and 12C(α,γ)16O, are then briefly discussed. (author)

  10. An unanticipated cardiac arrest and unusual post-resuscitation psycho-behavioural phenomena/near death experience in a patient with pregnancy induced hypertension and twin pregnancy undergoing elective lower segment caesarean section

    Directory of Open Access Journals (Sweden)

    Mridul M Panditrao

    2010-01-01

    Full Text Available A case report of a primigravida, who was admitted with severe pregnancy induced hypertension (BP 160/122 mmHg and twin pregnancy, is presented here. Antihypertensive therapy was initiated. Elective LSCS under general anaesthesia was planned. After the birth of both the babies, intramyometrial injections of Carboprost and Pitocin were administered. Immediately, she suffered cardiac arrest. Cardio pulmonary resucitation (CPR was started and within 3 minutes, she was successfully resuscitated. The patient initially showed peculiar psychological changes and with passage of time, certain psycho-behavioural patterns emerged which could be attributed to near death experiences, as described in this case report.

  11. 昂丹司琼预防剖宫产产妇寒战的临床观察%Preventive Effect of Ondansetron on Shivering in Caesarean Section Patients

    Institute of Scientific and Technical Information of China (English)

    曾振平

    2007-01-01

    目的:研究昂丹司琼对剖宫产产妇寒战的预防作用.方法:选择在腰硬联合麻醉下行剖宫产的产妇80例, ASAⅠ~Ⅱ级,随机分成2组:昂丹司琼组(Ⅰ组),对照组(Ⅱ组)每组40例.麻醉前开放静脉通路,Ⅰ组即给予昂丹司琼8 mg静脉注射,Ⅱ组即给予注射用水4 mL静脉注射.观察记录产妇术中寒战发生的情况,并持续监测围术期呼吸循环的变化,测定麻醉阻滞平面,记录胎儿出生后的Apgar评分. 结果:寒战发生率Ⅰ组为27、5%,Ⅱ组为60.0%;Ⅰ组与Ⅱ组比较差异均有显著性(P<0.05);2组比较围术期呼吸循环变化差异无显著性(P>0.05);2组胎儿出生后Apgar评分差异亦无显著性(P>0.05);术中恶心、呕吐发生率Ⅰ组(5.0%)比Ⅱ组(20%)显著降低(P<0.05).结论:麻醉前预先静脉注射昂丹司琼8 mg,有助于预防剖宫产产妇寒战,昂丹司琼还可明显降低术中恶心、呕吐的发生率.

  12. 恩丹西酮预防剖宫产产妇寒战的临床观察%The clinic study of ondansetron for prevention of shivering in caesarean section

    Institute of Scientific and Technical Information of China (English)

    刘德昭; 黄品婕; 陈信芝; 周少丽; 黑子清; 马武华

    2004-01-01

    目的研究恩丹西酮对剖宫产产妇寒战的预防作用,并与曲马多进行比较.方法选择在腰硬联合麻醉下行剖宫产产妇90例,ASA Ⅰ~Ⅱ级,随机分成3组:恩丹西酮组(E组),曲马多组(T组),对照组(C组),每组30例.麻醉前开放静脉通路,E组即给予恩丹西酮8mg静脉注射(用生理盐水稀释到10ml),T组即给予曲马多50mg静脉注射(用生理盐水稀释到10 ml),C组即给予生理盐水10 ml静脉注射.观察记录产妇术中寒战发生的情况,并持续监测围术期呼吸、循环的变化,测定麻醉阻滞平面,记录胎儿出生后的Apgar评分.结果寒战发生率E组为10%,T组为6.7%,C组为33.3%;E,T组与C组比较差异均有显著性(P<0.05).3组比较围术期呼吸循环变化差异无显著性(P>0.05);3组胎儿出生后Apgar评分差异亦无显著性(P>0.05).术中恶心、呕吐发生率E组(3.3%)比C组(20%)和T组(26.7%)显著降低(P<0.05),而T组和C组比较差异无显著性(P>0.05).结论麻醉前预先静脉注射恩丹西酮8 mg与曲马多50 mg均有助于预防剖宫产产妇寒战,恩丹西酮还可明显降低术中恶心、呕吐发生率.

