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Sample records for cesarean delivery affects

  1. Osteogenesis imperfecta: cesarean deliveries in identical twins.

    Science.gov (United States)

    Dinges, E; Ortner, C; Bollag, L; Davies, J; Landau, R

    2015-02-01

    Osteogenesis imperfecta is a congenital disorder resulting in multiple fractures and extremely short stature, usually necessitating cesarean delivery. Identical twins with severe osteogenesis imperfecta each of whom underwent a cesarean delivery with different anesthetic modalities are presented. A review of the literature and anesthetic options for cesarean delivery and postoperative analgesia for women with osteogenesis imperfecta are discussed. PMID:25433579

  2. Elective cesarean delivery affects gut maturation and delays microbial colonization but does not increase necrotizing enterocolitis in preterm pigs

    DEFF Research Database (Denmark)

    Siggers, R. H.; Thymann, Thomas; Jensen, Bent B.;

    2008-01-01

    Although preterm birth and formula feeding increase the risk of necrotizing enterocolitis (NEC), the influences of cesarean section (CS) and vaginal delivery (VD) are unknown. Therefore, gut characteristics and NEC incidence and severity were evaluated in preterm pigs (92% gestation) delivered by...

  3. Risk of Asthma from Cesarean Delivery Depends on Membrane Rupture

    DEFF Research Database (Denmark)

    Sevelsted, Astrid; Stokholm, Jakob; Bisgaard, Hans

    2016-01-01

    weight, gestational age, multiple births, parity, and maternal factors (age, smoking/antibiotics during pregnancy,employment status, and asthma). RESULTS: In the Copenhagen Prospective Studies on Asthma in Childhood2000 cohort, the adjusted hazard ratio for asthma was increased by cesarean delivery...... rate ratio to vaginal delivery 1.12 [1.09-1.16]). CONCLUSIONS: We confirmed cesarean delivery to be a risk factor for childhood asthma. This effect was more pronounced for cesarean delivery performed before rupture of membranes.......OBJECTIVE: To assess our prospective mother-child cohort and the national registry data to analyze the risk of asthma by delivery mode and whether cesarean delivery before or after membrane rupture affects this risk differently. STUDY DESIGN: The Copenhagen Prospective Studies on Asthma in...

  4. Quality of Life after Cesarean and Vaginal Delivery

    Directory of Open Access Journals (Sweden)

    Seyed Abbas Mousavi

    2013-07-01

    Full Text Available Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery.Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum.Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65 ± 12.7 and 72.12 ± 11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05. In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350] and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023] domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]. While multiparas, there was no relationship between QOL and type of delivery.Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery.

  5. Imaging evaluation of maternal complications associated with repeat cesarean deliveries.

    Science.gov (United States)

    Moshiri, Mariam; Osman, Sherif; Bhargava, Puneet; Maximin, Suresh; Robinson, Tracy J; Katz, Douglas S

    2014-09-01

    The rate of cesarean deliveries continues to rise, while the rate of vaginal delivery after cesarean birth continues to decline. Many women now tend to undergo multiple cesarean deliveries, and therefore the associated chronic maternal morbidities are of growing concern. Accurate diagnosis of these conditions is crucial in maternal and fetal well-being. Many of these complications are diagnosed by imaging, and radiologists should be aware of the type and imaging appearances of these conditions. PMID:25173662

  6. The Brazilian preference: cesarean delivery among immigrants in Portugal.

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    Cristina Teixeira

    Full Text Available OBJECTIVE: To evaluate how the country of origin affects the probability of being delivered by cesarean section when giving birth at public Portuguese hospitals. STUDY DESIGN: Women delivered of a singleton birth (n = 8228, recruited from five public level III maternities (April 2005-August 2006 during the procedure of assembling a birth cohort, were classified according to the country of origin and her migration status as Portuguese (n = 7908, non-Portuguese European (n = 84, African (n = 77 and Brazilian (n = 159. A Poisson model was used to evaluate the association between country of birth and cesarean section that was measured by adjusted prevalence ratio (PR and respective 95% confidence intervals (95%CI. RESULTS: The cesarean section rate varied from 32.1% in non-Portuguese European to 48.4% in Brazilian women (p = 0.008. After adjustment for potential confounders and compared to Portuguese women as a reference, Brazilian women presented significantly higher prevalence of cesarean section (PR = 1.26; 95%CI: 1.08-1.47. The effect was more evident among multiparous women (PR = 1.39; 95%CI: 1.12-1.73 and it was observed when cesarean section was performed either before labor (PR = 1.43; 95%CI: 0.99-2.06 or during labor (PR = 1.30; 95%CI: 1.07-1.58. CONCLUSIONS: The rate of cesarean section was significantly higher among Brazilian women and it was independent of the presence of any known risk factors or usual clinical indications, suggesting that cultural background influences the mode of delivery overcoming the expected standard of care and outcomes in public health services.

  7. Neonatal outcomes and operative vaginal delivery versus cesarean delivery.

    LENUS (Irish Health Repository)

    Contag, Stephen A

    2010-06-01

    We compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at >or=36 weeks\\' gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess (P = 0.35 and 0.78 for failure of descent and nonreassuring fetal status) or frequencies of pH below 7.0 (P = 0.73 and 0.34 for failure of descent and nonreassuring fetal status) among the three delivery methods. Birth outcomes and umbilical cord blood gas values were similar for those neonates with a forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. The occurrence of significant fetal acidemia was not different among the three delivery methods regardless of the indication.

  8. Sharp compared with blunt fascial incision at cesarean delivery

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Hare, Kristine J; Krebs, Lone;

    2014-01-01

    To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control.......To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control....

  9. Comparing Quality of Life in Women after Vaginal Delivery and Cesarean Section

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    Mohammad Mahdi Majzoobi

    2014-10-01

    Full Text Available Background & aim: Postpartum period is accompanied by significant changes in women’s quality of life. These alterations can affect the health of mothers and children. Considering the importance of postnatal quality of life and its different contributing factors, this study aimed to compare women’s quality of life after vaginal delivery and cesarean section. Methods:This retrospective cohort study included a random sample of 2100 women, referring to Hamadan health care centers for congenital hypothyroidism screening or infant vaccination. The participants’ quality of life was examined, using Short Form-36 (SF-36 questionnaire, evaluating five periods of time including one week, two months, four months, six months, and one year after delivery (either vaginal or cesarean delivery. Data were analyzed using t-test. Results: Quality of life was significantly higher in women with vaginal delivery, compared to women with cesarean section in all periods including one week (68.77 vs. 42.44, two months (69.11 vs. 54.76, four months (78.19 vs. 53.02, six months (75.62 vs. 54.94,and one year(78.43 vs. 53.77 after delivery. Conclusion: Considering women’s higher quality of life after vaginal delivery, compared to cesarean section, it seems that vaginal delivery is a safer and less expensive option, which is recommended for all pregnant women.

  10. Cesarean delivery on maternal request and childhood intelligence: a cohort study

    Institute of Scientific and Technical Information of China (English)

    LI Hong-tian; YE Rong-wei; PEI Li-jun; REN Ai-guo; ZHENG Xiao-ying; LIU Jian-meng

    2011-01-01

    Background Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China.Cesarean delivery on maternal request is a major contributor to this upward trend,and there has been of much concern about its impact on maternal and child health.Most of mothers believe that cesarean delivery on maternal request can improve the child's intelligence,but direct evidence is sparse.In this cohort study,we aimed to directly assess the impact of cesarean delivery on maternal request on childhood intelligence.Methods Intelligence quotient (IQ) of 4144 preschool children from 21 cities/counties of Zhejiang and Jiangsu province whose mothers were registered in a population-based perinatal surveillance program during 1993-1996 was assessed with Chinese Wechsler Young Children Scale of Intelligence (C-WYCSI) in 2000.The outcomes were full-scale IQ,verbal IQ,and performance IQ of C-WYCSI.Mode of delivery and covariates were obtained from the surveillance program.We estimated unadjusted and adjusted effects of cesarean delivery on maternal request and assisted vaginal delivery on IQ scores compared with spontaneous vaginal delivery using regression analysis.Results The mean full-scale,verbal,and performance IQ for all children was 99.3±16.1,93.6±17.7,and 105.3±14.3.In crude analysis,cesarean delivery on maternal request versus spontaneous vaginal delivery was associated with an increase of 3.9 (95% confidence interval,0.6 to 7.2) points in full-scale IQ,4.8 (1.2 to 8.4) points in verbal IQ,and 2.4(-0.6 to 5.3) points in performance IQ.After adjusting for maternal education,occupation,and IQ,the advantage was reduced to 1.6 (-1.3 to 4.5),2.3 (-0.8 to 5.5),and 0.6 (-2.0 to 3.3) points for full-scale,verbal,and performance IQ,respectively.Assisted vaginal delivery versus spontaneous vaginal delivery was not associated with IQ scores in any analysis.Conclusion Neither cesarean delivery on maternal request nor assisted vaginal delivery

  11. Risk factors for cesarean delivery in primigravida during spontaneous labor

    International Nuclear Information System (INIS)

    Objective: To identify the risk factors for cesarean delivery among primigravida at Hospital Serdang. Methodology: This was a case control study which involved total 260 of 130 primigravida patients that underwent cesarean section (cases) and 130 primigravida patients that underwent vaginal delivery (control) at obstetrics and gynaecology department of Hospital Serdang, Malaysia from January until June 2013. A standardized proforma was used to collect the data of each primigravida patient presenting in spontaneous labour at term with singleton pregnancy with either caesarean or vaginal delivery. Results: Majority of the cases were Malaysian (86.9%) and mostly were from Malay ethnic group (75.4%). In multivariate logistic regression analysis, presence of hypertension status (odds ratio (OR) 5.7, 95% CI; 1.56-20.84) and gestational age less than 40 weeks (OR 2.60, 95% CI 1.34-5.02), fetal weight more than 3000 gm (OR 1.8, 95% CI 1.1-2.95), were associated with higher odds of cesarean delivery. Conclusion: Primigravida with presence of hypertension, having gestational age less than 40 weeks and heavier fetus were associated with higher odds of cesarean delivery. (author)

  12. Vaginal delivery versus cesarean section for term breech delivery

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    Babović Ivana

    2010-01-01

    Full Text Available Background/Aim. The optimal method of delivery for breech presentation at term still remains a matter of controversy. This is probably due to the fact that the skills of vaginal breech delivery are being lost. The aim of this study was to examine risk factors: mother's age, parity, labor's duration, estimated neonatal birth weight for the mode of breech presentation delivery at term as well as the influence of the delivery mode on neonatal outcome. Methods. A retrospective study of 401 terms (more than 37 week's gestation breech deliveries at the Institute of Gynecology and Obstetrics, Belgrade, from 2007 to 2008 was made. The following groups with respect to mode of delivery were included: the group I - vaginal delivery (VD in 139 patients; the group II - urgent cesarean section (UCS in 128 patients; and the group III - elective cesarean section (ECS in 134 patients. Mother's age, parity, duration of VD, neonatal birth weight (BW, the Apgar score at 5th minute, and duration of stay in a neonatal intensive care unit (NICU vere determined. Neonatal mortality and major neonatal morbidity were compared according to the route of delivery. Fetuses and neonates with hemolytic disease and fetal and neonatal anomalies were excluded from the study. For statistical analyses we performed Student's t test, χ2 likelihood ratio, Kruskall-Wallis test, Mann Whitney test, and ANOVA. Results. The mean age of patients in the group I was 28.29 ± 4.97 years, in the group II 29.68 ± 5.92 years and in the group III 30.06 ± 5.41 years. Difference in mother's age between the group I and III was significant (p = 0.022. In the group III there were 73.9% nuliparous similarly to the gropu II (73.4%. We performed ECS in 54.6% of the nuliparous older than 35 years, and 54.4% multiparous younger than 35 years were delivered by VD. The use of oxytocin for stimulation of vaginal labor was not associated with its duration (p = 0.706. Lowset maneuver was performed in 88.5% of

  13. Nontraumatic Fat Embolism Found Following Maternal Death after Cesarean Delivery

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    Tabitha Schrufer-Poland

    2015-04-01

    Full Text Available Introduction - Fat embolism is a rare form of nonthrombotic embolization. Limited literature exists regarding the diagnosis of fat embolism during the perinatal period. We present the first case of maternal death that resulted from nontraumatic fat embolization following Cesarean delivery. Case Description - A 29-year-old gravida 1 with a complex medical and surgical history underwent a primary Cesarean delivery at term. On postoperative day 2 the patient was found to be unresponsive. Despite resuscitative efforts, the patient succumbed. Autopsy findings were remarkable for diffuse pulmonary fat emboli. Furthermore, there was no histological evidence of either amniotic fluid embolism or thromboembolism. The primary cause of death was attributed to nontraumatic fat embolization. Discussion - Multiple risk factors may have contributed to the development of nontraumatic fat embolization in our patient. Obstetricians should maintain a high level of suspicion for nontraumatic fat embolization in cases of maternal respiratory decompression and sudden maternal mortality.

  14. Outcomes of vaginal delivery and cesarean in Mashhad Ghaem University Hospital

    OpenAIRE

    Hassan Boskabadi; Maryam Zakerihamidi; Fatemeh Bagheri

    2014-01-01

    Background: Normal vaginal delivery is the best method of delivery. Vaginal delivery is followed by the best pregnancy outcomes. Reducing the rate of cesarean delivery has been a health goal for the United States with economic and social advantages. This study has been conducted with aim of maternal and neonatal outcomes of Normal Vaginal Delivery (NVD) and comparing with cesarean delivery. Methods: This descriptive- analytic study was conducted in Ghaem University Hospital in Mashhad duri...

  15. Remote prognosis after primary cesarean delivery: the association of VBACs and recurrent cesarean deliveries with maternal morbidity

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    Erez O

    2012-03-01

    Full Text Available Offer Erez1, Lena Novack2, Vered Kleitman-Meir1, Doron Dukler1, Idit Erez-Weiss3, Francesca Gotsch4, Moshe Mazor11Department of Obstetrics and Gynecology, Soroka University Medical Center, 2Department of Epidemiology, 3Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 4Obstetrics and Gynecology Departement, Policlinico GB Rossi Azienda Ospedaliera Universitaria Integrata Verona, ItalyPurpose: To determine the effects of vaginal birth after cesarean (VBAC versus repeated cesarean sections (RCS after a primary cesarean section (CS, on the rate of intraoperative and postpartum maternal morbidity.Patients and methods: This is a retrospective population-based cohort study. During the study period (1988–2005 there were 200,012 deliveries by 76,985 women at our medical center; 16,365 of them had a primary CS, of which 7429 women delivered a singleton infant after the primary CS, met the inclusion criteria, were included in our study, and were followed for four consecutive deliveries. Patients were divided into three study groups according to the outcome of their consecutive delivery after the primary CS: VBAC (n = 3622, elective CS (n = 1910, or an urgent CS (n = 1897. Survival analysis models were used to investigate the effect of the urgency of CS and the numbers of pregnancy predating the primary CS on peripartum complications.Results: Women who failed a trial of labor had a higher rate of uterine rupture than those who had a VBAC. Patients who delivered by CS had a higher rate of endometritis than those giving birth vaginally. The rate of cesarean hysterectomy and transfer to other departments increased significantly at the fourth consecutive surgery (P = 0.02 and P = 0.003, respectively. VBAC was associated with a 55% reduction in the risk of intrapartum complications in comparison to a planned CS (hazard ratio [HR] 0.45; 95% confidence interval [CI]: 0.22–0.89. A greater

  16. Delivery by Cesarean Section and risk of childhood cancer

    DEFF Research Database (Denmark)

    Momen, Natalie; Olsen, Jørn; Gissler, Mika;

    suggest CS does not influence overall childhood cancer risk. We did not see any difference between the two types of CS. Additionally it was not strongly associated with any specific childhood cancer, but power was limited for some types. Considering the high CS rates, even a small increase in risk of......Introduction Studies suggest delivery by Cesarean section (CS) may impact the development of the immune system. Meta-analyses on CS and risks of type I diabetes mellitus and asthma have found risks increased by 20%. Three different mechanisms have been proposed by which CS may influence immune...... childhood cancer could therefore have public health impact....

  17. Women who conceived with infertility treatment were more likely to receive planned cesarean deliveries in Taiwan.

    Science.gov (United States)

    Chien, Li-Yin; Lee, Yu-Hsiang; Lin, Yu-Hung; Tai, Chen-Jei

    2015-06-01

    The objective of this study was to examine the effect of conception with infertility treatment on planned cesarean delivery. The participants were from a panel of primiparous pregnant women in northern Taiwan. The data analysis included 771 women with a singleton pregnancy, of whom 160 had a planned cesarean delivery and 611 who had a vaginal delivery. The study women answered structured questionnaires during the second and third trimesters of pregnancy, and at one-month postpartum. Women who conceived with infertility treatment were more likely to have planned cesarean deliveries than women who conceived without it (44.7% versus 18.1%, p maternal age over 35 years, whether they were currently unmarried, selection of time for birth in advance, gestational hypertension, and birthweight maternal age or higher number of morbidities during pregnancy. Counseling for women who conceive with infertility treatments may be needed to decrease unnecessary cesarean deliveries. PMID:25581216

  18. Emergency cesarean delivery in a parturient who had an intractable paroxysmal supraventricular tachycardia -A case report-

    OpenAIRE

    Kim, Kyoung Ok; Chang, Eun-jung; Han, Jin; Cho, Hun

    2012-01-01

    Paroxysmal supraventricular tachycardia (SVT) is a common arrhythmia in the parturient and can occur with or without an underlying organic heart disease. A woman of 35 weeks' gestation, who had a paroxysmal SVT that was resistant to antiarrhythmic drugs and electric cardioversion, required emergency Cesarean delivery. The Cesarean delivery was performed under spinal anesthesia and a healthy baby was delivered uneventfully. SVT spontaneously converted to normal sinus rhythm right after deliver...

  19. Epidural anesthesia for repeat cesarean delivery in a parturient with Klippel-Feil syndrome

    OpenAIRE

    Smith, Kathleen A.; Adrienne P Ray

    2011-01-01

    A patient with Klippel-Feil syndrome, morbid obesity, and scoliosis required cesarean delivery. Her previous cesarean deliveries were performed under general anesthesia. She desired a regional technique. Following aspiration prophylaxis and placement of standard monitors, ultrasound was used to identify midline and L 2-3 interspace. Unintentional dural puncture occurred at 10 cm, with an inability to advance the catheter. On second attempt, an epidural catheter was placed easily. After negati...

  20. The use of quality control performance charts to analyze cesarean delivery rates nationally.

    LENUS (Irish Health Repository)

    Turner, Michael J

    2012-02-01

    OBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+\\/-2.6% (n=9337) and 13.8+\\/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+\\/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.

  1. Risk factors for cesarean section and instrumental vaginal delivery after successful external cephalic version.

    Science.gov (United States)

    de Hundt, Marcella; Vlemmix, Floortje; Bais, Joke M J; de Groot, Christianne J; Mol, Ben Willem; Kok, Marjolein

    2016-06-01

    Aim of this article is to examine if we could identify factors that predict cesarean section and instrumental vaginal delivery in women who had a successful external cephalic version. We used data from a previous randomized trial among 25 hospitals and their referring midwife practices in the Netherlands. With the data of this trial, we performed a cohort study among women attempting vaginal delivery after successful ECV. We evaluated whether maternal age, gestational age, parity, time interval between ECV and delivery, birth weight, neonatal gender, and induction of labor were predictive for a vaginal delivery on one hand or a CS or instrumental vaginal delivery on the other hand. Unadjusted and adjusted odds ratios were calculated with univariate and multivariate logistic regression analysis. Among 301 women who attempted vaginal delivery after a successful external cephalic version attempt, the cesarean section rate was 13% and the instrumental vaginal delivery rate 6%, resulting in a combined instrumental delivery rate of 19%. Nulliparity increased the risk of cesarean section (OR 2.7 (95% CI 1.2-6.1)) and instrumental delivery (OR 4.2 (95% CI 2.1-8.6)). Maternal age, gestational age at delivery, time interval between external cephalic version and delivery, birth weight and neonatal gender did not contribute to the prediction of failed spontaneous vaginal delivery. In our cohort of 301 women with a successful external cephalic version, nulliparity was the only one of seven factors that predicted the risk for cesarean section and instrumental vaginal delivery. PMID:26333291

  2. Uterus Wrapping: A Novel Concept in the Management of Uterine Atony during Cesarean Delivery

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    N. Kimmich

    2015-01-01

    Full Text Available Uterine atony during cesarean delivery is a serious cause of maternal morbidity and mortality. Management strategies include medical treatment with uterotonic agents, manual compression of the uterus, and interventional or surgical procedures. A novel technique to compress the uterus by wrapping it with an elastic bandage and its outcome in 3 cases of uterine atony during cesarean section are presented. Our novel method of intermittent wrapping of the uterus during cesarean delivery seems to be a successful additional approach in the management of uterine atony during cesarean delivery and may be an alternative treatment option to other compressing procedures in order to avoid high blood loss and last but not least postpartum hysterectomy.

  3. Outcomes of vaginal delivery and cesarean in Mashhad Ghaem University Hospital

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    Hassan Boskabadi

    2014-03-01

    Conclusion: The results of this study showed in comparison with cesarean delivery, normal vaginal delivery provides better outcomes in terms of breast problems, breast feeding status, duration of labor and duration of maternal hospitalization for both mother and infant. So, adopting careful instructions in management and administration of deliveries will help the prevalence of making decisions for normal vaginal delivery and the recovery of delivery outcomes.