  13. The preemptive analgesia of propacetamol hydrochloride on contractions pain after caesarean section%超前应用盐酸丙帕他莫预防剖宫产术后宫缩痛的临床研究

    Institute of Scientific and Technical Information of China (English)

    韩玉龙; 王欣欣; 李彦平

    2013-01-01

    目的 观察在剖宫产手术中超前应用盐酸丙帕他莫预防术后宫缩痛的临床疗效.方法 选择剖宫产手术术后行硬膜外自控镇痛(PCEA)患者60例,随机分为两组:丙帕他莫+PCEA组(P-E组,n=30)和单纯PCEA组(E组,n=30).全部病例均在硬膜外麻醉下手术,术毕均于硬膜外腔留置导管内注入镇痛药物(0.125%甲磺酸罗哌卡因+舒芬太尼1 μg)5 ml后接镇痛泵.术后镇痛泵药物配方:舒芬太尼40 μg+0.12%甲磺酸罗哌卡因+生理盐水共100 ml;镇痛泵给药模式:维持量为2 ml/h,单次负荷剂量为0.5 ml,锁定时间为15 min.E-P组剖宫产手术在婴儿取出后,丙帕他莫2 g溶于100 ml盐水中15 min内静脉输入;E组剖宫产手术在婴儿取出后,应用100 ml盐水15 min内静脉输入.观察指标:①应用VAS疼痛评分法观察两组术后30 min、2 h、6 h、12 h的手术伤口疼痛强度;②应用VAS疼痛评分法观察两组术后30 min、2 h、6 h、12 h的宫缩痛疼痛强度;③术后宫缩痛评定标准对比观察;④观察两组术后2 h内恶心、呕吐、瘙痒、发热、呼吸抑制等并发症的发生率.结果 E-P组与P组的伤口镇痛效果无显著性差异(P>0.05),而E-P组的宫缩痛的发生率和疼痛强度明显低于P组(P<0.05),且恶心、呕吐、发热等发生率低于P组,差异有显著性(P<0.05).结论 超前应用丙帕他莫对剖宫产术后宫缩痛的发生具有预防作用,可有效控制宫缩痛的疼痛程度,同时减少副作用发生率.

  14. Cesarean Section Birth

    Medline Plus

    Full Text Available ... c-section delivery without labor, there's an increased risk for the baby to need some extra help. ... with each successive c-section, there's an increased risk of there being scar tissue, which may increase ...

  15. Cesarean Section Birth

    Medline Plus

    Full Text Available ... classical cesarean sections, because the risk of uterine rupture with subsequent labor is greater, we generally don' ... With a BVAC, there's a risk of uterine rupture. With multiple cesarean sections, there's a risk of ...

  16. Cesarean Section Birth

    Medline Plus

    Full Text Available ... JODI JACKSON, MD: Anytime that you have a c-section delivery without labor, there's an increased risk ... important to think about the reasons why a c-section is indicated. The literature suggests that once ...

  17. 47 CFR 64.1900 - Nondominant interexchange carrier certifications regarding geographic rate averaging and rate...

    Science.gov (United States)

    2010-10-01

    ... such services in compliance with its geographic rate averaging and rate integration obligations... certifications regarding geographic rate averaging and rate integration requirements. 64.1900 Section 64.1900 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED)...

  18. Trends in the obstetric features and management of twin pregnancies.

    LENUS (Irish Health Repository)