  4. Trial of labor compared to repeat cesarean section in women with no other risk factors than a prior cesarean delivery

    DEFF Research Database (Denmark)

    Studsgaard, Anne; Skorstengaard, Malene; Glavind, Julie;

    2013-01-01

    prior vaginal delivery (adjusted OR 1.8, 95% CI 1.1-3.0), index emergency cesarean during labor (adjusted OR 3.0, 95% CI 2.3-4.1), maternal age ≥35 years (adjusted OR 1.9, 95% CI 1.3-2.8), pre-pregnancy body mass index ≥30 (adjusted OR 2.1, 95% CI 1.3-3.3), and birthweight 4000-4499 g (adjusted OR 1...... prospective registration of the deliveries. MAIN OUTCOME MEASURES: Adverse neonatal outcomes, risk factors for emergency cesarean, and uterine rupture in case of TOLAC. RESULTS: TOLAC was associated with an increased risk of neonatal depression [odds ratio (OR) 3.6, 95% confidence interval (CI) 1.1-19.1] and...... neonatal intensive care unit admission (adjusted OR 1.9, 95% CI 1.3-2.8). Within the TOLAC group 67% delivered vaginally. In the TOLAC group 1.3% (n = 15) of the women had a complete uterine rupture. None of these infants had sequelae after 12 months. Significant risk factors for emergency cesarean were no...

  5. Risk Factors for Cesarean Delivery following Labor Induction in Multiparous Women

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    Corine J. Verhoeven

    2013-01-01

    Full Text Available Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the data of two successful inductions as controls. Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position. Results. Between 1995 and 2010, labor was induced in 2548 parous women, of whom 80 had a cesarean delivery (3%. These 80 cases were compared to the data of 160 parous women with a successful induction of labor. In the multivariate analysis history of preterm delivery (odds ratio (OR 5.3 (95% CI 1.1 to 25, maternal height (OR 0.87 (95% CI 0.80 to 0.95 and dilatation at the start of induction (OR 0.43 (95% CI 0.19 to 0.98 were associated with failed induction. Conclusion. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction.

  6. Anesthetic management of urgent cesarean delivery in a parturient with acute malaria infection: a case report.

    Science.gov (United States)

    Zanfini, Bruno Antonio; Dell'Anna, Antonio Maria; Catarci, Stefano; Frassanito, Luciano; Vagnoni, Salvatore; Draisci, Gaetano

    2016-04-01

    Malaria is associated with high rates of morbidity and mortality worldwide, particularly in Africa, Southeast Asia and South America. Nonetheless, several cases of malaria have been reported in Western countries involving travelers from endemic areas, though very few involve pregnant women. In this article, we report a case of a young woman born in Sierra Leone who had been living in Italy for two years. She was admitted to our hospital with malaise; worsening of her condition led to Plasmodium falciparum infection diagnosis early during her hospital stay, as well as an urgent cesarean delivery. We briefly discuss the features of malaria in pregnancy, the difficulties associated with early diagnosis, and the possible fetal and maternal implications, and also consider how the disease may affect anesthetic management. PMID:27066212

  7. Epidural anesthesia for repeat cesarean delivery in a parturient with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Kathleen A Smith

    2011-01-01

    Full Text Available A patient with Klippel-Feil syndrome, morbid obesity, and scoliosis required cesarean delivery. Her previous cesarean deliveries were performed under general anesthesia. She desired a regional technique. Following aspiration prophylaxis and placement of standard monitors, ultrasound was used to identify midline and L 2-3 interspace. Unintentional dural puncture occurred at 10 cm, with an inability to advance the catheter. On second attempt, an epidural catheter was placed easily. After negative test dose, 18 ml of 2% lidocaine with epinephrine was administered to the patient. A T4 level was achieved. The patient tolerated surgery well. Complete block resolution occurred at 4 hours with no neurologic sequelae.

  8. Is Cesarean Delivery Preferable in Twin Pregnancies at >=36 Weeks Gestation?

    Science.gov (United States)

    Dong, Yu; Luo, Zhong-Cheng; Yang, Zu-Jing; Chen, Lu; Guo, Yu-Na; Branch, Ware; Zhang, Jun; Huang, Hong

    2016-01-01

    Background The optimal mode of delivery in twin pregnancies remains controversial. A recent randomized trial did not find any benefit of planned cesarean vs. vaginal delivery at 32–38 weeks gestation, but the trial was not powered to detect a moderate effect. We aimed to evaluate the impact of cesarean delivery on perinatal mortality and severe neonatal morbidity in twin pregnancies at ≥32 weeks through a large database exploration approach with the power to detect moderate risk differences. Methods In a retrospective birth cohort study using the U.S. matched multiple births, 1995–2000 (the available largest multiple birth dataset), we compared perinatal outcomes in twins (n = 181,810 pregnancies) delivered at 32–41 weeks gestation without congenital anomalies. The primary outcome was a composite of perinatal death and severe neonatal morbidity. Cox regression was used to estimate the adjusted hazard ratio (aHR) controlling for the propensity to cesarean delivery, fetal characteristics (sex, birth weight, birth weight discordance, same-sex twin or not) and twin-cluster level dependence. Prospective risks were calculated using the fetuses-at-risk denominators. Results The overall rates of the primary outcome were slightly lower in intended cesarean (6.20%) vs. vaginal (6.45%) deliveries. The aHRs of the primary outcome were in favor of vaginal delivery at 32 (aHR = 1.06, p = 0.03) or 33 (aHR = 1.22, ppregnancies at ≥36 weeks gestation. PMID:27227678

  9. Obstetricians' choice of cesarean delivery in ambiguous cases

    DEFF Research Database (Denmark)

    Fuglenes, Dorthe; Oian, Pål; Kristiansen, Ivar Sønbø

    2009-01-01

    survey of Norwegian obstetricians (n = 716; response rate, 71%) using clinical scenarios. The risk attitude was measured by 6 items from the Jackson Personality Inventory-Revised. RESULTS: The proportion of obstetricians consenting to the cesarean request varied both within and across the scenarios. The...

  10. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial.

    LENUS (Irish Health Repository)

    McDonnell, John G

    2008-01-01

    The transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing midline abdominal wall incisions. We evaluated its analgesic efficacy over the first 48 postoperative hours after cesarean delivery performed through a Pfannensteil incision, in a randomized controlled, double-blind, clinical trial.

  11. Midline versus transverse incision for cesarean delivery in low-income countries

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Aabakke, Anna J M; Secher, Niels J

    2014-01-01

    While transverse incision is the recommended entry technique for cesarean delivery in high-income countries, it is our experience that midline incision is still used routinely in many low-income settings. Accordingly, international guidelines lack uniformity on this matter. Although evidence is l...

  12. Cesarean delivery on maternal request: Can the ethical problem be solved by the principlist approach?

    Directory of Open Access Journals (Sweden)

    Da Frè Monica

    2008-06-01

    Full Text Available Abstract In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications. We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice. Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent risks makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation. Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging.

  13. The intelligence quotient of school aged children delivered by cesarean section and vaginal delivery

    OpenAIRE

    Khadem, Nayereh; Khadivzadeh, Talaat

    2010-01-01

    BACKGROUND: There has always been an asking question with physicians and health staff whether delivery mode can effect on child intelligence. This study was conducted to compare the intelligence quotient (IQ) of school aged children delivered by cesarean section and vaginal delivery in Mashhad, Iran. METHODS: This study conducted in two stages; a cross-sectional section in which 5000 randomly selected children, who were 6-7 years old, attended at 10 Cognitive Examination Posts in Mashhad. The...

  14. Emergency bedside cesarean delivery: lessons learned in teamwork and patient safety

    Directory of Open Access Journals (Sweden)

    Kinney Michelle A O

    2012-08-01

    Full Text Available Abstract Background Maternal cardiovascular and pulmonary events during labor and delivery may result in adverse maternal and fetal outcome. Potential etiologies include primary cardiac events, pulmonary embolism, eclampsia, maternal hemorrhage, and adverse medication events. Remifentanil patient-controlled analgesia is an alternative when conventional neuraxial analgesia for labor is contraindicated. Although remifentanil is a commonly used analgesic, its use for labor analgesia is not clearly defined. Case presentation We present an unexpected and unique case of remifentanil toxicity resulting in the need for an emergent bedside cesarean delivery. A 30-year-old G3P2 woman receiving subcutaneous heparin anticoagulation due to a recent deep vein thrombosis developed cardiopulmonary arrest during labor induction due to remifentanil toxicity. Conclusion A rapid discussion among the attending obstetric, anesthesia, and nursing teams resulted in consensus to perform an emergent bedside cesarean delivery resulting in an excellent fetal outcome. During maternal cardiopulmonary arrest, a prompt decision to perform a bedside cesarean delivery is essential to avoid significant maternal and fetal morbidity. Under these conditions, rapid collaboration among obstetric, anesthesia, and nursing personnel, and an extensive multi-layered safety process are integral components to optimize maternal and fetal outcomes.

  15. Emergency cesarean delivery in primigravida with portal hypertension, esophageal varices, and preeclampsia.

    Science.gov (United States)

    Khanna, Puneet; Garg, Rakesh; Roy, Kajari; Punj, Jyotsna; Pandey, Ravindra; Darlong, Vanlal

    2012-10-01

    The incidence of cirrhosis and advanced portal hypertension during pregnancy is very low, and the literature is scarce with regard to the anesthetic management of a parturient with this coexisting disease. We report the successful perioperative management of a parturi- ent with a history of cirrhosis and portal hypertension with esophageal varices and mild preeclampsia who presented at 38 weeks' gestation in active labor with a breech presentation requiring emergency cesarean delivery. She required endoscopic esophageal varices banding during the second trimester of pregnancy. After correction of her coagulopathy, she was administered subarachnoid block and cesarean delivery, which was conducted uneventfully. Anesthetic management of these patients depends on understanding and avoiding variceal hemorrhage, encephalopathy, renal failure, and careful fluid and electrolyte management. PMID:26050279

  16. Feto-maternal Outcomes in Cesarean Section Compared to Vaginal Delivery in Eclamptic Patients in a Tertiary Level Hospital

    Directory of Open Access Journals (Sweden)

    Arifa Akter Jahan

    2013-07-01

    Full Text Available Background: Over half-a-million women die each year from pregnancy-related causes, and 99 percent of these occur in developing countries. In Bangladesh though maternal mortality rate (MMR declined significantly around 40% in the past decade, still eclampsia accounts for 20% of maternal deaths. Eclampsia is uniquely a disease of pregnancy, and the only cure is delivery regardless of gestational age. A rational therapy for general management of hypertension and convulsion has been established in Bangladesh by the Eclampsia Working Group. But controversy still exists regarding obstetric management. Objective: To evaluate the feto-maternal outcome in cesarean section compared to vaginal delivery in eclamptic patients. Materials and Methods: This prospective cohort study was conducted in the department of Obstretics & Gynecology, Dhaka Medical College & Hospital (DMCH, from January to December 2011. A total 100 eclamptic women with term pregnancy and live fetus were purposively included in the study (Group I, 50 patients with vaginal delivery and Group II, 50 with cesarean section. Results: Out of these 100 patients 56% were aged ≤20 years, 71% were primigravida and 77% were from low socioeconomic status. Sixteen percent patients from vaginal delivery group and 18% from cesarean section group had no antenatal care. The mean gestational age was about 38 weeks in two groups. No significant difference was found between the two groups regarding blood pressure, proteinuria, consciousness level and convulsion. Recurrence of convulsion occurred in 30% patients of vaginal delivery group compared to 6% in cesarean section group. Maternal complications such as postpartum hemorrhage, cerebrovascular accident, renal failure, obstetric shock and abruptio placenta were higher among vaginal delivery group patients (46% than cesarean section patients (16%. Maternal mortality was 6% in the vaginal delivery group and none in the cesarean section group. Regarding

  17. A randomized, clinical trial of ketorolac tromethamine vs ketorolac trometamine plus complex B vitamins for cesarean delivery analgesia

    OpenAIRE

    J J Beltrán-Montoya; T Herrerias-Canedo; Arzola-Paniagua, A.; Vadillo-Ortega, F; Omar Felipe Dueñas-Garcia; H Rico-Olvera

    2012-01-01

    Background: Ketorolac is widely used for postoperative analgesia in patients who undergo cesarean delivery. In countries where the use of opioids is considerably restricted, alternatives to narcotics are required. Aim: We hypothesize that the addition of complex B synergize the analgesic effect of ketorolac in postoperative cesarean patients, thus requiring a smaller dose of the anti-inflammatory agent, and therefore decreasing the potential side effects of ketorolac. Methods: A randomized cl...

  18. Efficacy of Intramuscular Nalbuphine versus Diphenhydramine for the Prevention of Epidural Morphine-induced Pruritus after Cesarean Delivery

    Directory of Open Access Journals (Sweden)

    Chia-Chih Liao

    2011-04-01

    Full Text Available Background: Pruritus is the most common side effect of epidural morphine analgesia.Diphenhydramine is a widely used agent for the treatment of urticarial pruritus.Nalbuphine is a mixed opioid agonist–antagonist and has been reportedto be effective in treating opioid-induced pruritus. We compared the effectivenessof intramuscular diphenhydramine and nalbuphine for the preventionof epidural morphine-induced pruritus after cesarean section.Methods: One hundred and fifty, American Society of Anesthesiologists physical statusI or II, women undergoing cesarean section with epidural anesthesia wererandomly assigned to three groups. Group S, group D, and group N receivedintramuscular normal saline (1 ml; n = 50, diphenhydramine (30 mg/1 ml; n= 50, and nalbuphine (10 mg/1 ml; n = 50, respectively, after delivery of thebaby. The occurrence and the severity of pruritus were assessed at 1, 4, 12,and 24 hours after surgery.Results: The overall incidence of pruritus during the 24 hr follow-up period was 72%,68%, and 44% for group S, group D, and group N, respectively. Pruritusoccurred less frequently in group N than group D (p = 0.027. At 4 and 12hrs postoperatively, the pruritus severity was significantly different (p =0.003 and p = 0.002 and was significantly less in group N than group D inthe intergroup comparison (p = 0.013 and p = 0.012.Conclusion: Nalbuphine proved better than diphenhydramine for prevention of epiduralmorphine-induced pruritus in patients who underwent cesarean section.Prophylactic intramuscular nalbuphine (10 mg is effective in decreasing theincidence and severity of pruritus and does not affect analgesia.

  19. Primary cesarean delivery results in emergency hysterectomy due to placenta accreta: a case study.

    Science.gov (United States)

    Humphrey, Jaclyn

    2015-02-01

    Placenta accreta is a major cause of obstetric hemorrhage, a situation that remains the most significant cause of maternal morbidity and mortality worldwide. It is generally recognized that a previous cesarean delivery increases the risk of placenta accreta. However, the risk also increases with previous intrauterine procedures. In 2010, The Joint Commission released a sentinel event alert regarding the prevention of maternal death, which recommended the adoption of protocols to treat postpartum hemorrhage. This case study demonstrates the success of quickly initiating protocol interventions necessary to prevent disseminated intravascular coagulation and maternal mortality, while reviewing current literature on risk identification, management, and treatment of obstetric hemorrhage resulting from placenta accreta. PMID:25842631

  20. Effects of Reiki on Post-cesarean Delivery Pain, Anxiety, and Hemodynamic Parameters: A Randomized, Controlled Clinical Trial.

    Science.gov (United States)

    Midilli, Tulay Sagkal; Eser, Ismet

    2015-06-01

    The aim of this study was to investigate the effect of Reiki on pain, anxiety, and hemodynamic parameters on postoperative days 1 and 2 in patients who had undergone cesarean delivery. The design of this study was a randomized, controlled clinical trial. The study took place between February and July 2011 in the Obstetrical Unit at Odemis Public Hospital in Izmir, Turkey. Ninety patients equalized by age and number of births were randomly assigned to either a Reiki group or a control group (a rest without treatment). Treatment applied to both groups in the first 24 and 48 hours after delivery for a total of 30 minutes to 10 identified regions of the body for 3 minutes each. Reiki was applied for 2 days once a day (in the first 24 and 48 hours) within 4-8 hours of the administration of standard analgesic, which was administered intravenously by a nurse. A visual analog scale and the State Anxiety Inventory were used to measure pain and anxiety. Hemodynamic parameters, including blood pressure (systolic and diastolic), pulse and breathing rates, and analgesic requirements also were recorded. Statistically significant differences in pain intensity (p = .000), anxiety value (p = .000), and breathing rate (p = .000) measured over time were found between the two groups. There was a statistically significant difference between the two groups in the time (p = .000) and number (p = .000) of analgesics needed after Reiki application and a rest without treatment. Results showed that Reiki application reduced the intensity of pain, the value of anxiety, and the breathing rate, as well as the need for and number of analgesics. However, it did not affect blood pressure or pulse rate. Reiki application as a nursing intervention is recommended as a pain and anxiety-relieving method in women after cesarean delivery. PMID:26025798

  1. Ampicillin/Sulbactam versus Cefuroxime as antimicrobial prophylaxis for cesarean delivery: a randomized study

    Directory of Open Access Journals (Sweden)

    Giamarellou Helen

    2010-11-01

    Full Text Available Abstract Background The efficacy and safety of a single dose of ampicillin/sulbactam compared to a single dose of cefuroxime at cord clamp for prevention of post-cesarean infectious morbidity has not been assessed. Methods Women scheduled for cesarean delivery were randomized to receive a single dose of either 3 g of ampicillin-sulbactam or 1.5 g of cefuroxime intravenously, after umbilical cord clamping. An evaluation for development of postoperative infections and risk factor analysis was performed. Results One hundred and seventy-six patients (median age 28 yrs, IQR: 24-32 were enrolled in the study during the period July 2004 - July 2005. Eighty-five (48.3% received cefuroxime prophylaxis and 91 (51.7% ampicillin/sulbactam. Postoperative infection developed in 5 of 86 (5.9% patients that received cefuroxime compared to 8 of 91 (8.8% patients that received ampicillin/sulbactam (p = 0.6. In univariate analyses 6 or more vaginal examinations prior to the operation (p = 0.004, membrane rupture for more than 6 hours (p = 0.08 and blood loss greater than 500 ml (p = 0.018 were associated with developing a postoperative surgical site infection (SSI. In logistic regression having 6 or more vaginal examinations was the most significant risk factor for a postoperative SSI (OR 6.8, 95% CI: 1.4-33.4, p = 0.019. Regular prenatal follow-up was associated with a protective effect (OR 0.04, 95% CI: 0.005-0.36, p = 0.004. Conclusions Ampicillin/sulbactam was as safe and effective as cefuroxime when administered for the prevention of infections following cesarean delivery. Trial registration Clinicaltrials.gov identifier: NCT01138852

  2. Neuraxial anesthesia for labor and cesarean delivery in a parturient with hereditary antithrombin deficiency on recombinant human antithrombin infusion therapy.

    Science.gov (United States)

    Pamnani, Anup; Rosenstein, Megan; Darwich, Alaeldin; Wolfson, Alexander

    2010-09-01

    A recombinant human antithrombin (rhAT; generic name: antithrombin Alfa) has recently been developed. A 37 year-old parturient with hereditary antithrombin deficiency, receiving rhAT infusion therapy, who successfully received an epidural catheter for analgesia and anesthesia during labor and cesarean delivery, is presented. PMID:20868967

  3. Risk of Autism Associated with General Anesthesia during Cesarean Delivery: A Population-Based Birth-Cohort Analysis

    Science.gov (United States)

    Chien, Li-Nien; Lin, Hsiu-Chen; Shao, Yu-Hsuan Joni; Chiou, Shu-Ti; Chiou, Hung-Yi

    2015-01-01

    The rates of Cesarean delivery (C-section) have risen to >30 % in numerous countries. Increased risk of autism has been shown in neonates delivered by C-section. This study examined the incidence of autism in neonates delivered vaginally, by C-section with regional anesthesia (RA), and by C-section with general anesthesia (GA) to evaluate the…

  4. Safe prevention of the primary cesarean delivery%安全避免首次剖宫产

    Institute of Scientific and Technical Information of China (English)

    龚琳; 刘兴会; 张力

    2016-01-01

    In 201 1,33% women who gave birth in the United States did so by cesarean delivery.Although cesarean delivery can be lifesaving for both mother and fetus under specific circumstances,the rapid increase in the rate of cesarean delivery without concomitant decreases in maternal or neonatal morbidity or mortality.Those data prompt a significant concern that cesarean delivery is overused.This paper reviews the first obstetric care consensus released jointly by American Congress of Obstetricians and Gynecologists (ACOG ) and Society for Maternal-Fetal Medicine (SMFM).%2011年,美国剖宫产率达到33%,虽然剖宫产在特定情况下可以挽救母儿生命,但剖宫产率的快速增加并没有相应地降低围生期母儿发病率及病死率,这使过度应用剖宫产的医疗问题备受关注。笔者拟对美国妇产科联盟(ACOG)与母胎医学会(SMFM)联合发布的首个产科医疗共识进行综述。

  5. Does dexamethasone prevent subarachnoid meperidin-induced nausea, vomiting and pruritus after cesarean delivery?

    Directory of Open Access Journals (Sweden)

    Nadia Banihashem

    2013-01-01

    Full Text Available Background: Opioid-induced side effects such as nausea and vomiting and pruritus are common and may be more debilitating than pain itself. We performed a study to assess the efficacy of dexamethasone in reducing postoperative nausea, vomiting, and pruritus in patients receiving neuraxial anesthesia with meperidine. Methods: Fifty-two women undergoing cesarean section were enrolled in the study. The control group and dexamethasone group received intravenously normal saline and dexamethasone, respectively, before spinal anesthesia. The occurrence of postoperative nausea, vomiting, and pruritus was assessed for 24 h in both groups. Results: The overall incidence of nausea and vomiting during the 24 h follow-up period was 37% and 22.2% for group saline and 20% and 12% for group dexamethasone, respectively (P=0.175, 0.469. The incidence of pruritus was not significantly different between the two groups. Pruritus severity was significantly less in the dexamethasone group than in the saline group (P=0.019. Conclusion: Prophylactic dexamethasone does not reduce the incidence of subarachnoid meperidine-induced nausea, vomiting, and pruritus in women undergoing cesarean delivery.

  6. Comparison of Neonatal Arterial Blood Oxygen Saturation Rate Immediately After Birth in Normal and Elective Cesarean Delivery

    Directory of Open Access Journals (Sweden)

    Mahmoodi Fatemeh

    2016-01-01

    Full Text Available Objective: Ninety percent of neonates pass the transition from fetal life to outside uterus successfully, and only 1% needs intensive support for survival. The quantity of oxygen saturation immediately after birth shows the need for resuscitation immediately after birth. The present research was carried out with the objective of comparing saturation rate of arterial blood hypoxia in neonates born with normal vaginal delivery and cesarean method. Materials and Methods: 220 neonates born with elective cesarean section and normal delivery were studied in an analytical-descriptive study. Demographic questionnaire was completed. Then a pulse oxymeter with its sensor fixed on the right wrist of the neonates was used. Heart rate was recorded and the level of oxygen saturation (SaO2 under 90% was considered as hypoxia. To compare the quantitative and qualitative variable between the two groups, paired t test and chi-square test was used, respectively. Pearson correlation test was used to study the correlation between the variables. Results: The age range of mothers was 16-38 years. The mothers’ average age, gestational age and neonates’ weight were not significantly different between groups. The average SaO2 in minutes 1, 3 and 5 was 72%, 81% and 89%, respectively in vaginal delivery, which showed a significant difference compared to cesarean neonates with average of 65%, 75% and 83%, respectively. No significant difference was observed after10 minutes. Also there were not significant statistical correlation between mothers age, number of pregnancies, sex and weight of neonate with SaO2 of arterial blood after 1, 3, 5 and 10 minutes after birth. Conclusion: With respect to the results of the present research SaO2 was higher in neonates of vaginal delivery in comparison to cesarean neonates. Encouraging mothers to delivery vaginally and also using aid-oxygen is proposed for the cesarean neonates at birth.

  7. The Effect of Chewing Sugar Free Gum after Elective Cesarean-Delivery on Return of Bowel Function in Primiparous Women:

    OpenAIRE

    Safdari Dehcheshmeh F; Salehian T; Gangi F; Beigi M

    2011-01-01

    Background and Objectives: An important cause of delayed recovery from abdominal surgery is delay in return of bowel Function. The aim of the present study was to assess the effects of chewing sugar free gum after elective Cesarean-delivery on return of bowel function in primiparous women in Hajar hospital of Shahrekord.Methods: In a randomized clinical trial, 120 patients, who were scheduled for elective cesarean were randomly allocated to 2 groups of gum-chewing group (n=60) and control gro...

  8. Ruptured Noncommunicating Rudimentary Horn Pregnancy at 19 Weeks with Previous Cesarean Delivery: A Case Report

    Directory of Open Access Journals (Sweden)

    Sita Thakur

    2012-01-01

    Full Text Available Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during nonpregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done.

  9. Recurrent antepartum compression of a single artery double nuchal cord necessitating emergency cesarean delivery.

    Science.gov (United States)

    Sherer, David M; Khoury-Collado, Fady; Dalloul, Mudar; Osho, Joseph A; Lamarque, Madelene D; Fomitcheva, Larissa; Abulafia, Ovadia

    2005-11-01

    Fetuses with a single umbilical artery are considered at increased risk for chromosomal and structural abnormalities, and increased adverse perinatal outcome. A young nulliparous patient was followed with weekly nonstress testing due to well-controlled gestational diabetes, a single umbilical artery, and a double nuchal cord. At 31 weeks gestation, following the occurrence of a severe prolonged variable deceleration of the fetal heart rate the patient was hospitalized for close fetal surveillance with consideration that the deceleration may represent recurring intermittent compression of the single umbilical artery. Continuous fetal monitoring depicted recurrent severe variable decelerations of the fetal heart rate. Thirty-six hours after admission, prolonged fetal bradycardia to 60 bpm necessitated emergency cesarean delivery of a nonhypoxic nonacidotic fetus, which subsequently did well. This case suggests that fetuses with a single umbilical artery nuchal cord(s) may be at increased risk of significant umbilical cord compression. PMID:16283603

  10. Ruptured noncommunicating rudimentary horn pregnancy at 19 weeks with previous cesarean delivery: a case report.

    Science.gov (United States)

    Thakur, Sita; Sood, Ajay; Sharma, Chanderdeep

    2012-01-01

    Unicornuate uterus with noncommunicating rudimentary horn occurs due to incomplete fusion of mullerian ducts. Pregnancy in this horn is a rare phenomenon usually resulting in rupture during second trimester of pregnancy. Prerupture diagnosis of pregnancy in rudimentary horn with ultrasonography is technically difficult, with sensitivity of 30%. We report a case of ruptured non-communicating rudimentary horn at 19 weeks in a woman with previous Cesarean delivery. She had a routine malformation scan in which diagnosis was missed. Later she presented to emergency in shock, with massive hemoperitoneum and ruptured horn. So a high index of suspicion is required to save this catastrophic event and associated maternal morbidity and mortality. In our opinion, routine excision of rudimentary horn should be undertaken during nonpregnant state laparoscopically. However, those women who refuse should be adequately counseled regarding potential complications and if pregnancy occurs in rudimentary horn, first trimester laparoscopic excision should be done. PMID:23119197

  11. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Angélica Mércia Pascon Barbosa

    2011-01-01

    Full Text Available OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes. RESULTS: The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6% and two years after a cesarean (44.8% vs. 18.4%. Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%. Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence. CONCLUSIONS: The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.

  12. Risk of Chronic Low Back Pain Among Parturients Who Undergo Cesarean Delivery With Neuraxial Anesthesia

    Science.gov (United States)

    Chia, Yuan-Yi; Lo, Yuan; Chen, Yan-Bo; Liu, Chun-Peng; Huang, Wei-Chun; Wen, Chun-Hsien

    2016-01-01

    Abstract To investigate the risk of chronic low back pain (LBP) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA). LBP is common during pregnancy and also after delivery, but its etiology is poorly understood. Previous studies that investigated the correlation between epidural labor analgesia and chronic low back pain were inconclusive. These studies lacked objective diagnostic criteria for LBP and did not exclude possible confounders. We performed this nationwide population-based retrospective cohort study to explore the relationship between CD with NA and subsequent LBP. From the Taiwan National Health Insurance Research Database (NHIRD), we identified all primiparas who had given birth between January 1, 2000 and December 31, 2013. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes, we identified the women who had vaginal delivery (VD) and those who had CD. The mode of anesthesia was ascertained by the NHI codes. Multivariable logistic regression was used to estimate the odds of postpartum LBP in women undergoing CD with NA compared with those having VD. The outcome was a diagnosis of LBP according to the first ICD-9-CM diagnosis code. The patients were observed for 3 years after delivery or until diagnosis of postpartum LBP, withdrawal from the NHI system, death, or December 31, 2013. Of the 61,027 primiparas who underwent delivery during the observation period, 40,057 were eligible for inclusion in the study. Of these women, 27,097 (67.6%) received VD, 8662 (21.6%) received CD with spinal anesthesia, and 4298 (10.7%) received CD with epidural anesthesia (EA). Women who received CD with EA were found to have higher risk of LBP than did women who received VD, with the adjusted OR being 1.26 (95% CI: 1.17–1.34). CD with EA might increase the risk of subsequent chronic LBP. PMID:27100449

  13. Quality assurance: The 10-Group Classification System (Robson classification), induction of labor, and cesarean delivery.

    Science.gov (United States)

    Robson, Michael; Murphy, Martina; Byrne, Fionnuala

    2015-10-01

    Quality assurance in labor and delivery is needed. The method must be simple and consistent, and be of universal value. It needs to be clinically relevant, robust, and prospective, and must incorporate epidemiological variables. The 10-Group Classification System (TGCS) is a simple method providing a common starting point for further detailed analysis within which all perinatal events and outcomes can be measured and compared. The system is demonstrated in the present paper using data for 2013 from the National Maternity Hospital in Dublin, Ireland. Interpretation of the classification can be easily taught. The standard table can provide much insight into the philosophy of care in the population of women studied and also provide information on data quality. With standardization of audit of events and outcomes, any differences in either sizes of groups, events or outcomes can be explained only by poor data collection, significant epidemiological variables, or differences in practice. In April 2015, WHO proposed that the TGCS (also known as the Robson classification) is used as a global standard for assessing, monitoring, and comparing cesarean delivery rates within and between healthcare facilities. PMID:26433499

  14. Comparison of Neonatal Arterial Blood Oxygen Saturation Rate Immediately After Birth in Normal and Elective Cesarean Delivery

    OpenAIRE

    Mahmoodi Fatemeh; Mobaraki Asieh; Mahmoodi Zainab; Najar Shahnaz; Haghighi Mohammad hosein; Borzoueisileh Sajad; Ebrahimpour Soheil

    2016-01-01

    Objective: Ninety percent of neonates pass the transition from fetal life to outside uterus successfully, and only 1% needs intensive support for survival. The quantity of oxygen saturation immediately after birth shows the need for resuscitation immediately after birth. The present research was carried out with the objective of comparing saturation rate of arterial blood hypoxia in neonates born with normal vaginal delivery and cesarean method. Materials and Methods: 220 neonates bo...

  15. Transvaginal Ultrasonographic Cervical Measurement in Predicting Failed Labor Induction and Cesarean Delivery for Failure to Progress in Nulliparous Women

    OpenAIRE

    Park, Kyo Hoon

    2007-01-01

    The aim of this study was to evaluate the value of transvaginal sonographic cervical measurement in predicting failed labor induction and cesarean delivery for failure to progress in nulliparous women. One hundred and sixty-one women scheduled for labor induction underwent transvaginal ultrasonography and digital cervical examinations. Logistic regression demonstrated that cervical length and gestational age at induction, but not the Bishop score, significantly and independently predicted fai...

  16. The Effect of Chewing Sugar Free Gum after Elective Cesarean-Delivery on Return of Bowel Function in Primiparous Women:

    OpenAIRE

    F Safdari Dehcheshmeh

    2012-01-01

    Background and Objectives: An important cause of delayed recovery from abdominal surgery is delay in return of bowel Function. The aim of the present study was to assess the effects of chewing sugar free gum after elective Cesarean-delivery on return of bowel function in primiparous women in Hajar hospital of Shahrekord. Methods: In a randomized clinical trial, 120 patients, who were s...

  17. Anesthesia for cesarean delivery in a patient with large anterior mediastinal tumor presenting as intrathoracic airway compression

    Directory of Open Access Journals (Sweden)

    Yatish Bevinaguddaiah

    2014-01-01

    Full Text Available Anterior mediastinal mass is a rare pathology that presents considerable anesthetic challenges due to cardiopulmonary compromise. We present a case that was referred to us in the third trimester of pregnancy with severe breathlessness and orthopnea. An elective cesarean delivery was performed under combined spinal epidural anesthesia with a favorable outcome. We discuss the perioperative considerations in these patients with a review of the literature.

  18. Efficacy of prophylactic intravenous ondansetron on the prevention of hypotension during cesarean delivery: a dose-dependent study

    Science.gov (United States)

    Wang, Meng; Zhuo, Lang; Wang, Qun; Shen, Ming-Kun; Yu, Yan-Yun; Yu, Jun-Jing; Wang, Zhi-Ping

    2014-01-01

    Objective: This study was to determine the optimal dosage of ondansetron for preventing maternal hypotension during cesarean delivery. Methods: One hundred and fifty parturient women scheduled for elective cesarean section were randomly assigned to five groups (n=30). Five minutes prior to spinal anesthesia, women were injected with 5 ml of physiological saline (S), 2 mg (O2), 4 mg (O4), 6 mg (O6), or 8 mg (O8) of ondansetron in saline, respectively. Maternal blood pressure and heart rate were measured at 2-min intervals for 30 min. The serum parameters in umbilical cord blood were analyzed after delivery. Results: Compared with group S, the incidence of maternal hypotension was significantly lower in groups O4 and O6 (P < 0.05). The umbilical venous pH was significantly higher in group O4 (P < 0.05); while the partial pressure of carbon dioxide (Pco2) was significantly lower in groups O4, O6, and O8 (P < 0.05); and the bicarbonate (Hco3 -) and base excess in extracellular fluid (BEecf) were significantly lower in groups O6 and O8 (P < 0.05). Moreover, minimal changes of systolic blood pressure, diastolic blood pressure, and mean arterial blood pressure were observed in group O4 (P < 0.05). Conclusion: The optimal dose of ondansetron preloading was 4 mg during cesarean delivery. PMID:25664023

  19. A simple checklist for preventing major complications associated with cesarean delivery.

    Science.gov (United States)

    Duff, Patrick

    2010-12-01

    I propose a simple, evidence-based, eight-item checklist that, if followed, should reduce the frequency of many of the most serious complications associated with cesarean delivery: endometritis, wound infection, wound disruption, thrombophlebitis, and uterine scar dehiscence in a subsequent pregnancy. The frequency of abdominal wound infections can be reduced significantly by using electric clippers, rather than a razor, to remove the hair at the site of the surgical incision, washing the skin with a chlorhexidine solution, and administering broad-spectrum antibiotic prophylaxis before the start of surgery rather than after the neonate's umbilical cord has been clamped. Administration of broad-spectrum antibiotic prophylaxis and removal of the placenta by traction on the umbilical cord, rather than by manual extraction, will reduce the frequency of postcesarean endometritis. Closure of the uterine incision in two layers rather than one will significantly reduce the frequency of scar dehiscence in a subsequent pregnancy. Closure of the deep subcutaneous layer in patients whose subcutaneous tissue is greater than 2 cm in thickness will significantly reduce the risk of seroma, hematoma, and subsequent wound disruption. Institution of appropriate prophylaxis for deep vein thrombosis in intermediate and high-risk patients will reduce the risk of subsequent thromboembolic events. PMID:21099608

  20. Algorithm for the anesthetic management of cesarean delivery in patients with unsatisfactory labor epidural analgesia [v1; ref status: indexed, http://f1000r.es/5a3

    Directory of Open Access Journals (Sweden)

    Sonia Vaida

    2015-04-01

    Full Text Available The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery. Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter. The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block.  We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.

  1. A randomized, clinical trial of ketorolac tromethamine vs ketorolac trometamine plus complex B vitamins for cesarean delivery analgesia

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    J J Beltrán-Montoya

    2012-01-01

    Full Text Available Background: Ketorolac is widely used for postoperative analgesia in patients who undergo cesarean delivery. In countries where the use of opioids is considerably restricted, alternatives to narcotics are required. Aim: We hypothesize that the addition of complex B synergize the analgesic effect of ketorolac in postoperative cesarean patients, thus requiring a smaller dose of the anti-inflammatory agent, and therefore decreasing the potential side effects of ketorolac. Methods: A randomized clinical trial with 100 patients undergoing a primary elective cesarean delivery enrolled in the study. Pain was assessed in the recovery room and then they were randomized to receive ketorolac 30 mg intramuscular (i.m. or 15 mg of ketorolac plus complex B vitamin (CBV. The pain score with an analog scale was assessed 1, 2, 6, 12, 18, and 24 h after the baseline. The student′s t test was performed to compare the demographic differences between the 2 means. Results: 100 patients were included in the study, showing no statistical differences in the demographics. The patient′s pain score at 1, 2, 6, 12, 18 and 24 hours showed no statistical differences between the control group (ketorolac 30mg compared to the group of ketorolac 15mg and complex B vitamins. No changes in the coagulation studies were found in both groups. Conclusion: The present study demonstrates that ketorolac 30 mg and ketorolac 15 mg plus complex B vitamins can provide acceptable analgesia in many patients with severe pain.

  2. Cesarean section without clinical indication versus vaginal delivery as a paradigmatic model in the discourse of medical setting decisions.

    Science.gov (United States)

    Demontis, Roberto; Pisu, Salvatore; Pintor, Michela; D'aloja, Ernesto

    2011-12-01

    Natural childbirth has ceased to be considered the gold standard in the delivery room. For this reason cesarean section on demand is increasing. Many obstetricians justify this phenomenon on evidence-based obstetrical practice. However, other pieces of evidence demonstrate that the data are often a product of the social milieu, and as stated by Wendland, "technology magically wards off the unpredictability and danger of birth". In a recent paper, Kalish pointed out several problems with cesarean deliveries in the absence of medical indications regarding issues of good clinical practice, autonomy, and informed consent. From the late 1990s, the medical community began to speak in favor of women's autonomy in childbirth decisions thus supporting the maternal choice and request for a cesarean section. Starting from these new considerations, it is of primary importance to understand whether emphasizing patient's autonomy is the best, or the only, way to helping the medical decisional process. This general approach may be helpful in all the other cases in which patient's autonomy and physician's responsibility appear to be intertwined in an apparent conflicting manner. We fear that the rhetoric of autonomous choice represents a fundamental shift from medicine-based beneficence toward a perilous relationship founded mainly on patient's wishes, representing a dangerous slippery slope where the physician could be reduced to the role of a functionary delegated to execute patient's claims and demands. PMID:21158491

  3. Prelabor cesarean delivery and early-onset acute childhood leukemia risk.

    Science.gov (United States)

    Thomopoulos, Thomas P; Skalkidou, Alkistis; Dessypris, Nick; Chrousos, George; Karalexi, Maria A; Karavasilis, Theodoros G; Baka, Margarita; Hatzipantelis, Emmanuel; Kourti, Maria; Polychronopoulou, Sophia; Sidi, Vasiliki; Stiakaki, Eftichia; Moschovi, Maria; Loutradis, Dimitrios; Petridou, Eleni Th

    2016-03-01

    The long-term impact of cesarean delivery (CD) on the health of the offspring is being explored methodically. We sought to investigate the effect of birth by (a) prelabor and (b) during-labor CD on the risk of early-onset (≤3 years) acute lymphoblastic leukemia (ALL), specifically of its prevailing precursor B (B-ALL) subtype. A total of 1099 incident cases of ALL (957 B-ALL), 131 of acute myeloid leukemia (AML), and their 1 : 1 age-matched and sex-matched controls, derived from the Nationwide Registry for Childhood Hematological Malignancies (1996-2013), were analyzed using multivariate regression models. A null association was found between prelabor and/or during labor CD and either ALL (B-ALL) or AML in the 0-14 age range. By contrast, birth by CD increased significantly the risk of early-onset ALL [odds ratioCD (ORCD)=1.57, 95% confidence interval (CI): 1.10-2.24] mainly on account of prelabor CD (ORprelaborCD=1.66, 95% CI: 1.13-2.43). The respective figures were even higher for the early-onset precursor B-ALL (ORCD=1.66, 95% CI: 1.15-2.40 and ORprelaborCD=1.79, 95% CI: 1.21-2.66), whereas no association emerged for early-onset AML. Prelabor CD, which deprives exposure of the fetus/infant to the presumably beneficial effect of stress hormones released in both vaginal labor and during labor CD, was associated exclusively with an increased risk of early-onset ALL, particularly the precursor B-ALL subtype. If confirmed, these adverse long-term outcomes of CD may point to re-evaluation of prelabor CD practices and prompt scientific discussion on the best ways to simulate the effects of vaginal delivery, such as a precesarean induction of labor. PMID:25793919

  4. Related Factors to Choose Cesarean Rather than Normal Delivery among Shirazian Pregnant Women

    OpenAIRE

    Majid Movahed; Halimeh Enayat; Esfandiar Ghaffarinasab; Sedigheh Alborzi; Rohollah Mozafari

    2012-01-01

    Background & objective: Although delivering with Cesarean method is preferred in limited cases which has dangerous effects on child or mother's health, rate of cesarean is increasing vastly nowadays. The main purpose of this study was to explore Social, Cultural and Demographic factors related to this phenomenon among pregnant women of Shiraz. Materials & Methods: In this study 600 pregnant women residing in Shiraz were selected using Lin cross size of sample (multistage sampling). Data were ...