    Smith, K E

    2010-03-01

    There are no reports outlining the trends in obstetric features and clinical management of twin pregnancies in an Irish obstetric population. The aim of this study was to investigate these factors for all twin pregnancies delivered during the 19 year period between 1989 and 2007, at Galway University Hospital (GUH). There were 52,199 infants delivered at GUH, of which 1594 infants (3.05% of births) were twins, related to 797 twin pregnancies. The overall incidence of twin pregnancies was 1.52%, increasing from 0.8%-1.0% in the early years of the study to 1.7-1.8% in the latter years of the study (P<0.001). There was a significant increase in incidence of twins born to mothers aged 30-39 years, alongside a significant reduction to mothers aged 20-29 years (P<0.01). The caesarean section rate overall was 41.5% (331\\/797), of which 54% (n=179) were elective, and 46% (n=152) were emergency, representing an emergency caesarean section rate of 19.1% of all twin pregnancies, and of 24.6% after exclusion of elective caesarean sections. The caesarean section rate for twins increased from 30% in 1989 to greater than 50% in the latter years of the study (P<0.01), related largely to a significant increase in elective caesarean sections (P<0.01). The combined vaginal-caesarean delivery rate was remarkably low at 0.75% of all twin pregnancies, and 1% after exclusion of elective caesarean sections. The preterm delivery rates were 4.1% (<32 weeks), and 16.3% (<36 weeks), with an overall perinatal mortality rate of 37 per 1000. These findings highlight the altered demographic and clinical aspects of twin pregnancies in an Irish obstetric population.

  19. GESTATIONAL OBESITY AS A DETERMINANT OF GENERAL ANESTHESIA TECHNIQUE FOR CAESAREAN DELIVERY: A CASE REPORT Obesidad en la gestación como determinante de técnica anestésica general para cesárea: reporte de caso

    OpenAIRE

    José Ricardo Navarro-Vargas; José Luis Aldana-Díaz; Javier H. Eslava-Schamalbach

    2009-01-01

    Background. The incidence of obesity has undergone a dramatic increase around the world during the last few years. Such epidemic behavior has been associated with obstetric patient’s frequent presentation of different stages of obesity when undergoing anesthetic procedure. Obesity in pregnant women involves the risk of adverse maternal and fetal outcomes. Hypertension and preeclampsia, diabetes, fetal macrosomia, caesarean delivery, difficult airway management and neuroaxial techniques are mo...

  20. Analysis of the Factors Affecting the Choice of Cesarean Section in Women of Childbearing Age%育龄期妇女选择剖宫产的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    黄凯清

    2015-01-01

    目的:分析育龄妇女选择剖宫产的影响因素,以利于实施针对性的健康教育,提高育龄妇女对分娩方式的认知水平。方法采用调查问卷对2013年1月至2013年12月于我区8家镇医院分娩的1580位育龄妇女的分娩方式进行调查,统计剖宫产率及产妇选择剖宫产的原因。结果1048例剖宫产,520例阴道分娩,12例阴道助产,剖宫产率达66.33%;选择剖宫产分娩的产妇中,高等教育者显著多于低等教育者,职业劳动量较少者显著多于劳动量较多者,超过35岁的产妇显著多于35岁以下产妇,经产妇与初产妇之间的差异较少。剖宫产及阴道分娩母婴结局的比较无统计学意义(P ﹥0.05)。结论职业文化、年龄、助产技术及社会因素是造成育龄期妇女选择剖宫产的重要原因,提高医护人员的专业水平,对手术指征进行合理控制,有利于降低剖宫产率。%Objective To analyze factors affected women of childbearing age choose cesarean section,in order to facilitate the implementation of targeted health education,improved the cognitive level of women of childbearing age on mode of delivery. Methods The mode of delivery by questionnaire in 2013 January to 2013 December in the district 8 home town hospital childbirth 1580 women of childbearing age were investigated,statistics of cesarean section rate and maternal selection causes of cesarean section. Results 1048 cases of cesarean section,520 cases of vaginal delivery,12 cases of vaginal delivery,cesarean section rate was 66. 33% ;the choice of caesarean birth mothers,higher education were significantly more than low education,occupation labor less significantly more than the amount of labor is more and more,more than 35 years old is significantly more than the following maternal maternal at the age of 35,the difference between maternal and early maternal less. Cesarean section and vaginal delivery on maternal and neonatal

  1. Cesarean section in twin pregnancies in two Danish counties with different cesarean section rates

    DEFF Research Database (Denmark)

    Henriksen, T B; Sperling, Lene; Hedegaard, M;

    1994-01-01

    scaled follow-up studies regarding maternal and perinatal morbidity and mortality. Other more subtle determinants of the physicians' and the pregnant women's attitude towards CS, however, seem quantitatively important, and these can only be evaluated in observational studies and through discussions....