  5. Usefulness of chewing gum for recovering intestinal function after cesarean delivery: A systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Huang, Hua-Ping; He, Mei

    2015-04-01

    Chewing gum has been reported to enhance bowel function. However, the efficacy remains unclear for women undergoing cesarean delivery. The aim of this meta-analysis is to evaluate the efficacy of chewing gum for recovering intestinal function following cesarean delivery in the early postoperative period. Electronic databases including MEDLINE, EMBASE, Cochrane Library were searched to identify English language randomized controlled trials comparing chewing gum with other procedures for promoting the recovery of intestinal function after cesarean delivery. Two of the authors independently extracted data from the eligibility studies, and Review Manager Version 5.2 was used to pool the data. Finally, five randomized controlled trials involving 882 patients were included and all the trials were considered as at high risk of bias. The pooled findings showed that chewing gum after cesarean delivery can significantly shorten the time to first flatus [standardized mean difference (SMD) = -0.73; 95% confidence interval (CI) = -1.01 to -0.14; p chewing gum group; however, these results were not statistically significant. The current evidence suggests that chewing gum has a positive effect on intestinal function recovery following cesarean delivery in the early postoperative period. However, more large-scale and high-quality randomized controlled trials are needed to confirm these results. PMID:25951713

  6. Neonatal apgar scores and umbilical blood gas changes in vaginal delivery and cesarean: a comparative study

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    SH. Raafati

    2006-07-01

    Full Text Available Background: Umbilical cord blood gas analysis is a useful method for assessment of oxygenation and acid-base status in neonates. Severe fetal acidemia is associated with increased perinatal mortality and increased risk of subsequent impaired neurological development. Due to high percentage of C/S in our country and the effect of anesthetic medications on umbilical blood gases which can cause neonatal acidosis and hypoxemia, the study of umbilical cord blood gas in vaginal delivery versus cesarean section is mandatory. Methods: In this cross-sectional study one hundred samples were taken from Mostafa Khomeini hospital in summer 2004. The samples were taken immediately of umbilical vein after clamping the umbilical cord and analyzed after 10 minutes. Cases were classified in to 3 groups: vaginal delivery (n=40, elective C/S under general anesthesia (n=35 and C/S under spinal anesthesia (n=25. Duration of anesthesia and its effect on blood gas and infants apgar were assessed. Results: In the first group (vaginal delivery mean blood gase parameters were; pH=7.3064.73, pO2=25.246.87, HCO3=20.562.03, Apgar=8.820.38 and pCO2=41.826.57. In the second group (general anesthesia mean blood gaze parameters were: pH=7.3044.73, pO2=38.7014.02, pCO2=43.265.87, HCO3=21.1113 and apgar score=8.170.7. In the third group (spinal anesthesia mean blood gaze parameters were: pH=7.3014.50, pCO2=44.14.99, HCO3=21.382.15, pO2=26.625.5 and apgar=8.600.62. The apgar scores and pO2 demonstrated significant relationship with type of anesthesia. The apgar score was lower and pO2 was higher in C/S under general anesthesia compared with the other two groups. There was significant relationship between duration of anesthesia and umbilical pO With increasing duration of anesthesia, pO2 was reduced. Between the type of delivery and anesthesia duration with PH, pO2, pCO2 and HCO3 were not meaningful relationship (P<0.05. Conclusion: There

  7. RELATIONSHIP OF TIMING OF CORD CLAMP TO THE NEONATAL HA EMATOLOGICAL STATUS OF NEWBORN - A COMPARISON IN TERM BABIES BORN VIA NORMAL VAGINAL DELIVERY & CESAREAN DELIVERY

    Directory of Open Access Journals (Sweden)

    Madhur

    2014-02-01

    Full Text Available AIM : To study the relationship of timing of cord clamping to the hematocrit and hemoglobin values within 0 - 6 hours of life - comparison in term normal vaginal delivery to cesarean delivery . Clamping and cutting of the umbilical cord at birth is by far the oldest and most prevalent intervention i n humans. In spite of that the optimal time of cord clamping has been a con troversial issue for decades . There are no formal practice guidelines as such but practitioners in western countries clamp and cut the cord immediately after birth while the pr actic e worldwide is variable . OBJECTIVE : To study and observe the effect of timing of cord clamping on neonatal hematocrit and hemoglobin within 0 – 6 hours of life & compare in term normal vaginal delivery to cesarean delivery. METHODS : This is a randomized , c ontrol trial conducted in the Dept. of Pediatrics and Dept. of Gyn & Obst. , Mahatma Gandhi Medical College & hospital. Jaipur , between 20 th to 30 th September 2013. Patients admitted in labor ward were selected according to the inclusion criteria of the study. Group A included 50 term normal vaginal delivery babies in whom the time of cord clamp from birth was noted and a cord blood or venous blood of baby was send within 6 hours of life for estimation of hematocrit & hemoglobin values , while group B incl uded 50 term babies born via cesarean section and same procedure was followed . RESULTS : It was observed that delayed cord clamping ( at 1 or 2 minutes after birth in healthy term newborns increases hematocrit & hemoglobin value within physiologic ranges wi thout causing any harmful effects . Umbilical cord clamping at 1 minute of life increases hematocrit in no more than much 8 - 10 points compared with cord clamping in first 15 seconds after birth. As per normal practice of early cord clamping in Indian scena rio timing of cord clamping in term normal vaginal delivery was at least more than 30 seconds to 1 minute while in term

  8. STUDY OF MATERNAL AND FETAL OUTCOME AND FACTORS AFFECTING SUCCESS WITH VAGINAL BIRTH AFTER CESAREAN SECTION IN TERTIARY CARE CENTRE

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    Vijayasree

    2014-01-01

    Full Text Available Cesarean section must be justified only when benefits outweigh harm to the mother and fetus. The impact of Cesarean section on maternal and child health and its high cost compared with vaginal birth represent a public health problem. Cesarean section rate is increasing globally and reported to be 25 - 30% in recent studies . Several factors contribute to this increase , but repeat CS stands as the most relevant factor and contribute to about 29% of performed CS. One of the strategies proposed to reduce the CS rate is to increase the number of trials of labor among women who had previous one lower segment cesarean section. However , concern still remains r egarding associated maternal or neonatal complications and factors that lead to success or failure of VBAC. So , we undertook this study to evaluate the factors affecting success of VBAC. AIMS AND OBJECTIVE: To study maternal and fetal outcomes associated w ith trial of vaginal birth after cesarean section and to evaluate factors associated with its success. MATERIALS AND METHODS : It is an Observational prospective study performed on 100 partu rients in the department of OBG, in Mamata General Hospital , K hammam , Andhra Pradesh. Patients with previous one lower segment Cesarean section and a single fetus with cephalic presentation without cephalo - pelvic disproportion were included in the study. These women were given a trial for vaginal birth with observati on during labor by a partogram and external fetal cardiotocography. RESULTS: Vaginal birth was successful in 50%. Repeat Cesarean section was done in the other 50% due to suspicious scar (62% , fetal distress (24% and failure to progress (14%. Scar Ruptu re occurred in (6% , postpartum hemorrhage in (4% , neonatal incubation in (10% and the neonatal mortality was (2%. Vaginal birth was significantly higher in the age group 20 - 30 years , body mass index in between 20 - 25 , patients with prior vaginal birth , inter - pregnancy interval

  9. 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 ...

  10. Cesarean Section Birth

    Medline Plus

    Full Text Available ... Actually, data would indicate that those kinds of issues with bladder problems and reproductive tract prolapse can ... birth versus a repeat cesarean delivery. There's an issue called placenta accreta, which if you have multiple ...

  11. Cesarean Section Birth

    Medline Plus

    Full Text Available ... to be able to schedule the birth. Some women have a preference for a cesarean delivery because ... subject doesn't really come up. But in women with a prior uterine incision that's compatible with ...

  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 ... after delivery. And that's over here so that mom can hear the baby and the baby will ... So we don't encourage elective first-time moms having a cesarean birth. 00:09:12 LEAH ...

  15. The Efficacy of Postoperative Wound Infusion with Bupivacaine for Pain Control after Cesarean Delivery: Randomized Double Blind Clinical Trial

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    Azin Alavi

    2007-06-01

    Full Text Available Objective: This study investigated the efficacy of bupivacaine wound infusion for pain control and opioid sparing effect after cesarean delivery.Materials and methods: We conducted a randomized double blind, placebo controlled clinical trial on 60 parturients undergoing cesarean section at a university hospital in Tehran. Patients were randomized to receive a pump infusion system that was filled with either 0.25% bupivacaine or equal volume of distilled water. A catheter was placed above the fascia and connected to electronic pump for 24 hours. Postoperative analog pain scores and morphine consumption were assessed at 6, 12 and 24 hours. Also time interval to first ambulation, length of hospitalization, complications and patient satisfaction were recorded. Data were analyzed using the SPSS software and P < 0.05 was considered statistically significant. Mann-Whitney u-test, student t-test and chi-square were used. Results: There were no differences in patient demographics and length of hospitalization and patient-generated resting pain scores between the two groups. Pain scores after coughing and leg raise during the first 6 postoperative hours were significantly less in the Bupivacaine group (P<0.001. The total dose of morphine consumption during the 24 hours study period was 2.5 ± 2.5 mg vs. 7.3 ± 2.7 mg for the bupivacaine and control groups, respectively (P<0.001. Compared with the control group, time to first ambulation was shorter in the bupivacaine group (11± 5h vs. 16 ± 4h (P< 0.01. Conclusion: Bupivacaine wound infusion was a simple and safe technique that provides effective analgesia and reduces morphine requirements after cesarean delivery.

  16. Adverse birth outcome: a comparative analysis between cesarean section and vaginal delivery at Felegehiwot Referral Hospital, Northwest Ethiopia: a retrospective record review

    OpenAIRE

    Abebe Eyowas, Fantu

    2016-01-01

    Fantu Abebe Eyowas,1 Ashebir Kidane Negasi,1 Gizachew Eyassu Aynalem,1 Abebaw Gebeyehu Worku2 1International NGO, Strengthening Human Resource for Health, Bahir Dar, 2Institute of Public Health, University of Gondar, Gondar, Ethiopia Introduction: Some studies favor elective cesarean delivery, and other surveys benefit vaginal delivery, while others emphasize that the quality of care during labor, birth, and immediate postpartum period plays a great role than the route of delivery. However, l...

  17. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    van de Mheen, L; Schuit, E; Liem, S M S; Lim, A C; Bekedam, D J; Goossens, S M T A; Franssen, M T M; Porath, M M; Oudijk, M A; Bloemenkamp, K W M; Duvekot, J J; Woiski, M D; de Graaf, I; Sikkema, J M; Scheepers, H C J; van Eijk, J; de Groot, C J M; van Pampus, M G; Mol, B W J

    2015-01-01

    OBJECTIVE: To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. METHODS: This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable as

  18. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    Van de Mheen, L.; Schuit, E.; Liem, S. M. S.; Lim, A. C.; Bekedam, D. J.; Goossens, S. M. T. A.; Franssen, M. T. M.; Porath, M. M.; Oudijk, M. A.; Bloemenkamp, K. W. M.; Duvekot, J. J.; Woiski, M. D.; De Graaf, I.; Sikkema, J. M.; Scheepers, H. C. J.; Van Eijk, J.; De Groot, C. J. M.; Van Pampus, M. G.; Mol, B. W. J.

    2015-01-01

    Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable asso

  19. Intravenous granisetron attenuates hypotension during spinal anesthesia in cesarean delivery: A double-blind, prospective randomized controlled study

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    Ahmed A Eldaba

    2015-01-01

    Full Text Available Background and Aims: This study was conducted to determine the effectiveness of intravenous (IV granisetron in the prevention of hypotension and bradycardia during spinal anesthesia in cesarean delivery. Material and Methods: A total of 200 parturients scheduled for elective cesarean section were included in this study. They were randomly divided into two groups. Group I was given 1 mg granisetron diluted in 10 ml normal saline slowly IV, 5 min before spinal anesthesia. Group II was given 10 ml of normal saline, 5 min before spinal anesthesia. Mean arterial blood pressure and heart rate (HR were recorded every 3 min until the end of surgery (for 45 min. The total consumption of vasopressors and atropine were recorded. Apgar scores at 1 and 5 min were also assessed. Results: Serial mean arterial blood pressure and HR values for 45 min after onset of spinal anesthesia were decreased significantly in group II, P < 0.0001. The incidence of hypotension after spinal anesthesia was 64% in group II and 3% in group I (P < 0.0001. The total doses of ephedrine (4.07 ± 3.87 mg vs 10.7 ± 8.9 mg, P < 0.0001, phenylephrine (0.0 microg vs 23.2 ± 55.1 microg, P < 0.0001, and atropine (0.0 mg vs 0.35 ± 0.49 mg P < 0.0001 consumed in both the groups respectively, were significantly less in group I versus group II. Conclusion: Premedication with 1 mg IV granisetron before spinal anesthesia in an elective cesarean section significantly reduces hypotension, bradycardia and vasopressors usage.

  20. Ogilvie′s syndrome following cesarean delivery: The Dubai′s case

    OpenAIRE

    Strahil Kotsev

    2011-01-01

    We present a case of acute colonic pseudo obstruction (Ogilvie's Syndrome) post Cesarean Section in a 35 years old Arabic patient with co-existing systemic lupus erythematosus. Due to developed complications-perforations of the colon and peritonitis, the patient required laparotomy and right hemicolectomy. To our knowledge, this is the first case of Ogilvie's syndrome, reported from the Middle East. The possible etiologic factors, pathophysiology, clinical presentation, diagnostic work up and...

  1. Adverse birth outcome: a comparative analysis between cesarean section and vaginal delivery at Felegehiwot Referral Hospital, Northwest Ethiopia: a retrospective record review

    Directory of Open Access Journals (Sweden)

    Abebe Eyowas F

    2016-07-01

    Full Text Available Fantu Abebe Eyowas,1 Ashebir Kidane Negasi,1 Gizachew Eyassu Aynalem,1 Abebaw Gebeyehu Worku2 1International NGO, Strengthening Human Resource for Health, Bahir Dar, 2Institute of Public Health, University of Gondar, Gondar, Ethiopia Introduction: Some studies favor elective cesarean delivery, and other surveys benefit vaginal delivery, while others emphasize that the quality of care during labor, birth, and immediate postpartum period plays a great role than the route of delivery. However, little information is locally available regarding the incidences of adverse birth outcome with respect to the route of delivery. Methods: This study was a retrospective analysis of eligible patient records that included 3,003 pregnant women who had undergone either cesarean or vaginal delivery from July 1, 2012, to June 31, 2013. Pretested questionnaire was used to collect the data. The completeness and consistency of the data were checked, cleaned, and double entered to EPI-INFO 3.5.2 and analyzed with SPSS V20. Independent sample t-test and chi-square test were conducted to compare the outcome of vaginal delivery and cesarean section (CS using index variables. Significance was taken at P<0.05. Results: Among the enrolled women, 760 mothers had CS delivery and the remaining 2,243 mothers delivered vaginally. Children born through CS (mean =6.83, standard deviation =1.31 had a significantly lower first-minute Apgar score than those in the vaginal delivery group (mean =7.19, standard deviation =1.18, P=0.001. Similarly, the observed respiratory distress syndrome (c2=0.09, P=0.793 and neonatal transfer rate to neonatal intensive care unit (c2=0.086, P=0.766 were more in neonates delivered by CS than those in the vaginally delivered group. Besides, the observed neonatal death (c2=0.675, P=0.411 and maternal death (c2= 8.878, P=0.003 were higher among CS deliveries compared with vaginal deliveries. Conclusion: Neonatal and maternal morbidity and mortality appear

  2. 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

  3. Meralgia paresthetica affecting parturient women who underwent cesarean section -A case report-

    OpenAIRE

    Chung, Kum Hee; Lee, Jong Yeon; Ko, Tong Kyun; Park, Chung Hyun; Chun, Duk Hee; Yang, Hyeon Jeong; Gill, Hyun Jue; Kim, Min Ku

    2010-01-01

    Meralgia paresthetica is commonly caused by a focal entrapment of lateral femoral cuteneous nerve while it passes the inguinal ligament. Common symptoms are paresthesias and numbness of the upper lateral thigh area. Pregnancy, tight cloths, obesity, position of surgery and the tumor in the retroperitoneal space could be causes of meralgia paresthetica. A 29-year-old female patient underwent an emergency cesarean section under spinal anesthesia without any problems. But two days after surgery,...

  4. Changing trends in eclampsia and increasing cesarean delivery and ndash; an interesting retrospective study from a tertiary care hospital of Raipur, Chhattisgarh, India

    Directory of Open Access Journals (Sweden)

    Abha Singh

    2016-04-01

    Conclusions: Contrary to various studies hypertensive disorder to be the fourth most common cause of maternal death in developing countries, eclampsia came out to be the leading cause of maternal mortality in our study. Better antenatal and peripartum care can reduce its occurrence and related morbidity and mortality. Optimum outcome can be achieved by the speed with which the peripartum care is given. Cesarean delivery is preferable if vaginal delivery is not anticipated within 8 hrs as it gives better fetomaternal outcome. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1031-1035

  5. Association of neonatal respiratory morbidity with timing of elective cesarean delivery

    Directory of Open Access Journals (Sweden)

    Shraddha K. Shetty

    2015-04-01

    Methods: A retrospective study was conducted on all pregnant women who were delivered by elective caesarean at a gestational age of 37+0 to 38+6 weeks and were compared with those delivered at 39+0 to 41+6 weeks. Maternal and neonatal characteristics, neonatal respiratory morbidity including: respiratory distress syndrome, transient tachypnea of the newborn, persistent pulmonary hypertension of newborn and serious respiratory morbidity were analyzed. Results: Incidence of neonatal respiratory morbidity was 15.8% and 6.3% in neonates delivered at 37+0 to 38+6 weeks and and #8805;39 weeks gestation respectively. Combined respiratory morbidity risk (Odds ratio: OR 2.82; 95% Confidence interval CI: 1.34-5.94; P value <0.05 was significantly higher in the neonates delivered at 37+0 to 38+6 weeks compared with those delivered and #8805;39 weeks. Risk of TTN (OR 2.6; 95% CI: 0.95-7.45; P value 0.08 and RDS (OR 2.42; 95%CI: 0.48-12.15; P value 0.45 increased by two fold in neonates delivered before 39 weeks. Conclusions: Neonates delivered by elective cesarean at 37+0 to 38+6 weeks gestations are at increased risk of developing respiratory morbidity compared with infants delivered beyond 39 weeks. Respiratory morbidity can be reduced by delaying the ECD until 39 weeks of gestation. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 461-464

  6. ANALYSIS OF MATERNAL AND FETAL OUTCOME IN SPINAL VERSUS EPIDURAL ANESTHESIA FOR CESAREAN DELIVERY IN SEVERE PRE-ECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Jyothi

    2015-12-01

    Full Text Available AIM Our primary aim is to analyze of maternal and fetal outcome in spinal versus epidural anesthesia for cesarean delivery in severe pre-eclampsia. MATERIALS AND METHODS Sixty parturients (60 with severe pre-eclampsia posted for cesarean section were randomized into two groups of thirty (30 each for either spinal anesthesia that is group S or epidural anesthesia that is group E. Spinal group (group S, n=30 received 10mg (2ml of 0.5% of hyperbaric bupivacaine solution intrathecally in left lateral decubitus or sitting position at L3-4 lumbar space with 25G quincke-babcock spinal needle. Patients received 6l/min of oxygen through Hudson’s face mask throughout the surgery. In Epidural group (group E, n=30, after thorough aseptic precautions, an 18G Tuohy’s epidural needle inserted at the L3-4 lumbar space with the patient in lateral decubitus or sitting position. Three ml of 1.5% lidocaine with was given as a test dose. After ruling out any intrathecal injection of the drug, initially 8ml of 0.5% isobaric bupivacaine given and the vitals monitored. Then 3ml top-ups of the same bupivacaine solution is given in a graded manner slowly, simultaneously checking the height of block. A blockade upto T4 to T6 is required. Vitals are carefully monitored and oxygen is provided 6l/min throughout the procedure and surgery. Blood pressure (systolic, mean, diastolic, pulse rate, oxygen saturation are recorded immediately after giving anesthesia, every minute for first 10mins, then every 3mins for the rest of the surgery. Then vitals are also noted post-operatively for the first 24hrs. Apgar score after 1 and 5 minutes, of the newborn baby is also recorded. Other parameters noted were incidence and duration of hypotension or hypertension both intra-operatively and post-operatively, any usage of vasopressors (ephedrine and its dose, convulsions, renal failure, pulmonary edema, requirement for ICU stay and the number of days in the mother, and the incidence of

  7. ENTRAPMENT OF AFTER COMING HEAD IN BICORNUATE UTERUS DURING CESAREAN BREECH DELIVERY OF TERM FETUS

    Directory of Open Access Journals (Sweden)

    Vijayalakshmi

    2015-07-01

    Full Text Available INTRODUCTION: The incidence of breech presentation in about 3% in singleton term pregnancies and about 20% in preterm pregnancies. The predisposing factors for breech presentation include uterine distension ( P olyhydramnios, M ultiple gestation , lax uterus ( G rand multiparty , uterine anomalies, pelvic tumors, fetal abnormalities ( A nencephaly, hydrocephalus, low birth weight , previous breech, placenta previa. Breech presentation increases the risk of morbidity and mortality in both fetus and mother. Nowadays majority of breech deliveries are by caesarian section compared with vaginal delivery. Caesarian section can significantly reduce neonatal complications, with a trivial increase in maternal complications. However caesarian section cannot alleviate all the complications. Hereby we present a case with entrapment of after coming head in caesarian breech delivery of a term fetus. According to current clinical practice in 2001 the American college of obstetricians and gynecologists (ACOG recommended that “P atient with a persistent breech presentation at term in a singleton gestation should undergo a planned caesarian delivery”. Nevertheless it stated that “ A planned caesarian delivery does not apply to patients presenting in advanced labour with a fetus in breech presentation in whom deliveries likely to be imminent or in patients where 2 nd twin is non - vertex position” . 1

  8. 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)

  9. 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- ...

  10. A close call: does the location of incision at cesarean delivery matter in patients with vasa previa? A case report.

    OpenAIRE

    Neuhausser, Werner M; Baxi, Laxmi V

    2013-01-01

    We present here a case of vasa previa in a multipara, diagnosed at the time of her late second trimester ultrasonogram. The patient subsequently underwent an elective cesarean section after 37 weeks gestation, giving birth to a healthy child with an uneventful post-partum, neonatal and infant course. At the time of cesarean section, the incision was gradually deepened in layers through the myometrium by utmost care allowing the amniotic sac to protrude through the uterine incision hereby avoi...

  11. Emergency bedside cesarean delivery: lessons learned in teamwork and patient safety

    OpenAIRE

    Kinney Michelle A O; Rose Carl H; Traynor Kyle D; Deutsch Eric; Memon Hafsa U; Tanouye Staci; Arendt Katherine W; Hebl James R

    2012-01-01

    Abstract Background Maternal cardiovascular and pulmonary events during labor and delivery may result in adverse maternal and fetal outcome. Potential etiologies include primary cardiac events, pulmonary embolism, eclampsia, maternal hemorrhage, and adverse medication events. Remifentanil patient-controlled analgesia is an alternative when conventional neuraxial analgesia for labor is contraindicated. Although remifentanil is a commonly used analgesic, its use for labor analgesia is not clear...

  12. Does Method of Placental Removal or Site of Uterine Incision Repair Alter Endometritis After Cesarean Delivery?

    OpenAIRE

    Everett F. Magann; Dodson, Mark K.; Harris, Robert L.; Floyd, Randall C.; Martin, James N; John C. Morrison

    1993-01-01

    Objective: his investigation was undertaken to evaluate the relationship between postcesarean endometritis and (1) method of placental removal and (2) site for uterine repair. Methods: This prospective, randomized study included 120 patients who underwent primary or repeat abdominal delivery for arrest of progress in labor, fetal distress, or breech presentation. Parturients were divided into four groups: I—spontaneous placental detachment, in situ uterine repair; II—spontaneous placental det...

  13. Comparative analysis of fecal microflora of healthy full-term Indian infants born with different methods of delivery (vaginal vs cesarean): Acinetobacter sp. prevalence in vaginally born infants

    Indian Academy of Sciences (India)

    Prashant Kumar Pandey; Pankaj Verma; Himanshu Kumar; Ashish Bavdekar; Milind S Patole; Yogesh S Shouche

    2012-12-01

    In this study fecal microflora of human infants born through vaginal delivery (VB) and through cesarean section (CB) were investigated using culture-independent 16S rDNA cloning and sequencing approach. The results obtained clearly revealed that fecal microbiota of VB infants distinctly differ from those in their counterpart CB infants. The intestinal microbiota of infants delivered by cesarean section appears to be more diverse, in terms of bacteria species, than the microbiota of vaginally delivered infants. The most abundant bacterial species present in VB infants were Acinetobacter sp., Bifidobacterium sp. and Staphylococcus sp. However, CB infant’s fecal microbiota was dominated with Citrobacter sp., Escherichia coli and Clostridium difficile. The intestinal microbiota of cesarean section delivered infants in this study was also characterized by an absence of Bifidobacteria species. An interesting finding of our study was recovery of large number of Acinetobacter sp. consisting of Acinetobacter pittii (former Acinetobacter genomic species 3), Acinetobacter junii and Acinetobacter baumannii in the VB infants clone library. Among these, Acinetobacter baumannii is a known nosocomial pathogen and Acinetobacter pittii (genomic species 3) is recently recognized as clinically important taxa within the Acinetobacter calcoaceticus–Acinetobacter baumannii (ACB) complex. Although none of the infants had shown any sign of clinical symptoms of disease, this observation warrants a closer look.

  14. [Cesarean section and eye disorders].

    Science.gov (United States)

    Karska-Basta, Izabella; Tarasiewicz, Marta; Kubicka-Trząska, Agnieszka; Miniewicz, Joanna; Romanowska-Dixon, Bożena

    2016-01-01

    Recently, a growing tendency for cesarean birth has been noted both, in Poland and worldwide. Non-obstetric problems constitute a large part of indications for cesarean section. Many ophthalmologists and obstetricians still believe that high myopia, the presence of peripheral retinal degenerations, history of retinal detachment surgery, diabetic retinopathy, or glaucoma are indications for surgical termination of pregnancy. However, these recommendations are not evidence-based. The literature offers no proof that high myopia and previous retinal surgery increase the risk of retinal detachment during spontaneous vaginal delivery. There is only one indication for cesarean section in myopic patients, i.e. the presence of choroidal neovascularization, which can cause subretinal bleeding with acute visual loss. Prolonged and intensified Valsalva maneuver during labor in patients with an active proliferative diabetic retinopathy may be an indication for an elective cesarean section. Uterine contractions during the second stage of vaginal delivery lead to a marked elevation of intraocular pressure. Intraocular pressure fluctuations during the delivery may damage retinal ganglion cells, resulting in further progression of visual field. Thus, glaucoma associated with advanced visual field changes is the next ophthalmic indication for cesarean section. The report presents the current state of knowledge concerning the effect of pregnancy on pre-existing ocular disorders and the influence of physiological changes on the clinical course of these diseases during the stages of natural delivery. The authors discuss also the ophthalmic indications for cesarean section. PMID:27306132

  15. Efficacy of the Bilateral Ilioinguinal-Iliohypogastric Block with Intrathecal Morphine for Postoperative Cesarean Delivery Analgesia

    Directory of Open Access Journals (Sweden)

    Manuel C. Vallejo

    2012-01-01

    Full Text Available The ilioinguinal-iliohypogastric (IIIH block is frequently used as multimodal analgesia for lower abdominal surgeries. The aim of this study is to compare the efficacy of IIIH block using ultrasound visualization for reducing postoperative pain after caesarean delivery (CD in patients receiving intrathecal morphine (ITM under spinal anesthesia. Participants were randomly assigned to 1 of 3 treatment groups for the bilateral IIIH block: Group A = 10 mL of 0.5% bupivacaine, Group B = 10 mL of 0.5% bupivacaine on one side and 10 mL of a normal saline (NSS placebo block on the opposite side, and Group C = 10 mL of NSS placebo per side. Pain and nausea scores, treatment for pain and nausea, and patient satisfaction were recorded for 48 hours after CD. No differences were noted with respect to pain scores or treatment for pain over the 48 hours. There were no differences to the presence of nausea (P=0.64, treatment for nausea (P=0.21, pruritus (P=0.39, emesis (P=0.35, or patient satisfaction (P=0.29. There were no differences in pain and nausea scores over the measured time periods (MANOVA, P>0.05. In parturients receiving ITM for elective CD, IIIH block offers no additional postoperative benefit for up to 48 hours.

  16. Ultrasound-guided epidural anesthesia for a parturient with severe malformations of the skeletal system undergoing cesarean delivery: a case report

    Directory of Open Access Journals (Sweden)

    Luo LL

    2015-05-01

    Full Text Available LinLi Luo,* Juan Ni,* Lan Wu, Dong Luo Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China  *These authors contributed equally to this work and should be considered co-first authors Abstract: Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients' complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal system and airway problems. The ultrasound-guided epidural anesthesia was performed in the L1–L2 space, followed by an intravenous administration of ketamine (0.5 mg/kg for sedation and analgesia. Satisfactory anesthesia was provided to the patient and spontaneous ventilation was maintained during the surgery. The mother and the baby were discharged 5 days after surgery, no complications were reported for either of them. Our work demonstrated that an ultrasound-guided epidural anesthesia combined with low-dose ketamine can be used to successfully maintain spontaneous ventilation and provide effective analgesia during surgery and reduce the risk of postoperative anesthesia-related pulmonary infection. Keywords: anesthesia, regional, cesarean delivery, ketamine, ultrasound-guided

  17. 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

  18. Breastfeeding After Cesarean Delivery

    Science.gov (United States)

    ... Prenatal Baby Bathing & Skin Care Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Breastfeeding > Breastfeeding After ...

  19. Obstetrical correlates of the first time cesarean section, compared with the repeated cesarean section

    International Nuclear Information System (INIS)

    To determine the clinical and epidemiological characteristics in patients having their first cesarean section (FCS) and compare it with findings in patients with repeated cesarean section (RCS). This study included all the women who gave birth by cesarean sections, 817 of the total 5992 deliveries, at this unit during the study period. Data on potential risk factors for the first cesarean section (FCS) and repeated cesarean section (RCS were extracted from medical records, which were reviewed and compared between these two groups of women. Data were statistically analyzed with student t-test for comparison between means and Chi-square test for comparison between percentages. Crude odds ratio (OR) with 95% confidence interval (95% CI) were calculated. Significance was taken at p 0.05). The frequency of first cesarean section and repeat cesarean section is high in our setup. Adequate following of the programs to diminish the percentage of FCS by curtailing its predisposing factors is needed. (author)

  20. Treatment of postoperative nausea and vomiting after spinal anesthesia for cesarean delivery: A randomized, double-blinded comparison of midazolam, ondansetron, and a combination

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2012-01-01

    Full Text Available Background: The antiemetic efficacy of midazolam and ondansetron was shown before. The aim of the present study was to compare efficacy of using intravenous midazoalm, ondansetron, and midazolam in combination with ondansetron for treatment of nausea and vomiting after cesarean delivery in parturient underwent spinal anesthesia. Materials and Methods: One hundred thirty two parturients were randomly allocated to one of three groups: group M (n = 44 that received intravenous midazoalm 30 μg/kg; group O (n = 44 that received intravenous ondansetron 8 mg; group MO (n = 44 that received intravenous midazoalm 30 μg/kg combined with intravenous ondansetron 8 mg if patients had vomiting or VAS of nausea ≥ 3 during surgery (after umbilical cord clamping and 24 hours after that. The incidence and severity of vomiting episodes and nausea with visual analog scale (VAS > 3 were evaluated at 2 hours, 6 hours, and 24 hours after injection of study drugs. Results: The incidence of nausea was significantly less in group MO compared with group M and group O at 6 hours postoperatively (P = 0.01. This variable was not significantly different in three groups at 2 hours and 24 hours after operation. The severity of nausea and vomiting was significantly different in three groups at 6 hours after operation (P < 0.05. Conclusion: Our study showed that using intravenous midazolam 30 μg/kg in combination with intravenous ondansetron 8 mg was superior to administering single drug in treatment of emetic symptoms after cesarean delivery under spinal anesthesia.

  1. The short and long-term influence of cesarean delivery on maternal and child%剖宫产对母婴近远期的影响

    Institute of Scientific and Technical Information of China (English)

    王桂兰

    2013-01-01

    目的 探讨剖宫产对母婴近远期的影响.方法 调查504例孕产妇的临床资料,随访至产后10年.并采用丹佛发育筛查测验(DDST)小儿智能发育筛查工具测查生后1岁小儿,学习能力评估测查工具测查学龄期儿童.结果 顺产组产妇在产后第1天的抑郁量表得分低于剖宫产组(t =16.54,P<0.05).顺产组的产时和产后并发症的发生概率均低于剖宫产组(x2 =4.62、4.17、14.62、6.37,均P<0.05).胆红素指数和Apgar评分≤7分的发生率顺产组均低于剖宫产组(t=23.62,x2=4.12,均P<0.05).调查产后10年自然分娩与剖宫产妇女,顺产组宫外孕、子宫内膜异位、继发性不孕、再次妊娠异常例数均显著低于对照组(x2 =1.57、6.78、4.35、4.26、7.34,均P<0.05).顺产组个人与社会、精细动作、语言能力、大运动发育情况均显著优于剖宫产组(x2=13.76、12.75、13.32、15.23,均P<0.05).顺产组过敏性哮喘、多动症、人际交流、社会适应能力差人数均显著低于剖宫产组(x2 =4.58、4.04、6.34,均P<0.05).结论 剖宫产对母儿近远期可产生不同程度影响,应采取有力措施降低剖宫产率,维护妇女儿童身心健康.%Objective To explore the short and long-term influence of cesarean delivery on maternal and child.Methods The clinical data of 504 cases of maternal postpartum were investigated,and followed up for 10 years.The 1-year-old children were given DDST of pediatric mental development screening investigation.The schoolage children were examined by the learning ability assessment and check measurement tools.Results The postpartum depression scale score in the first day of maternal eutocia group was significantly lower than that of the cesarean group (t =16.54,P < 0.05).The probability occurrence of intrapartum and postpartum complications of eutocia group were lower than those of cesarean group(x2 =4.62,4.17,14.62,6.37,all P < 0.05).The bilirubin index and the incidence of

  2. Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2015-01-01

    Full Text Available Background: The transverse abdominis plane (TAP block, a regional block provides effective analgesia after lower abdominal surgeries if used as part of multimodal analgesia. In this prospective, randomized double-blind study, we determined the efficacy of TAP block in patients undergoing cesarean section. Materials and Methods: Totally, 62 parturients undergoing cesarean section were randomized in a double-blind manner to receive either bilateral TAP block at the end of surgery with 20 ml of 0.25% bupivacaine or no TAP block, in addition to standard analgesic comprising 75 mg diclofenac 8 hourly and intravenous patient-controlled analgesia (PCA tramadol. Each patient was assessed at 0, 4, 8, 12, 24, 36, and 48 h after surgery by an independent observer for pain at rest and on movement using numeric rating scale of 0-10, time of 1 st demand for tramadol, total consumption of PCA tramadol, satisfaction with pain management and side effects. Results: Use of tramadol was reduced in patients given TAP block by 50% compared to patients given no block during 48 h after surgery (P < 0.001. Pain scores were lower both on rest and activity at each time point for 24 h in study group (P < 0.001, time of first analgesia was significantly longer, satisfaction was higher, and side effects were less in study group compared to control group. Conclusion: Transverse abdominis plane block was effective in providing analgesia with a substantial reduction in tramadol use during 48 h after cesarean section when used as adjunctive to standard analgesia.

  3. Risk of Chronic Low Back Pain Among Parturients Who Undergo Cesarean Delivery With Neuraxial Anesthesia: A Nationwide Population-Based Retrospective Cohort Study.

    Science.gov (United States)

    Chia, Yuan-Yi; Lo, Yuan; Chen, Yan-Bo; Liu, Chun-Peng; Huang, Wei-Chun; Wen, Chun-Hsien

    2016-04-01

    To investigate the risk of chronic low back pain (LBP) in parturients undergoing cesarean delivery (CD) with neuraxial anesthesia (NA).LBP is common during pregnancy and also after delivery, but its etiology is poorly understood. Previous studies that investigated the correlation between epidural labor analgesia and chronic low back pain were inconclusive. These studies lacked objective diagnostic criteria for LBP and did not exclude possible confounders. We performed this nationwide population-based retrospective cohort study to explore the relationship between CD with NA and subsequent LBP.From the Taiwan National Health Insurance Research Database (NHIRD), we identified all primiparas who had given birth between January 1, 2000 and December 31, 2013. Using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure codes, we identified the women who had vaginal delivery (VD) and those who had CD. The mode of anesthesia was ascertained by the NHI codes. Multivariable logistic regression was used to estimate the odds of postpartum LBP in women undergoing CD with NA compared with those having VD. The outcome was a diagnosis of LBP according to the first ICD-9-CM diagnosis code. The patients were observed for 3 years after delivery or until diagnosis of postpartum LBP, withdrawal from the NHI system, death, or December 31, 2013.Of the 61,027 primiparas who underwent delivery during the observation period, 40,057 were eligible for inclusion in the study. Of these women, 27,097 (67.6%) received VD, 8662 (21.6%) received CD with spinal anesthesia, and 4298 (10.7%) received CD with epidural anesthesia (EA). Women who received CD with EA were found to have higher risk of LBP than did women who received VD, with the adjusted OR being 1.26 (95% CI: 1.17-1.34).CD with EA might increase the risk of subsequent chronic LBP. PMID:27100449

  4. How to improve quality of cesarean section in sub-saharan Africa countries?

    OpenAIRE

    Zongo, Koudnoaga Augustin

    2015-01-01

    Cesarean rates are rising steadily worldwide. In recent years, there has been an increasing cesarean rates in low-resource countries despite the World Health Organization recommended to not exceed 10-15%. In Senegal and Mali free cesarean policies were implemented nationally since 2005 and have contributed to increase the access to cesarean section. Access to cesarean deliveries has been improved substantially but quality of care has not always followed. However, excessive increase in cesarea...

  5. OUR EXPLODING CESAREAN RATES: A SYSTEM FOR AUDITING

    Directory of Open Access Journals (Sweden)

    Deepthi

    2014-04-01

    Full Text Available OBJECTIVE: To identify the groups of women contributing most to the cesarean section rate. METHOD: An analysis of 480 cesarean deliveries conducted at SUT Academy of Medical Sciences over a period of 2yrs (Jan2010-Dec2011 was done with Robson classification system. RESULTS: Group 2, 4 and 5 are really driving our cesarean rate i.e., the first time pregnant women, induced women and the women with previous uterine scar. CONCLUSION: Analyzing the cesarean section rates is very important as this will help us to develop appropriate guidelines to reduce our exploding rates of cesarean section

  6. Anesthesia for cesarean section in pregnancies complicated by placenta previa

    International Nuclear Information System (INIS)

    Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)

  7. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  8. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?

    Directory of Open Access Journals (Sweden)

    Walid Hamed Nofal

    2014-01-01

    Full Text Available Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH, also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placebo. Spinal anesthesia was achieved with 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl. Babies were followed up by Apgar scores, umbilical artery blood gases, breastfeeding difficulties, and need for NICU admission. The mothers were followed up for any side-effects of gabapentin for 24 h. Patients with PDPH were re-admitted and onset and duration of the headache were reported and severity was assessed using a visual analog scale (VAS for 4 days from diagnosis. Paracetamol with caffeine and diclofenac were given for treatment, and the doses were adjusted according to VAS; also number of doses given for each group was recorded. Results: Eighty eight patients were randomized, and 2 were excluded. The incidence of headache and co-existing symptoms were similar in both groups. The onset of headache was significantly delayed in gabapentin group (P < 0.05. Also, severity and duration of headache were significantly less in gabapentin group (P < 0.05. The incidence of sedation was more in gabapentin group 11 (26.19% versus placebo group 3 (6.81%. Neonatal outcomes were statistically insignificant between both groups. Conclusion: Pre-operative administration of gabapentin has no effect on incidence of (PDPH but delays its onset and reduces its severity and duration in parturients undergoing cesarean section with spinal anesthesia without significant adverse effects on the mother or the baby.

  9. Mechanisms linking employee affective delivery and customer behavioral intentions.

    Science.gov (United States)

    Tsai, Wei-Chi; Huang, Yin-Mei

    2002-10-01

    Past empirical evidence has indicated that employee affective delivery can influence customer reactions (e.g., customer satisfaction, service quality evaluation). This study extends previous research by empirically examining mediating processes underlying the relationship between employee affective delivery and customer behavioral intentions. Data were collected from 352 employee-customer pairs in 169 retail shoe stores in Taiwan. Results showed that the influence of employee affective delivery on customers' willingness to return to the store and pass positive comments to friends was indirect through the mediating processes of customer in-store positive moods and perceived friendliness. The study also indicated that employee affective delivery influences customers' time spent in store, which, in turn, influences customer behavioral intentions. PMID:12395825

  10. A Prospective Cohort Study Evaluating the Ability of Anticipated Pain, Perceived Analgesic Needs, and Psychological Traits to Predict Pain and Analgesic Usage following Cesarean Delivery.

    Science.gov (United States)

    Carvalho, Brendan; Zheng, Ming; Harter, Scott; Sultan, Pervez

    2016-01-01

    Introduction. This study aimed to determine if preoperative psychological tests combined with simple pain prediction ratings could predict pain intensity and analgesic usage following cesarean delivery (CD). Methods. 50 healthy women undergoing scheduled CD with spinal anesthesia comprised the prospective study cohort. Preoperative predictors included 4 validated psychological questionnaires (Anxiety Sensitivity Index (ASI), Fear of Pain (FPQ), Pain Catastrophizing Scale, and Eysenck Personality Questionnaire) and 3 simple ratings: expected postoperative pain (0-10), anticipated analgesic threshold (0-10), and perceived analgesic needs (0-10). Postoperative outcome measures included post-CD pain (combined rest and movement) and opioid used for the 48-hour study period. Results. Bivariate correlations were significant with expected pain and opioid usage (r = 0.349), anticipated analgesic threshold and post-CD pain (r = -0.349), and perceived analgesic needs and post-CD pain (r = 0.313). Multiple linear regression analysis found that expected postoperative pain and anticipated analgesic needs contributed to post-CD pain prediction modeling (R (2) = 0.443, p Preoperative psychological tests combined with simple pain prediction ratings accounted for 44% and 42% of pain and analgesic use variance, respectively. Preoperatively determined expected postoperative pain and perceived analgesic needs appear to be useful predictors for post-CD pain and analgesic requirements. PMID:27143966

  11. A Prospective Cohort Study Evaluating the Ability of Anticipated Pain, Perceived Analgesic Needs, and Psychological Traits to Predict Pain and Analgesic Usage following Cesarean Delivery

    Directory of Open Access Journals (Sweden)

    Brendan Carvalho

    2016-01-01

    Full Text Available Introduction. This study aimed to determine if preoperative psychological tests combined with simple pain prediction ratings could predict pain intensity and analgesic usage following cesarean delivery (CD. Methods. 50 healthy women undergoing scheduled CD with spinal anesthesia comprised the prospective study cohort. Preoperative predictors included 4 validated psychological questionnaires (Anxiety Sensitivity Index (ASI, Fear of Pain (FPQ, Pain Catastrophizing Scale, and Eysenck Personality Questionnaire and 3 simple ratings: expected postoperative pain (0–10, anticipated analgesic threshold (0–10, and perceived analgesic needs (0–10. Postoperative outcome measures included post-CD pain (combined rest and movement and opioid used for the 48-hour study period. Results. Bivariate correlations were significant with expected pain and opioid usage (r=0.349, anticipated analgesic threshold and post-CD pain (r=-0.349, and perceived analgesic needs and post-CD pain (r=0.313. Multiple linear regression analysis found that expected postoperative pain and anticipated analgesic needs contributed to post-CD pain prediction modeling (R2=0.443, p<0.0001; expected postoperative pain, ASI, and FPQ were associated with opioid usage (R2=0.421, p<0.0001. Conclusion. Preoperative psychological tests combined with simple pain prediction ratings accounted for 44% and 42% of pain and analgesic use variance, respectively. Preoperatively determined expected postoperative pain and perceived analgesic needs appear to be useful predictors for post-CD pain and analgesic requirements.