  2. A Comparison of Urinary Catheter Intubation Before and After Anaesthesia in Selective Caesarean Delivery%择期剖宫产麻醉前后留置尿管的比较观察

    Institute of Scientific and Technical Information of China (English)

    林丽萍

    2014-01-01

    目的:观察择期剖宫产手术孕妇在麻醉前后留置尿管的不适程度及尿路感染情况的比较。方法选择自愿择期剖宫产的孕妇120例,将其随机分为两组。其中Ⅰ组为腰硬联合麻醉后留置尿管,Ⅱ组为在病房进行术前准备时留置尿管,对孕妇插管时舒适度,疼痛程度及术后3d内发出尿路感染的比较。结果Ⅰ组孕妇在留置尿管时比Ⅱ组孕妇舒适度高,疼痛感不明显,插管成功率高,术后3d内尿路感染发生率低。结论麻醉后留置尿管可减轻患者疼痛、不适,提高一次性插管的成功率,减少尿路感染发生率。%Objective To observe the discomfort level and urinary infection of indwel ing urinary catheter in selective caesarean delivery. Methods 120 cases of selective caesarean delivery was divided randomly into two groups, intubation of urinary catheter was carried out after combined subarachnoid epidural analgesia in group one, while it was done during preoperative preparation in the ward in group two. The discomfort in intubation, pain and urinary infection 3 days after operation were compared. Results: Patients in Group one had less pain and higher success in intubation, the pain and urinary infection were significantly less compared with Group two patients. Conclusion Intubation of urinary catheter after combined subarachnoid epidural analgesia can lessen the pain and discomfort , improve the success of intubation and decrease the incidence of urinary infection.

  3. 18 CFR 300.14 - Filings under section 7(k).

    Science.gov (United States)

    2010-04-01

    ...(k). 300.14 Section 300.14 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... section 7(k). Any application for Commission review and approval of a rate or rate schedules established by the Administrator of the Bonneville Power Administration pursuant to section 7(k) of the...

  4. Cesarean Section Birth

    Medline Plus

    Full Text Available ... opinion on this seemingly growing trend to undergo electric cesarean section instead of traditional vaginal delivery, especially ... that we've got a completely dry operative field. And it looks really great. So we sort ...

  5. Flow Cytometry Section

    Data.gov (United States)

    Federal Laboratory Consortium — The primary goal of the Flow Cytometry Section is to provide the services of state-of-the-art multi-parameter cellular analysis and cell sorting for researchers and...

  6. Light Imaging Section

    Data.gov (United States)

    Federal Laboratory Consortium — The mission of the Light Imaging Section is to give NIAMS scientists access to state-of-the-art light imaging equipment and to offer training and assistance at all...

  7. Cesarean Section Birth

    Medline Plus

    Full Text Available ... for granted and feel that this is not something that's potentially dangerous, and therefore, maybe we might ... be with the family as much, so it's something to consider always when performing a c-section ...

  8. Cesarean Section Birth

    Medline Plus

    Full Text Available ... sections sometimes have a good bit of scar tissue. Sometimes there's really not a whole lot there. ... there's an increased risk of there being scar tissue, which may increase the patient's risk for complications ...

  9. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Just a moment, please. You've saved this page It's been added to your dashboard . Cesarean section: ... Map Premature birth report card Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness ...

  10. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Your e-mail was sent. Save to my dashboard Sign in or Sign up to save this ... saved this page It's been added to your dashboard . Cesarean section: The operation 3:12 Dr. Siobhan ...

  11. Cesarean Section Birth

    Medline Plus

    Full Text Available ... may increase the patient's risk for complications or injury to surrounding organs such as bowel or bladder. ... sections, there's a risk of scar tissue and injury to surrounding organs. So I think it's oftentimes ...

  12. Cesarean Section Birth

    Medline Plus

    Full Text Available ... hear the baby and the baby will be right here with her immediately after delivery. So we' ... a repeat cesarean section, we make the incision right through the patient's previous incision. This is called ...