  12. Spontaneous Uterine Rupture at 15 Weeks' Gestation in a Patient with a History of Cesarean Delivery after Removal of Shirodkar Cerclage

    Directory of Open Access Journals (Sweden)

    Serika Kanao

    2014-05-01

    Full Text Available A pregnant woman presented with acute upper abdominal pain and nausea at 15 weeks' gestation. She had a history of cesarean delivery for abruption after the removal of a Shirodkar cerclage that was placed because of cervical shortening caused by conization. She became pregnant again 14 months later. Ultrasonography revealed no significant findings, and a single intrauterine pregnancy with positive fetal heart activity was confirmed. An intestinal obstruction was suspected because abdominal radiography showed multiple air–fluid levels in the colon. Over the 3 hours following admission, her symptoms gradually worsened, and plain abdominal computed tomography (CT showed a large hemorrhage in the abdominal cavity, but the uterine wall appeared intact at this time. Subsequently, dynamic CT revealed discontinuity of the uterine muscle layer. During laparotomy, uterine rupture with complete opening of the uterine wall at the site of the previous transverse scar was identified. A dead fetus was located within the amniotic sac in a blood-filled abdominal cavity. She received a total of 10 units of packed red blood cells and 6 units of fresh frozen plasma for the resuscitation. She was discharged on the eighth postoperative day without any complications.

  13. The Wiley Spinal Catheter-Over-Needle System for Continuous Spinal Anesthesia: A Case Series of 5 Cesarean Deliveries Complicated by Paresthesias and Headaches.

    Science.gov (United States)

    McKenzie, Christine P; Carvalho, Brendan; Riley, Edward T

    2016-01-01

    Intrathecal catheter devices using a catheter-over-needle design and softer flexible material have been introduced to clinical practice with the aim of reducing some of the complications such as postdural puncture headaches and paresthesias seen with previous versions of intrathecal catheters. We present a case series of 5 cesarean deliveries using the Wiley Spinal intrathecal system (Epimed, Johnstown, New York), which was recently approved by the US Food and Drug Administration. The intrathecal catheter system consists of a flexible 23-gauge intrathecal cannula over a 27-gauge pencil-point spinal needle. The placement of the intrathecal catheter was successful in all 5 cases; however, paresthesias in 3 cases and postdural puncture headaches in 2 cases complicated the placement and use of the device. Although the unique catheter-over-needle design facilitates the use of smaller-gauge spinal needles for dural puncture and larger-gauge catheters for medication administration, this case series using the Wiley Spinal suggests that paresthesias and postdural puncture headaches may still limit its widespread utilization. Future studies are needed to determine the true incidence of complications and to determine the role of continuous spinal anesthesia in the obstetric population. PMID:26909488

  14. Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial

    OpenAIRE

    Barakat Carballo, Ruben; Peláez Puente, Mireia; Coteron Lopez, Francisco Javier

    2012-01-01

    Objective: In this study, the authors assessed the effects of a structured, moderate-intensity exercise program during the entire length of pregnancy on a woman’s method of delivery. Methods: A randomized controlled trial was conducted with 290 healthy pregnant Caucasian (Spanish) women with a singleton gestation who were randomly assigned to either an exercise (n=138) or a control (n=152) group. Pregnancy outcomes, including the type of delivery, were measured at the end ...

  15. Cesarean Section in Morbidly Obese Parturients: Practical Implications and Complications

    OpenAIRE

    Lovina SM Machado

    2012-01-01

    The prevalence of obesity has reached pandemic proportions across nations. Morbid obesity has a dramatic impact on pregnancy outcome. Cesarean section in these women poses many surgical, anesthetic, and logistical challenges. In view of the increased risk of cesarean delivery in morbidly obese women, the practical implications and complications are reviewed in this article. A Medline search was conducted to review the recent relevant articles in english literature on cesarean section in morbi...

  16. Cesarean section for the second twin

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Nielsen, Elise Hoffmann; Perin, Trine;

    2013-01-01

    BACKGROUND: Although management of twin deliveries has been a topic of discussion for decades, a consensus on how to deliver twins is lacking. The objective of this study was to examine short-term neonatal outcome of the second twin delivered by cesarean section after vaginal delivery of the firs...

  17. 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 ...

  18. Effectiveness of Educational Program Based on the Theory of Reasoned Action to Decrease the Rate of Cesarean Delivery Among Pregnant Women in Fasa, Southern Iran

    OpenAIRE

    Ali Khan-Jeihooni; Fatemeh Shahidi; Seyed Mansour Kashfi

    2014-01-01

    Introduction: Cesarean section is considered as a major surgery accompanied by several complications. The present study aimed to determine the effect of educational intervention based on the theory of reasoned action to reduce the rate of cesarean section among pregnant women in Fasa, Southern Iran. Materials and Methods: This quasi-experimental study was performed on 100 (50 participants in each of the control and intervention groups) primiparous women in the third trimester of pregnancy...

  19. Cesarean Section and Chronic Immune Disorders

    DEFF Research Database (Denmark)

    Sevelsted, Astrid; Stokholm, Jakob; Bønnelykke, Klaus;

    2015-01-01

    OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated with the...... development of some of these diseases. METHODS: Mature children born by cesarean delivery were analyzed for risk of hospital contact for chronic immune diseases recorded in the Danish national registries in the 35-year period 1977-2012. Two million term children participated in the primary analysis. We...... studied childhood diseases with a suspected relation to a deviant immune-maturation and a debut at young age. The effect of cesarean delivery on childhood disease incidences were estimated by means of confounder-adjusted incidence rate ratios with 95% confidence intervals obtained in Poisson regression...

  20. Impact of a diagnosis-related group payment system on cesarean section in Korea.

    Science.gov (United States)

    Kim, Seung Ju; Han, Kyu-Tae; Kim, Sun Jung; Park, Eun-Cheol; Park, Hye Ki

    2016-06-01

    Cesarean sections (CSs) are the most expensive method of delivery, which may affect the physician's choice of treatment when providing health services to patients. We investigated the effects of the diagnosis-related group (DRG)-based payment system on CSs in Korea. We used National Health Insurance claim data from 2011 to 2014, which included 1,289,989 delivery cases at 674 hospitals. We used a generalized estimating equation model to evaluate the association between the likelihood of cesarean delivery and the length of the DRG adoption period. A total of 477,309 (37.0%) delivery cases were performed by CSs. We found that a longer DRG adoption period was associated with a lower odds ratio of CSs (odds ratio [OR]: 0.997, 95% CI: 0.996-0.998). In addition, a longer DRG adoption period was associated with a lower odds ratio for CSs in hospitals that had voluntarily adopted the DRG system. Similar results were also observed for urban hospitals, primiparas, and those under 28 years old and over 33 years old. Our results suggest that the change in the reimbursement system was associated with a low likelihood of CSs. The impact of DRG adoption on cesarean delivery can also be expected to increase with time, as our finding provides evidence that the reimbursement system is associated with the health provider's decision to provide health services for patients. PMID:27173768

  1. Cesarean Section and Interferon-Induced Helicase Gene Polymorphisms Combine to Increase Childhood Type 1 Diabetes Risk

    OpenAIRE

    E. Bonifacio; Warncke, K; Winkler, C.; Wallner, M.; Ziegler, A.-G.

    2011-01-01

    OBJECTIVE The incidence of type 1 diabetes is increasing. Delivery by cesarean section is also more prevalent, and it is suggested that cesarean section is associated with type 1 diabetes risk. We examine associations between cesarean delivery, islet autoimmunity and type 1 diabetes, and genes involved in type 1 diabetes susceptibility. RESEARCH DESIGN AND METHODS Cesarean section was examined as a risk factor in 1,650 children born to a parent with type 1 diabetes and followed from birth for...

  2. Closure or Non-Closure of Peritoneum in Cesarean Section: Outcomes of Short-Term Complications

    OpenAIRE

    Tabasi, Zohreh; Mahdian, Mehrdad; Abedzadeh-Kalahroudi, Masoumeh

    2013-01-01

    Background Cesarean section (CS) is one of the most frequently performed surgical procedures worldwide. The complications following a CS include fever, wound infection, post-operative pain and bleeding which are not usually found in a normal vaginal delivery. Traditionally, suturing of peritoneal layers for CS patients has been done, but in some studies it has been shown that this procedure could be eliminated without affecting the rate of morbidity. Objectives The objective of this study was...

  3. 剖宫产术后再次妊娠分娩方式的临床分析%Clinical analysis on delivery mode of patients with prior cesarean

    Institute of Scientific and Technical Information of China (English)

    陈静; 吴雄辉; 林进; 陈雪芳; 吴岸晓

    2010-01-01

    Objective For further exploration on the delivery mode of patients who have certain prior cesarean sections.Methods 380cases of re-pregnant women from our hospital who were analyzed retrospectively on delivery mode and delivery effects, cheek the thickness of lower pare uterus sear by ultrasonic during late pregnancy.Results 350 cases were chosen to be given cesarean sections and 350 cases section primary cesarean section(PCS) as a comparison, we have analyzed the operations to have such a result: time >60 rain and operation bleed> 400 ml ,this data was statistically distinct between these two groups(P 0.05) Conclusion Most of the patients with prior cesarean sections could deliver safely through vaginal labour as long as the indication and contraindication of vaginal labour could be inspected strictly and intensively.%目的 探讨剖宫产术后再次妊娠的分娩方式.方法 对380例剖宫产术后再次妊娠的孕妇,妊娠晚期用超声检查子宫下段疤痕厚度,选择分娩方式及分娩结局进行回顾性分析.结果 380例前次剖宫产孕妇中350例再次剖宫产,手术产率92.1%,其中无手术指征者235例,占67.1%.阴道试产40例,试产成功30例,占7.9%,试产成功率75%.试产中出现先兆子宫破裂1例改行剖宫产手术,无子宫破裂发生.RCS组与PCS组产妇不同指标比较RCS组产妇术中出血>400ml 55例,手术时间>60min90例;PCS组产妇术中出血>400ml15例,手术时间>60min 10例,比较差异有显著性(P<0.05).结论 严格掌握阴道试产的适应证和禁忌证,严密观察产程,剖宫产术后再次妊娠者可经阴道安全分娩.

  4. 剖宫产与经阴道分娩对产妇盆底功能的影响%Cesarean Section and Vaginal Delivery Impact on Maternal Pelvic Floor Function

    Institute of Scientific and Technical Information of China (English)

    刘芳华

    2014-01-01

    ObjectiveTo study the effect of cesarean section and vaginal delivery on maternal pelvic floor function.Methods Select 120 cases of lying in women in our hospital received, with different modes of delivery wil be divided into the observation group and the control group, the control group using vaginal delivery, cesarean section was used in the observation group, two groups were compared with POP and pelvic floor muscle condition.Results The patients in the observation group the vaginal and uterine prolapse, pelvic floor muscle tension score were significantly better than the control group (P<0.05).Conclusion Compared with vaginal delivery, cesarean section can effectively reduce the effect of postpartum pelvic floor function on postpartum rehabilitation, but to promote the recovery of pelvic floor function has better effect, so there is no need to be selected as the main part according to mode of delivery.%目的:探讨剖宫产与经阴道分娩对产妇盆底功能的影响。方法选取我院接收的120例产妇,以分娩方式的不同将其分为观察组和对照组,对照组采用经阴道分娩,观察组采用剖宫产,比较两组产妇的POP及盆底肌力情况。结果观察组患者阴道及子宫脱垂情况、产后盆底肌张力评分均明显优于对照组(P<0.05)。结论相较于阴道分娩,剖宫产可有效的减少产后对盆底功能的影响,但产后康复对促进盆底功能恢复有较好的效果,因而无需将其作为选择分娩方式的主要依据。

  5. What Is a Cesarean Delivery?

    Science.gov (United States)

    ... not dilate normally. The infant's health is in danger. This could include problems with the umbilical cord ... A-Z Topics Birth Defects Breastfeeding and Breast Milk High-Risk Pregnancy All related topics NICHD News ...

  6. 75 FR 3745 - NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice

    Science.gov (United States)

    2010-01-22

    ... cesarean delivery, the reason for the previous surgical delivery, her age, how far along the pregnancy is... harms to the baby of maternal attempt at trial of labor after prior cesarean versus elective repeat... implications for health services planning. To advance understanding of these important issues, the...

  7. Effectiveness of Educational Program Based on the Theory of Reasoned Action to Decrease the Rate of Cesarean Delivery Among Pregnant Women in Fasa, Southern Iran

    Directory of Open Access Journals (Sweden)

    Ali Khan-Jeihooni

    2014-06-01

    Full Text Available Introduction: Cesarean section is considered as a major surgery accompanied by several complications. The present study aimed to determine the effect of educational intervention based on the theory of reasoned action to reduce the rate of cesarean section among pregnant women in Fasa, Southern Iran. Materials and Methods: This quasi-experimental study was performed on 100 (50 participants in each of the control and intervention groups primiparous women in the third trimester of pregnancy admitted to health centers of Fasa city, Fars province, Iran. The data-gathering tool was a multipart questionnaire containing demographic variables and the theory of reasoned action structures. After the pretest, the intervention group underwent exclusive training based on the theory of reasoned action. Then, after 3 months, both groups took part in the posttest. Data was analyzed by paired T-test, independent T-test and chi-square using SPSS-18 software. Results: A significant difference was found between the two groups regarding knowledge, evaluations behavioral outcomes, Behavioral beliefs and intention (P<0.001. Chi-square analysis showed a significant difference between the two groups regarding their performance (P<0.001. Conclusion: The present intervention was effective in increasing the pregnant women’s knowledge, evaluation of outcomes, attitude and strengthening their intention as well as performance. Therefore, it is suggested to use this model and other systematic straining for pregnant women to decrease the rate of cesarean section.

  8. Successful delivery by a cesarean section in a parturient with severe dilated cardiomyopathy, an implantable cardioverter defibrillator, and a repaired tetralogy of fallot

    Directory of Open Access Journals (Sweden)

    Rafid Fayadh Al-Aqeedi

    2011-01-01

    Full Text Available Repaired congenital heart disease has become more prevalent in women of childbearing age. We report an unusual case of a 24-year-old multigravida with a repaired tetralogy of Fallot, severe dilated cardiomyopathy, and implantable cardioverter defibrillator placement who was managed successfully by a cesarean section three times. This case underscores the impact of such events on maternal and fetal safety and the importance of a multidisciplinary approach in the management of pregnant patients with complex congenital and medical problems.

  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 ... 00:05:37 FEMALE VOICE: [Unintelligible.] 00:05:40 LEAH D. RIDGWAY, MD: Sure. The repeat cesarean ... get past 39 and one day compared to 40 weeks, there's probably not much difference in how ...

  12. THEORIES AND FACTORS AFFECTING MUCOADHESIVE DRUG DELIVERY SYSTEMS: A REVIEW

    Directory of Open Access Journals (Sweden)

    Alexander Amit

    2011-04-01

    Full Text Available Bioadhesion is an interfacial phenomenon in which two materials, at least one of which is biological, are held together by means of interfacial forces. When the associated biological system is mucous, it is called mucoadhesion. This property of certain polymeric systems have got place in the drug delivery research in order to prolong contact time in the various mucosal route of drug administration, as the ability to maintain a delivery system at a particular location for an extended period of time has a great appeal for both local action as well as systemic drug bioavailability. A complete and comprehensive theory that can predict adhesion based on the chemical and/or physical nature of a polymer is not yet available. Several theories have been proposed to explain the fundamental mechanisms of adhesion such as glues, adhesives, and paints, have been adopted to study the mucoadhesion. Mucoadhesion is a complex process and numerous theories have been presented to explain the mechanisms involved. These theories include mechanical-interlocking, electrostatic, diffusion–interpenetration, adsorption and fracture processes. They are Electronic theory, Adsorption theory, Wetting theory, Diffusion theory, Fracture theory. The objective of the study is to explain the different mechanisms involved in mucoadhesion and various factors affecting mucoadhesion.

  13. Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis

    OpenAIRE

    Eui Tai Lee1; Hyun Min Park; Dong Geun Lee1; Kyung Jin Shin1; Hak Soon Kim2; Ro Hyun Sung3; Dong Hee Ryu

    2012-01-01

    Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosis is a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-old woman presented with a 9×6 cm sized dark-brown, stony-hard, irregular, lower abdominal mass of four years duration. The patient had a history of two Cesarean deliveries, 14 and 16 years ago. Suspecting endometrio...

  14. Use of methergine for the prevention of postoperative endometritis in non-elective cesarean section patients.

    OpenAIRE

    Murray F. Dweck; Spellacy, William N.; Catherine M. Lynch

    2000-01-01

    Objective: Methergine increases constriction of uterine musculature which may facilitate sloughing of endometrial debris, close uterine vessels, and prevent post-cesarean endometritis. The objective of this study was to evaluate the efficacy of methergine in preventing endometritis in patients undergoing non-elective cesarean section delivery.Methods: Eighty patients undergoing non-elective cesarean section were enrolled in a prospective randomized clinical trial of methergine (41) versus no ...

  15. Use of Methergine for the Prevention of Postoperative Endometritis in Non-Elective Cesarean Section Patients

    Directory of Open Access Journals (Sweden)

    Murray F. Dweck

    2000-01-01

    Full Text Available Objective: Methergine increases constriction of uterine musculature which may facilitate sloughing of endometrial debris, close uterine vessels, and prevent post-cesarean endometritis. The objective of this study was to evaluate the efficacy of methergine in preventing endometritis in patients undergoing non-elective cesarean section delivery.

  16. Cervical dilation at the time of cesarean section for dystocia - effect on subsequent trial of labor

    DEFF Research Database (Denmark)

    Abildgaard, Helle; Diness, Marie; Nickelsen, Carsten; Secher, Niels Joergen; Andreasen, Kirsten Riis; Nørgaard, Kirsten

    2012-01-01

    cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010. Methods. Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural...... anesthesia and mode of birth was collected. Results. A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully...

  17. The history of cesarean technique.

    Science.gov (United States)

    Lurie, Samuel; Glezerman, Marek

    2003-12-01

    Cesarean section has been practiced since ancient times. Unfortunately, no ancient medical documents describing the techniques for cesarean section are extant. In the early medieval period, cesarean section was usually performed by midwives. One of the first explicit instructions in medical literature on cesarean technique dates from about 1480 ce from southern Germany. We discuss the evolution of cesarean surgical technique and point up the contribution of many giants in the field of obstetrics and gynecology, such as Blundell, Frank, Harris, Joel-Cohen, Kehrer, Kerr, Lebas, Levret, Maylard, Pfannenstiel, Porro, Portes, and Sanger. PMID:14710118

  18. 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

  19. Cesarean section in morbidly obese parturients: Practical implications and complications

    Directory of Open Access Journals (Sweden)

    Lovina SM Machado

    2012-01-01

    Full Text Available The prevalence of obesity has reached pandemic proportions across nations. Morbid obesity has a dramatic impact on pregnancy outcome. Cesarean section in these women poses many surgical, anesthetic, and logistical challenges. In view of the increased risk of cesarean delivery in morbidly obese women, the practical implications and complications are reviewed in this article. A Medline search was conducted to review the recent relevant articles in english literature on cesarean section in morbidly obese women. The types of incisions and techniques used during cesarean delivery, intra-operative and postpartum complications, anesthetic and logistical issues, maternal morbidity and mortality were reviewed. Morbidly obese women with a body mass index (BMI >40 kg/m 2 are at increased risk of pregnancy complications and a significantly increased rate of cesarean delivery. Low transverse skin incisions and transverse uterine incisions are definitely superior and must be the first option. Closure of the subcutaneous layer is recommended, but the placement of subcutaneous drains remains controversial. Thromboprophylaxis adjusted to body weight and prophylactic antibiotics help in reducing postpartum morbidity. Morbidly obese women are at increased risk of postpartum infectious morbidity. Weight reduction in the postpartum period and thereafter must be strongly encouraged for optimal future pregnancy outcomes and well-being.

  20. Cesarean Section Birth

    Medline Plus

    Full Text Available CESAREAN SECTION SHAWNEE MISSION MEDICAL CENTER MERRIAM, KANSAS March 13, 2008 00:00:09 ANNOUNCER: Tonight you will experience the miracle of birth during a live Internet broadcast from Shawnee Mission Medical Center in Merriam, Kansas. Over the next hour, ...

  1. THEORIES AND FACTORS AFFECTING MUCOADHESIVE DRUG DELIVERY SYSTEMS: A REVIEW

    OpenAIRE

    Alexander Amit; Sharma Sharad; Ajazuddin,; Khan Mohammed Junaid; Swarna

    2011-01-01

    Bioadhesion is an interfacial phenomenon in which two materials, at least one of which is biological, are held together by means of interfacial forces. When the associated biological system is mucous, it is called mucoadhesion. This property of certain polymeric systems have got place in the drug delivery research in order to prolong contact time in the various mucosal route of drug administration, as the ability to maintain a delivery system at a particular location for an extended period of...

  2. Feasibility of abdominoplasty with Cesarean section [Retraction

    Directory of Open Access Journals (Sweden)

    Thabet WN

    2013-01-01

    Full Text Available The Editor-in-Chief and Publisher of the International Journal of Women’s Health have been alerted by Dr Nadine Sherif, the corresponding author, to unacceptable levels of duplication with a previously published paper: Ali A, Essam A. Abdominoplasty Combined with Cesarean Delivery: Evaluation of the Practice. Aesthetic Plastic Surgery. 2011;35(1:80–86.It is worth noting that this paper was peer-reviewed by two peer-reviewers and the Editor-in-Chief of the International Journal of Women’s Health before publication. The paper concerned is: Thabet WN, Hossny AS, Sherif NA. Feasibility of abdominoplasty with Cesarean section. International Journal of Women’s Health. 2012;4:115–121.

  3. Obstetric and Non-Obstetric Risk Factors for Cesarean Section in Oman

    OpenAIRE

    Ibrahim Al Busaidi; Yahya Al-Farsi; Shyam Ganguly; Vaidyanathan Gowri

    2012-01-01

    Objectives: This study aims to explore the risk factors, profiles and neonatal outcomes of Cesarean sections among selected women in Oman.Methods: In this hospital-based case-control study, a total of 500 participants (250 cases who had cesarean section and 250 controls who had spontaneous vaginal delivery), were randomly selected from four hospitals. Cases and controls were matched according to timing and place of delivery.Results: The following predictors were found to be significantly asso...

  4. 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.

  5. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients

    OpenAIRE

    Cho, Hee Young; Park, Yong Won; Kim, Young Han; Jung, Inkyung; Kwon, Ja-Young

    2015-01-01

    Purpose The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation. Methods We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualifi...

  6. Cimetidine as pre-anesthetic agent for cesarean section

    DEFF Research Database (Denmark)

    Qvist, N; Storm, K; Holmskov, A

    1985-01-01

    In a prospective randomized study of 39 consecutive cesarean sections, 20 patients received cimetidine 400 mg intramuscularly as a pre-anesthetic, an 19 control patients were given NaCl. No perinatal effects on the infants were observed by cardiotocography before delivery, and K, Na, pH, PCO2, HCO...

  7. 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

  8. 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

  9. Goal-directed Fluid Therapy May Improve Hemodynamic Stability of Parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns

    Directory of Open Access Journals (Sweden)

    Wei Xiao

    2015-01-01

    Full Text Available Background: Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy (HDP can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy (GDFT with LiDCO rapid system can improve well-being of both HDP parturient and their babies. Methods: Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer′s solution (LR, parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume (ΔSV provided via LiDCO rapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. Results: The severity of HDP was similar between two groups. The total LR infusion (P < 0.01 and urine output (P < 0.05 were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group (P < 0.01. There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased (P < 0.05, and the incidences of neonatal hypercapnia and hypoxemia were statistically increased (P < 0.05 than in the GDFT group. Conclusions: Dynamic responsiveness guided fluid therapy with the LiDCO rapid system

  10. Anatomical and Histological Factors Affecting Intranasal Drug and Vaccine Delivery

    OpenAIRE

    Gizurarson, Sveinbjörn

    2012-01-01

    The aim of this review is to provide an understanding of the anatomical and histological structure of the nasal cavity, which is important for nasal drug and vaccine delivery as well as the development of new devices. The surface area of the nasal cavity is about 160 cm2, or 96 m2 if the microvilli are included. The olfactory region, however, is only about 5 cm2 (0.3 m2 including the microvilli). There are 6 arterial branches that serve the nasal cavity, making this region a very attractive r...

  11. 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.

  12. Anatomical and histological factors affecting intranasal drug and vaccine delivery.

    Science.gov (United States)

    Gizurarson, Sveinbjörn

    2012-11-01

    The aim of this review is to provide an understanding of the anatomical and histological structure of the nasal cavity, which is important for nasal drug and vaccine delivery as well as the development of new devices. The surface area of the nasal cavity is about 160 cm2, or 96 m2 if the microvilli are included. The olfactory region, however, is only about 5 cm2 (0.3 m2 including the microvilli). There are 6 arterial branches that serve the nasal cavity, making this region a very attractive route for drug administration. The blood flow into the nasal region is slightly more than reabsorbed back into the nasal veins, but the excess will drain into the lymph vessels, making this region a very attractive route for vaccine delivery. Many of the side effects seen following intranasal administration are caused by some of the 6 nerves that serve the nasal cavity. The 5th cranial nerve (trigeminus nerve) is responsible for sensing pain and irritation following nasal administration but the 7th cranial nerve (facial nerve) will respond to such irritation by stimulating glands and cause facial expressions in the subject. The first cranial nerve (olfactory nerve), however, is the target when direct absorption into the brain is the goal, since this is the only site in our body where the central nervous system is directly expressed on the mucosal surface. The nasal mucosa contains 7 cell types and 4 types of glands. Four types of cells and 2 types of glands are located in the respiratory region but 6 cell types and 2 types of glands are found in the olfactory region. PMID:22788696

  13. Intrauterine contraception after cesarean section and during lactation: a systematic review

    Directory of Open Access Journals (Sweden)

    Goldstuck ND

    2013-12-01

    Full Text Available Norman D Goldstuck,1 Petrus S Steyn2 1Department of Obstetrics and Gynaecology, Tygerberg Hospital, Cape Town, Western Cape, South Africa; 2Reproductive Health and Fertility Regulation, Department of Obstetrics and Gynaecology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa Background: All postpartum women, including those who are breastfeeding or have had a cesarean section, appear potentially suited to intrauterine contraception, a long acting reversible contraceptive (LARC. Like any other method used after delivery, it should not interfere with lactation or be affected by cesarean section. Study design: We searched the MEDLINE, PubMed, Popline, Google Scholar, and Clinicaltrials.gov databases from January 1968 through to December 2012. Studies were included if they reported event rates in women who had a cesarean section and event rates and clinical outcomes in lactating women or their infants in the breastfeeding group. Summary odds ratios were not calculated because of the diverse methods of reporting event rates in the cesarean section group and the heterogeneity of the results in the breastfeeding group. Results: We found 26 articles on event rates in interval and post-placental intrauterine device (IUD use, and 18 on event rates and clinical outcomes in breastfeeding IUD users. Four prospective studies and one retrospective study showed an increased expulsion rate in interval insertion. There were 19 studies, of which five were controlled in post-placental IUD insertion after cesarean section. Four studies had expulsion rates of 10 or more per 100 woman-years of use and 15 expulsion rates below 10 per 100 woman-years of use. Three studies showed that event rates for lactating IUD users are the same as those for non-lactating users. Fifteen controlled studies showed that the IUD had no effect on milk production and seven of these showed no effect on infant growth. Pharmacovigilance databases report an

  14. Obstetric and Non-Obstetric Risk Factors for Cesarean Section in Oman

    Directory of Open Access Journals (Sweden)

    Ibrahim Al Busaidi

    2012-11-01

    Full Text Available Objectives: This study aims to explore the risk factors, profiles and neonatal outcomes of Cesarean sections among selected women in Oman.Methods: In this hospital-based case-control study, a total of 500 participants (250 cases who had cesarean section and 250 controls who had spontaneous vaginal delivery, were randomly selected from four hospitals. Cases and controls were matched according to timing and place of delivery.Results: The following predictors were found to be significantly associated with increased risk of cesarean section: a advancing age (above the age of 25 years, OR=1.42; p=0.03, b prior cesarean section (previous cesarean section=1, OR=22.71; p=0.001, c increased body mass index (obesity, OR=2.11; p=0.07, d extremes of neonatal birth weight (neonates birth weight 4.0 kg, OR=7.3; p<0.001, and e prepregnancy diabetes (OR=9.3; p=0.04. On the contrary, increased parity and history of the use of birth spacing methods (OR=0.38; p=0.03 were associated with decreased risk of cesarean section.Conclusion: The study calls for increasing awareness about clinical and public health majors that would lead to prevention of risk factors associated with increased risk of cesarean section such as maintaining normal BMI and prevention of gestational and type 2 diabetes mellitus.

  15. Two-dimensional power Doppler-three-dimensional ultrasound imaging of a cesarean section dehiscence with utero-peritoneal fistula: a case report

    Directory of Open Access Journals (Sweden)

    Royo Pedro

    2009-01-01

    Full Text Available Abstract Introduction An imaging diagnosis after an iterative cesarean delivery is reviewed demonstrating a fine ultrasound-pathologic correlation. Case presentation A 33-year-old woman (G3, P3 presented referring intense dysmenorrhea and intermenstrual spotting since her third cesarean delivery, 1 year before. A cesarean section dehiscence with utero-peritoneal fistula was diagnosed by transvaginal ultrasound. Conclusion We can conclude that transvaginal two-dimensional power Doppler and three-dimensional ultrasound are highly accurate in detecting cesarean section dehiscence and uterine fistula.

  16. Safe management of cesarean section in a patient of Eisenmenger syndrome

    Directory of Open Access Journals (Sweden)

    Silvia Minicucci

    2012-01-01

    Full Text Available We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO (as a bridge to recovery or bridge to salvage was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.

  17. A close call: does the location of incision at cesarean delivery matter in patients with vasa previa? A case report. [v1; ref status: indexed, http://f1000r.es/2f8

    Directory of Open Access Journals (Sweden)

    Werner M Neuhausser

    2013-12-01

    Full Text Available We present here a case of vasa previa in a multipara, diagnosed at the time of her late second trimester ultrasonogram. The patient subsequently underwent an elective cesarean section after 37 weeks gestation, giving birth to a healthy child with an uneventful post-partum, neonatal and infant course. At the time of cesarean section, the incision was gradually deepened in layers through the myometrium by utmost care allowing the amniotic sac to protrude through the uterine incision hereby avoiding laceration of the vasa previa and its branches. Fetal exsanguination and a need for blood transfusion as well as a possible adverse neonatal course were therefore avoided.

  18. Cesarean Section Birth

    Medline Plus

    Full Text Available ... and that's our warmer where the baby will go after delivery. And that's over here so that ... immediately after delivery. So we're going to go ahead and get started. We've already tested ...

  19. 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.

  20. Cesarean Section: Recovering After Surgery

    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 ...

  1. Cesarean Section: Recovering After Surgery

    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: Recovering after surgery 3:47 Dr. ...

  2. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

    DEFF Research Database (Denmark)

    Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper; Weber, Tom

    2004-01-01

    OBJECTIVE: To assess Danish obstetricians' and gynecologists' personal preference and general attitude towards elective cesarean section on maternal request in uncomplicated single cephalic pregnancies at term. DESIGN: Nation-wide anonymous postal questionnaire. POPULATION: Four hundred and fifty......-five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...... and gynecologists would personally prefer vaginal delivery in uncomplicated pregnancies, but nearly 40% agree with the woman's right to request a cesarean section....

  3. Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia

    Directory of Open Access Journals (Sweden)

    Senturk MB

    2015-07-01

    Full Text Available Mehmet Baki Senturk,1 Yusuf Cakmak,2 Halit Atac,2 Mehmet Sukru Budak3 1Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey; 2Department of Obstetrics and Gynecology, Batman State Hospital, Batman, Turkey; 3Department of Obstetrics and Gynecology, Diyarbakir Research Hospital, Diyarbakir, Turkey Abstract: Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P<0.01, but these were minor. The rate of blood transfusion and prevalence of changes in hemoglobin level were similar in both groups (P>0.05. In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of

  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. Challenges in researching violence affecting health service delivery in complex security environments.

    Science.gov (United States)

    Foghammar, Ludvig; Jang, Suyoun; Kyzy, Gulzhan Asylbek; Weiss, Nerina; Sullivan, Katherine A; Gibson-Fall, Fawzia; Irwin, Rachel

    2016-08-01

    Complex security environments are characterized by violence (including, but not limited to "armed conflict" in the legal sense), poverty, environmental disasters and poor governance. Violence directly affecting health service delivery in complex security environments includes attacks on individuals (e.g. doctors, nurses, administrators, security guards, ambulance drivers and translators), obstructions (e.g. ambulances being stopped at checkpoints), discrimination (e.g. staff being pressured to treat one patient instead of another), attacks on and misappropriation of health facilities and property (e.g. vandalism, theft and ambulance theft by armed groups), and the criminalization of health workers. This paper examines the challenges associated with researching the context, scope and nature of violence directly affecting health service delivery in these environments. With a focus on data collection, it considers how these challenges affect researchers' ability to analyze the drivers of violence and impact of violence. This paper presents key findings from two research workshops organized in 2014 and 2015 which convened researchers and practitioners in the fields of health and humanitarian aid delivery and policy, and draws upon an analysis of organizational efforts to address violence affecting healthcare delivery and eleven in-depth interviews with representatives of organizations working in complex security environments. Despite the urgency and impact of violence affecting healthcare delivery, there is an overall lack of research that is of health-specific, publically accessible and comparable, as well as a lack of gender-disaggregated data, data on perpetrator motives and an assessment of the 'knock-on' effects of violence. These gaps limit analysis and, by extension, the ability of organizations operating in complex security environments to effectively manage the security of their staff and facilities and to deliver health services. Increased research

  6. New Views on Cesarean Section, its Possible Complications and Long-Term Consequences for Children's Health.

    Science.gov (United States)

    Kulas, Tomislav; Bursac, Danijel; Zegarac, Zana; Planinic-Rados, Gordana; Hrgovic, Zlatko

    2013-12-01

    Historical developments and advancements in cesarean section techniques and logistics have reduced the maternal and neonatal risks associated with the procedure, while increasing the number of operatively completed pregnancies for medically unjustifiable reasons. The uncritical attitude towards cesarean section and the fast emergence of 'modern' diseases such as obesity at a young age, asthma, type 1 diabetes mellitus and various forms of dermatitis have stimulated researches associating cesarean section with these diseases. Intestinal flora of the children born by cesarean section contains less bifidobacteria, i.e. their intestinal flora is similar to the intestinal flora in diabetic individuals. In children born by cesarean section, the 'good' maternal bacterial that are normally found in the maternal birth canal and rectum are lacking, while the 'bad' bacteria that may endanger the child's immune system are frequently present. In children born by vaginal delivery, the 'good' maternal bacteria stimulate the newborn's white blood cells and other components of the immune system, which has been taken as a basis for the hypotheses explaining the evident association of the above morbidities and delivery by cesarean section. PMID:25568522

  7. Ultrasound evaluation of the cesarean scar: comparison between one- and two layer uterotomy closure

    DEFF Research Database (Denmark)

    Glavind, Julie; Madsen, Lene Duch; Uldbjerg, Niels; Dueholm, Margit

    Objectives: To compare the residual myometrial thickness and the size of the cesarean scar defect after one- and two layer uterotomy closure. Methods: From July 2010 a continuous two-layer uterotomy closure technique replaced a continuous one-layer technique after cesarean delivery at the...... Department of Obstetrics and Gynecology at Aarhus University Hospital. A total of 149 consecutively invited women (68 women with one-layer and 81 women with two-layer closure) had their cesarean scar examined with 2D transvaginal sonography (TVS) 6-16 months post partum. Inclusion criteria were non......-pregnant women with one previous elective cesarean, no post-partum uterine infection or uterine re-operation, and no type 1 diabetes. Scar defect width, depth, and residual myometrial thickness were measured on the sagittal plane, and scar defect length was measured on the transverse plane. Results: The median...

  8. Rare complications of cesarean scar

    Directory of Open Access Journals (Sweden)

    Divyesh Mahajan

    2013-01-01

    Full Text Available Cesarean scar pregnancy (CSP and cesarean scar dehiscence (CSD are the most dreaded complications of cesarean scar (CS. As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG and confirmed on magnetic resonance imaging (MRI. These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions.

  9. Cesarean Section Birth

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    Full Text Available ... quite a monumental event. Thanks to our wonderful patient who has agreed to share this day with ... the delivery to tell us more about the patient. Dr. Ridgway? 00:02:28 LEAH D. RIDGWAY, ...

  10. Cesarean Section Birth

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    Full Text Available ... experience the miracle of birth during a live Internet broadcast from Shawnee Mission Medical Center in Merriam, ... later if you prefer. Now let me turn things over to the obstetrician performing the delivery to ...

  11. Cesarean Section Birth

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    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 ...

  12. Cesarean Section Birth

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    Full Text Available ... traditional vaginal delivery, especially for first-time expecting mothers? 00:08:17 ELIZABETH WICKSTROM, MD: Because c- ... the baby to do so and for the mother to do so. So we don't encourage ...

  13. Cesarean Section Birth

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    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 ...

  14. Cesarean Section Birth

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    Full Text Available ... to make sure that the baby's mature and lungs are ready for delivery. So anytime typically a ... of life is very helpful. It helps the lungs open up, helps her be able to take ...

  15. 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 ...

  16. Cesarean Section Birth

    Medline Plus

    Full Text Available ... viewer questions during the delivery. Or-Live makes it easy for you to learn more. Just click ... program. Also, we will archive this program and it will be available to you through this website ...

  17. A conceptual model for factors affecting the relationship between supply chain integration and customer delivery performance

    Directory of Open Access Journals (Sweden)

    Peyman Ghafari Ashtiani

    2013-09-01

    Full Text Available Supply chain is a widely used concept around the world. Nowadays, companies need to integrate their production processes, from the raw materials to the end-user. Supply chain management is a phenomenon that achieves this in a way that ensures customers get reliable and fast service and high quality products at the lowest possible cost. There is very limited and sporadic research on supply chain integration and how it affects supply chain performance. Therefore there is no real understanding of the concept of supply chain integration and how it affects supply chain performance nor is there a holistic model. This paper thus aims to present a model that identifies factors affecting the relationship between supply chain integration and customer delivery performance. After analyzing the collected data on supply chain integration and customer delivery performance, the preliminary model was proposed and completed, and using expert opinion in the Imam Khomeini Oil Refinery the final model and for factors affecting the relationship between supply chain integration and customer delivery performance were presented. To determine how these factors interrelate with each other, the DEMATEL method was then used. The statistical population included the staff at Imam Khomeini Oil Refinery in Shazand. The data, collected through the standard DEMATEL questionnaire, were analyzed using the DEMATEL method and a MATLAB program. The DEMATEL results indicate that intra-organizational factors, institutional norms, technological certainties are causal factors which influence other factors that affect the relationship between supply chain integration and customer delivery performance. Intra-organizational factor have a greater influence also among effect factors, substructures have the greatest influence.

  18. MedlinePlus: Cesarean Section

    Science.gov (United States)

    ... C-section C-section - slideshow Cesarean section Going home after a C-section Vaginal birth after C-section Related Health Topics Childbirth Childbirth Problems Languages Arabic (العربية) Bosnian (Bosanski) Chinese - ...

  19. Influence of mode of delivery at term on the neonatal respiratory morbidity

    International Nuclear Information System (INIS)

    Respiratory morbidity is an important complication of elective cesarean section. Our objective was to find out the incidence of respiratory distress in term neonates delivered by elective cesarean section and compare it with neonates delivered vaginally. We evaluated one thousands infants delivered by elective cesarean section and normal vaginal delivery for respiratory distress. Among 500 cesarean done, 27 (5.4%) neonates had respiratory distress and among 500 vaginal delivery infants, 8(1.6%) developed respiratory Distress (P<0.001). The odd ratio for neonatal respiratory distress was 3.38, almost threefold higher in cesarean section group than those delivered vaginally. (author)

  20. Effects of Cesarean Section on Infant Health in China:Matched Prospective Cohort Study

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To compare the medical outcomes of infants delivered by cesarean section with those of infants delivered vaginally.Methods A total of 301 healthy women with cesarean section and a matched control group of 301 women delivered vaginally were identified at three district-level hospitals in Shanghai from May 2001 to February 2003.Two groups were matched according to their medical indications Tor cesarean section.Their infants were assessed at delivery,1 month,6 month and 1 year after birth.Results The incidence of neonatal complications and infant morbidities at all measurement occasions did not differ significantly between groups.Rehospitalization was found to be more likely among infants delivered by cesarean section in the first month after birth.However,there was no difference between two groups in the incidence of rehospitalization in the first year after birth. Cesarean section was also associated with a higher risk of infant diarrhea (adjusted relative risk=1.25,95% CI:1.01,1.56).Conclusion Infants did not have health benefits from cesarean section if the pregnancy was at low risk.

  1. Pregnancy Outcomes of Repeat Cesarean Section in Peking Union Medical College Hospital

    Institute of Scientific and Technical Information of China (English)

    Liang-kun Ma; Na Liu; Xu-ming Bian; Li-rong Teng; Hong Qi; Xiao-ming Gong; Jun-tao Liu; Jian-qiu Yang

    2009-01-01

    Objective To evaluate the effect of elective repeat cesarean section on the maternal and neonatal outcomes.Methods A retrospective clinic-and hospital-based survey was designed for comparing the maternal and neonatal outcomes of elective repeat cesarean section [RCS group(one previous cesarean section)and MRCS group(two or more previous cesarean sections)] and primary cesarean section(FCS group)at Peking Union Medical College Hospital from January 1998 to December 2007.Results The incidence of repeat cesarean section increased from 1.26% to 7.32% .The mean gestational age at delivery in RCS group(38.1±1.8 weeks)and MRCS group(37.3±2.5 weeks)were significantly shorter than that in FCS group(38.9±2.1 weeks,all P<0.01).The incidence of complication was 33.8% and 33.3% in RCS group and MRCS group respectively,and was significantly higher than that in FCS group(7.9% ,P<0.05).Dense adhesion(13.5% vs.0.4% ,OR=7.156,95% CI:1.7-30.7,P<0.01)and uterine rupture(1.0% vs.0,P<0.05)were commoner in RCS group compared with FCS group.Neonatal morbidity was similar among three groups(P>0.05).Conclusions Repeat cesarean section is associated with more complicated surgery technique and increased frequency of maternal morbidity.However,the incidence of neonatal morbidity is similar to primary cesarean section.

  2. An Examination of Cesarean and Vaginal Birth Histories Among Hispanic Women Entering Prenatal Care in Two California Counties with Large Immigrant Populations

    OpenAIRE

    Gonzales-Mendez, Enrique; Gonzalez-Maddux, Catherine; Hall, Celeste; Maddux-Gonzalez, Mary; Handley, Margaret A

    2011-01-01

    Repeat cesarean delivery (CD) rates among US Hispanic women are the highest of all racial/ethnic groups (90%). Vaginal birth after cesarean (VBAC) is an alternative delivery method, but requires medical records documentation of a non-vertical incision and favorable conditions in the current pregnancy. VBAC rates for Hispanic women are extremely low. This study explores the birth histories and medical records access among Hispanic women in California, taking into account the potential role of ...

  3. Cesarean Scar Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Z Vahedpoor

    2015-07-01

    Conclusion: Previous cesarean scar pregnancy if not detected early can be associated with high morbidity and mortality. Therefore, the possibility of this pregnancy should be considered in pregnant women with uterine bleeding, abdominal pain as well as a history of cesarean section. It should be noted that after previous cesarean scar pregnancy was definitely diagnosed via ultrasound examination, treatment necessitates to be started utilizing methotrexate to ensure the future fertility of the mother.