  13. Cesarean Section Birth

    Medline Plus

    Full Text Available ... We've already started, so things are going well. 00:05:37 FEMALE VOICE: [Unintelligible.] 00:05: ... D. RIDGWAY, MD: Sure. The repeat cesarean section. Well, typically we try not to do elective deliveries ...

  14. Cesarean Section Birth

    Medline Plus

    Full Text Available ... need a lot of special help. So it's real important when c-sections are performed that we ... patients, the particular risks of both, and both options need to be discussed. And then the patient ...

  15. Utility straight sections

    Energy Technology Data Exchange (ETDEWEB)

    Leemann, B.; Peggs, S.; Peterson, J.

    1985-10-01

    Utility straight sections are insertions in the SSC lattice to provide relatively free space to facilitate various beam manipulations. These uses include beam-abort, injection (and conceivably ejection), space for the rf system, and collimation. A typical utility straight section is 1500 meters in overall length (ranging from 500 to 1200 meters). It has zero dispersion and high values of the beta functions. The betatron phase shift across the insertion is about 90{degrees} in each plane.

  16. Vaginal birth after cesarean section

    Directory of Open Access Journals (Sweden)

    Vidyadhar B Bangal

    2013-01-01

    Full Text Available Background: The rate of primary cesarean section (CS is on the rise. More and more women report with a history of a previous CS. A trial of vaginal delivery can save these women from the risk of repeat CS. Aims: The study was conducted to assess the safety and success rate of vaginal birth after CS (VBAC in selected cases of one previous lower segment CS (LSCS. Materials and Methods: The prospective observational study was carried out in a tertiary care teaching hospital over a period of two years. One hundred pregnant women with a history of one previous LSCS were enrolled in the study. Results: In the present study, 85% cases had a successful VBAC and 15% underwent a repeat emergency LSCS for failed trial of vaginal delivery. Cervical dilatation of more than 3 cm at the time of admission was a significant factor in favor of a successful VBAC. Birth weight of more than 3,000 g was associated with a lower success rate of VBAC. The incidence of scar dehiscence was 2% in the present study. There was no maternal or neonatal mortality. Conclusion: Trial of VBAC in selected cases has great importance in the present era of the rising rate of primary CS especially in rural areas.

  17. Dosimetry and Calibration Section

    International Nuclear Information System (INIS)

    The two tasks of the Dosimetry and Calibration Section at CERN are the Individual Dosimetry Service which assures the personal monitoring of about 5000 persons potentially exposed to ionizing radiation at CERN, and the Calibration Laboratory which verifies all the instruments and monitors. This equipment is used by the sections of the RP Group for assuring radiation protection around CERN's accelerators, and by the Environmental Section of TISTE. In addition, nearly 250 electronic and 300 quartz fibre dosimeters, employed in operational dosimetry, are calibrated at least once a year. The Individual Dosimetry Service uses an extended database (INDOS) which contains information about all the individual doses ever received at CERN. For most of 1997 it was operated without the support of a database administrator as the technician who had assured this work retired. The Software Support Section of TIS-TE took over the technical responsibility of the database, but in view of the many other tasks of this Section and the lack of personnel, only a few interventions for solving immediate problems were possible

  18. 2013 FEMA Cross Sections

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — The National Flood Hazard Layer (NFHL) data incorporates all Digital Flood Insurance Rate Map(DFIRM) databases published by FEMA, and any Letters Of Map Revision...

  19. Cesarean Section Birth

    Medline Plus

    Full Text Available ... cesarean section delivery during this hour-long period. I am Dr. Reagan Wittek. I am an obstetrician with Shawnee Mission Medical Center ... joined us for this webcast. Next to me I have Dr. Elizabeth Wickstrom, who is a maternal- ...

  20. PRES 2012 special section

    DEFF Research Database (Denmark)

    Klemeš, Jiří Jaromír; Varbanov, Petar Sabev; Wang, Qiuwang; Lund, Henrik

    2013-01-01

    This Special Section provides introduction to the 15th Conference Process Integration, Modelling and Optimisation for Energy Saving and Pollution Reduction (PRES 2012). In this editorial introduction, the editors are highlighting the individual articles included in this issue and discussing the...