  4. Fragile and conflict affected states: report from the Consultation on Collaboration for Applied Health Research and Delivery

    OpenAIRE

    Raven, Joanna; Martineau, Tim; MacPherson, Eleanor; Baba Dieu-Merci, Amuda; Ssali, Sarah; Torr, Steve; Theobald, Sally

    2014-01-01

    Fragile and Conflict Affected States present difficult contexts to achieve health system outcomes and are neglected in health systems research. This report presents key debates from the Consultation of the Collaboration for Applied Health Research and Delivery, Liverpool, June, 2014.

  5. Cesarean Section Birth

    Medline Plus

    Full Text Available ... cutest little face. 00:11:05 KRISTEN: What color hair? 00:11:06 LEAH D. RIDGWAY, MD: ... possible infection to the eye that could affect vision later. So all babies get the ointment into ...

  6. Managing anesthesia for cesarean section in obese patients: current perspectives.

    Science.gov (United States)

    Lamon, Agnes M; Habib, Ashraf S

    2016-01-01

    Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients. Neuraxial techniques are the preferred anesthetic techniques for cesarean delivery in obese parturients but can be technically challenging. An existing labor epidural catheter can be topped up for cesarean delivery. In patients who do not have a well-functioning labor epidural, a combined spinal epidural technique might be preferred over a single-shot spinal technique since it is technically easier in obese parturients and allows for extending the duration of the block as required. A continuous spinal technique can also be considered. Studies suggest that there is no need to reduce the dose of spinal bupivacaine in the obese parturient, but there is little data about spinal dosing in super obese parturients. Intraoperatively, patients should be placed in a ramped position, with close monitoring of ventilation and hemodynamic status. Adequate postoperative analgesia is crucial to allow for early mobilization. This can be achieved using a multimodal regimen incorporating neuraxial morphine (with appropriate observations) with scheduled nonsteroidal anti-inflammatory drugs and acetaminophen. Thromboprophylaxis is also important in this patient population due to the increased risk of thromboembolic complications. These patients should be monitored carefully in the postoperative period, since there is increased risk of postoperative complications in the morbidly obese parturients. PMID:27574464

  7. Prior cesarean section is associated with increased preeclampsia risk in a subsequent pregnancy

    OpenAIRE

    Cho, Geum Joon; Kim, Log Young; Min, Kyung-Jin; Sung, Ye Na; Hong, Soon-Cheol; Oh, Min-Jeong; Seo, Hong-Seog; Kim, Hai-Joong

    2015-01-01

    Background To evaluate the impact of a prior cesarean section on preeclampsia risk in a subsequent pregnancy. Methods Study data were collected from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service for 2006–2010. Patients who had their first delivery in 2006 and subsequent delivery between 2007 and 2010 in Korea were enrolled. The overall incidence of preeclampsia during the second pregnancy was estimated and to evaluate the risk of pre...

  8. 盐酸右美托咪啶和地佐辛治疗腰硬联合麻醉剖宫产产妇寒颤效果比较%Comparison of dexmedetomidine with dezocne in prevention of shiver for parturients with cesarean delivery under CSEA

    Institute of Scientific and Technical Information of China (English)

    段静; 钟泰迪

    2014-01-01

    Objective To compare the preventive effect on shiver between dexmedetomidine and Dezocne in parturi-ents with cesarean delivery under combined spinal and extradural anesthesia (CSEA). Methods One hundred and twenty par-turients with ful- term pregnancy, no pregnancy complications, no contraindication for intra- spinal canal anesthesia were scheduled for cesarean delivery under CSEA. Parturients were randomly divided into 2 groups (n=60 in each):after fetal child-birth, group DEX received intravenous dexmedetomidine 0.4μg/kg and group Dez received dezocne 0.15mg/kg. The classifi-cation of shiver and adverse reactions were documented. Results There was no significant difference in incidence of shiver grades 1 and 2 between two groups (P >0.05), and no shiver of grades 3 and 4 occurred in both groups. The incidence of dizziness, nausea, vomiting, respiratory depression, and lethargy in group DEX was significantly lower than that in group Dez (P<0.05); and parturients in group DEX were more likely to be awoken from the sleep state (P<0.05). Conclusion Both dexmedetomidine and dezocne can effectively prevent shiver in parturients with cesarean delivery under CSEA, but dezocre has higher incidence of adverse reactions than dexmedetomidine.%目的:比较盐酸右美托咪啶和地佐辛治疗腰硬联合麻醉剖宫产产妇寒颤的效果及伴随的不良反应。方法选择拟行腰硬联合麻醉剖宫产手术的产妇120例,足月妊娠且无妊娠期并发症,无椎管内麻醉禁忌证。采用随机数字表法分为盐酸右美托咪啶组和地佐辛组,各60例。胎儿娩出即刻静脉给药,盐酸右美托咪啶组给予盐酸右美托咪啶0.4μg/kg,地佐辛组给予地佐辛0.15mg/kg。记录患者寒颤的分级情况及不良反应发生情况。结果两组产妇治疗前后各级寒颤发生率的差异均无统计学意义(均P>0.05),治疗后两组均未发生3级及4级寒颤。盐酸右美托咪啶组

  9. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2014-03-01

    Full Text Available OBJECTIVE: To assess the incidence and conditions associated with cesarean section in a cohort of pregnant women with intrauterine fetal death (IUFD, and clinical management to anticipate the childbirth. METHODS: It was a retrospective cohort study with 163 mothers with IUFD, at the second half of pregnancy, who were managed to anticipate childbirth using pharmacological preparations and/or a mechanical method (Foley catheter in a teaching hospital in Rio de Janeiro State, Brazil. Cox regression was used to evaluate the effect of the clinical methods on the kind of delivery. RESULTS: The Subgroups A (misoprostol or Oxytocin, B (misoprostol and Oxytocin, and C (Foley catheter alone or combined with misoprostol and/or Oxytocin were formed according to the applied methods. Nine out of 163 cases ended with cesarean section. The incidence of cesarean section was 3.5 per 1,000 people-hours, meaning that a pregnant woman with IUFD had a 15.6% risk of cesarean section during the first 48 hours of clinical management to anticipate childbirth. The conditions significantly associated with the mode of delivery were placental abruption (HR: 44.97, having two or more previous cesarean deliveries (HR: 10.03, and mechanical method with Foley catheter (HR: 5.01. CONCLUSION: Cesarean section was an essential conduct in this cohort and followed previous cesarean delivery and placental abruption. The effect of the mechanical method on the abdominal route suggests that the Foley catheter method was used in the most difficult cases and that the surgery was performed to ensure maternal health.

  10. SURGICAL RISK INDEX AND SURGICAL SITE INFECTION IN POSTPARTUM WOMEN SUBMITTED TO CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Luana Machado Chianca

    2015-07-01

    Full Text Available Backgound and Objectives: Considering the use of active surveillance assists in infection identification and the need for studies that use Surgical Risk Index (SRI for assessment of Surgical Site Infection (SSI in cesareans, this study aims to determine the incidence of SSI and analyze the applicability of SRI in the prediction of SSI in women in the postpartum period after being submitted to a cesarean section at a university hospital between April 2012 and March of 2013. Methods: Prospective cohort study. Information notifying SSI by active surveillance was collected daily from the medical records. After hospital discharge, the mothers were contacted through telephone calls to identify infection criteria within 30 days after the cesarean. Descriptive and comparative analyses were performed. The chi-square test was used to compare groups. Results: 737 cesareans were performed. Telephone contact was achieved with 507 (68.8% women up to 30 days postpartum, with loss of follow-up of 230 cases (31.2%. The medical consultation in the post-partum period occurred with 188 (37.08% women, with whom telephone contact was obtained, on average, 17.28 days (SD=8.39 after delivery. It was verified that 21 patients met the criteria for SSI, with a 4.14% rate. A total of 12 cases (57.1% were classified as superficial SSI, 5 (23.8% as deep and 4 (19.1% as infection of organs and cavities. The SRI and its risk variables were not associated with SSI in patients submitted to cesarean sections. Conclusion: The SRI and the risk variables included in this index were not associated to SSI in patients submitted to cesarean sections. KEYWORDS: Cesarean Section; Surgical Wound Infection; Epidemiological Surveillance; Infection Control; Risk Index; Disease Notification.

  11. Maternal postpartum complications according to delivery mode in twin pregnancies

    Directory of Open Access Journals (Sweden)

    Sonia Leme Stach

    2014-07-01

    Full Text Available OBJECTIVE:We aimed to examine maternal postpartum complications of twin deliveries according to mode of delivery and investigate the associated risk factors.METHODS:This was a retrospective cohort review of twin pregnancies with delivery after 26 weeks at a tertiary teaching hospital (1993-2008. The rates of maternal postpartum complications were compared among vaginal, elective cesarean and emergency cesarean deliveries. Significant predictors of complications were investigated with stepwise regression analysis and relative risks were calculated.RESULTS:A total of 90 complications were observed in 56/817 (6.9% deliveries: 7/131 (5.3% vaginal, 10/251 (4.0% elective cesarean and 39/435 (9.0% emergency cesarean deliveries. Significant predictors included high-risk pregnancy, gestational age at birth and delivery mode. The occurrence of complications was significantly increased in emergency compared to elective cesarean deliveries (RR = 2.34.CONCLUSIONS:Maternal postpartum complications in twin pregnancies are higher in emergency compared to elective cesarean deliveries and are also related to preexisting complications and earlier gestational age at delivery.

  12. Initial non-opioid based anesthesia in a parturient having severe aortic stenosis undergoing cesarean section with aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Subrata Podder

    2015-01-01

    Full Text Available Pregnancy in presence of severe aortic stenosis (AS causes worsening of symptoms needing further intervention. In the advanced stages of pregnancy, some patients may even require aortic valve replacement (AVR and cesarean delivery in the same sitting. Opioid based general anesthesia for combined lower segment cesarean section (LSCS with AVR has been described. However, the use of opioid may lead to fetal morbidity and need of respiratory support for the baby. We describe successful anesthetic management for LSCS with AVR in a >33 week gravida with severe AS and congestive heart failure. We avoided opioids till delivery of the baby AVR; the delivered neonate showed a normal APGAR score.

  13. Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus :A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ibrahima Farikou

    2014-01-01

    Full Text Available Introduction: The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice. Case Report: The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa. Conclusion: Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures. Keywords: Femur fracture; Cesarean section; Fibroid; Breech presentation; Africa.

  14. Successful vaginal birth after prior cesarean section in a patient with pyoderma gangrenosum.

    Science.gov (United States)

    Park, Jee Yoon; Lee, JoonHo; Park, Joong Shin; Jun, Jong Kwan

    2016-01-01

    Pyoderma gangrenosum is an extremely rare chronic cutaneous disease causing severe ulceration. It can be developed after minor trauma or surgical procedure. The typical features mimic acute infection site, however the treatment methods are opposing since pyoderma gangrenosum is improved with the use of corticosteroids, not antibiotic therapy. We here report a patient who had been diagnosed for acute infection after cesarean delivery in 2011 and treated with a number of antibiotics, but failed to recover. The patient had suffered from pain of the disease and also renal failure caused by antibiotics. Ultimately she had been diagnosed as pyoderma gangrenosum and managed successfully with steroids. For her next pregnancy in 2013, we tried vaginal delivery after prior cesarean section and it was uneventful during and after delivery. PMID:26866039

  15. Dynamics of Gut Microbiota According to the Delivery Mode in Healthy Korean Infants.

    Science.gov (United States)

    Lee, Eun; Kim, Byoung Ju; Kang, Mi Jin; Choi, Kil Yong; Cho, Hyun Ju; Kim, Yeongho; Yang, Song I; Jung, Young Ho; Kim, Hyung Young; Seo, Ju Hee; Kwon, Ji Won; Kim, Hyo Bin; Lee, So Yeon; Hong, Soo Jong

    2016-09-01

    Microbial colonization of the infant gut is unstable and shows a wide range of diversity between individuals. Gut microbiota play an important role in the development of the immune system, and an imbalance in these organisms can affect health, including an increased risk of allergic diseases. Microbial colonization of young infants is affected by the delivery mode at birth and the consequent alterations of gut microbiota in early life affect the development of allergic diseases. We investigated the effects of the delivery mode on the temporal dynamics of gut microbiota in healthy Korean infants. Fecal samples were collected at 1-3 days, 1 month, and 6 months after birth in six healthy infants. Microbiota were characterized by 16S rRNA shotgun sequencing. At the first and third days of life, infants born by vaginal delivery showed a higher richness and diversity of gut microbiota compared with those born by cesarean section. However, these differences disappeared with age. The Bacteroides genus and Bacteroidetes phylum were abundant in infants born by vaginal delivery, whereas Bacilli and Clostridium g4 were increased in infants born by cesarean section. The Firmicutes phylum and Bacteroides genus showed convergent dynamics with age. This study demonstrated the effect of delivery mode on the dynamics of gut microbiota profiles in healthy Korean infants. PMID:27334787

  16. Prelabor Cesarean Section and Risk of Childhood Type 1 Diabetes A Nationwide Register-based Cohort Study

    DEFF Research Database (Denmark)

    Clausen, Tine Dalsgaard; Bergholt, Thomas; Eriksson, Frank;

    2016-01-01

    BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish...... nationwide cohort study followed all singletons born during 1982-2010. Five national registers provided information on mode of delivery, outcome, and confounders. The risk of childhood type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 1,760,336 singletons...... contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental...

  17. The incidence of complications after cesarean section in HIV-infected women with advanced WHO stages of HIV disease

    Directory of Open Access Journals (Sweden)

    S Shevchenko

    2012-11-01

    Full Text Available Prevalence of HIV infection in Ukraine is 1.6% overall, with antenatal prevalence of 0.52%, the highest in Europe. According to national protocol, cesarean section has been recommended for women with viral load above 50 copies/mL to further prevent vertical transmission of HIV. The aim of our study was to compare the infectious complication rates after cesarean delivery in HIV-infected women with advanced WHO stages of HIV disease who received HAART, and HIV-infected women with I or II WHO stages. Materials and methods: A retrospective analysis was performed on data derived from 150 HIV-infected women with advanced WHO stages of HIV disease (group I and 150 HIV-infected women with I or II WHO stages (group II, who underwent cesarean delivery. Postoperative infectious morbidity in both groups was analyzed according to whether the cesarean section was an elective or emergent delivery. Descriptive, comparison analyses were performed. Results: There was no significant difference between the both groups in terms of gravidity, parity, number of previous cesarean sections, estimated gestational age at time of delivery. It has been shown that HIV-infected women from the group I have 2 times more factors for the appearance of postpartum infectious complications, such as anemia, the urinary tract infection, sexually transmitted infections. Both groups of women were statistically more likely to experience postpartum endometritis when being delivered by emergent cesarean section than by elective cesarean section (14.6% versus 4.6%, respectively in the group I and 5.3% versus 0.5%, respectively, in the group II, superficial or deep wound breakdown (22.6% versus 4.6%, respectively, in the first group and 5.3% versus 2.6%, respectively, in the second group. Septic pelvic thrombophlebitis was only in 2% of HIV-infected women from the group I. Urinary tract infection had 25% HIV-infected women in the both groups. Overall, the rate of postpartum infectious

  18. Cesarean Birth: A Journey in Historical Trends.

    Science.gov (United States)

    Cypher, Rebecca L

    2016-01-01

    Thirty years ago seems like yesterday: a time of immense socioeconomic changes, explosion of an "Internet" computer concept, and identification of human immunodeficiency virus. Like all events of the past, transformations in obstetrics developed over time. Cesarean birth can be better understood in a broader context when one considers how the art of obstetric practice has evolved. Cesarean birth progressed from delivering a fetus perimortem or postmortem to a time of operative births that simultaneously juggle a woman's safety, satisfaction, and freedom of choice concerning birth options. Thirty years of increasing cesarean birth rates have prompted government agencies, national organizations, state-level perinatal collaborative groups, and experts to address these rates and the impact on maternal-child health and healthcare systems. The purpose of this article is to explain cesarean birth's remarkable impact on obstetrics by reviewing key historical periods, current advances, and upcoming trends. PMID:27465462

  19. A Journey to Zero: Reduction of Post-Operative Cesarean Surgical Site Infections over a Five-Year Period

    Science.gov (United States)

    Hickson, Evelyn; Harris, Jeanette

    2015-01-01

    Abstract Background: Surgical site infections (SSI) are a substantial concern for cesarean deliveries in which a surgical site complication is most unwelcome for a mother with a new infant. Steps taken pre- and post-operatively to reduce the number of complications may be of substantial benefit clinically, economically, and psychologically. Methods: A risk-based approach to incision management was developed and implemented for all cesarean deliveries at our institution. A number of incremental interventions for low-risk and high-risk patients including pre-operative skin preparations, standardized pre- and post-operative protocols, post-operative nanocrystalline silver anti-microbial barrier dressings, and incisional negative pressure wound therapy (NPWT) were implemented sequentially over a 5-y period. A systematic clinical chart review of 4,942 patients spanning all cesarean deliveries between 2007–2012 was performed to determine what effects the interventions had on the rate of SSI for cesarean deliveries. Results: The percentage of SSI was reduced from 2.13% (2007) to 0.10% (2012) (p<0.0001). There were no substantial changes in the patient population risk factors over this time. As a result of the changes in incision management practice, a total of 92 cesarean post-operative SSIs were avoided: A total cost saving of nearly $5,000,000. Conclusion: Applying a clinical algorithm for assessing the risk of surgical site complication and making recommendations on pre-operative and post-operative incision management can result in a substantial and sustainable reduction in cesarean SSI. PMID:25826622

  20. [Bupivacaine-induced Anaphylaxis in a Parturient Undergoing Cesarean Section].

    Science.gov (United States)

    Iwasaki, Mitsuo; Tachibana, Kazuya; Mitsuda, Nobuaki; Kinouchi, Keiko

    2015-02-01

    We describe a case of anaphylaxis that occurred in a 33-year-old gravida 1, para 1 term woman scheduled for cesarean delivery for breech presentation. Her past history was unremarkable except for orciprenaline allergy. Spinal anesthesia was performed at L3-4 using 2.5 ml of 0.5% hyperbaric bupivacaine and 0.1 mg morphine. Seven minutes after spinal anesthesia, she complained of hoarseness and difficulty in breathing and 3 minutes later, blood pressure decreased to 76/51 mmHg, and oxygen saturation to 87% with supplemental oxygen. Skin flushing was noted in the face and trunk of the body and anaphylaxis was diagnosed. She was treated with a rapid intravenous infusion and iv administration of phenylephrine (total dose 0.4 mg), ephedrine (total dose 25 mg), hydrocortisone and famotidine. Cesarean section was started 23 minutes after spinal anesthesia when blood pressure and oxygen saturation recovered. A male infant was delivered (18 minutes after the onset of anaphylactic event) with Apgar scores of 2 and 5 at 1 and 5 min, respectively and resuscitated with mask ventilation. Umbilical artery blood gas analysis revealed pH 6.85, base excess -20.3 mmol x l (-1) and lactate 109 mg x dl (-1). The mother was discharged from the hospital on the 6th postoperative day. The baby's electroencephalogram, however, demonstrated a pattern consistent with mild hypoxic-ischemic encephalopathy. Lymphocyte stimulation test revealed that she was allergic to bupivacaine. If maternal hypotension persists, i.m. or i.v. adrenaline should be administered immediately because maternal hypotension and hypoxemia may cause significant fetal morbidity and mortality and prompt cesarean section should be considered. PMID:26121818

  1. Online Course Delivery: An Empirical Investigation of Factors Affecting Student Satisfaction

    Science.gov (United States)

    Beqiri, Mirjeta S.; Chase, Nancy M.; Bishka, Atena

    2010-01-01

    The authors investigated potential factors impacting students' satisfaction with online course delivery using business students as participants. The findings suggest that the student who would be more satisfied with the delivery of online courses fits the following profile: graduate, married, resides more than 1 mile away from campus, and male.…

  2. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey

    DEFF Research Database (Denmark)

    Bergholt, Thomas; Østberg, Birgitte; Legarth, Jesper; Weber, Tom

    2004-01-01

    -five obstetricians and gynecologists identified in the records of the Danish Society of Obstetrics and Gynecology from January 2000. MAIN OUTCOME MEASURES: Personal preference on the mode of delivery and general attitude towards elective cesarean section on maternal request in an uncomplicated single cephalic...

  3. The Survey of knowledge and attitude of pregnant women referred to Medical Centers of Qom towards type of delivery

    Directory of Open Access Journals (Sweden)

    Amir Kasaian

    2007-01-01

    Full Text Available Introduction: Vaginal delivery is the best method of delivery. Regarding to recent data (1382 33% of deliveries were carried out using cesarean method in Iran. Increasing of cesarean percentage is probably due to negative attitude about vaginal delivery and low knowledge about cesarean side effects. This research is aimed to determine knowledge and attitude of pregnant women about type of delivery. Methods: This descriptive study was conducted on 136 pregnant women attended to eight health centers in Qom during Jun to August of 2003. The tool for data collection was questionnaire including, demographic obstetrical and gynecological factors and some questions about knowledge and attitude about vaginal and cesarean delivery. The questionnaire was provided by counseling with experts in midwifery and gynecology and its reliability was confirmed by test and retest. Data were analyzed using descriptive statistics, ², Man Whitney and Kruskal Wallis. Results: The levels of knowledge in the pregnant women about type of delivery, in 40.4% were average and in 59.6% were good. In this study 94.1% of women toward vaginal delivery and 63.2% toward cesarean delivery had positive atitudes, 5.9% of subjects toward vaginal delivery and 36% toward cesarean had indifferent attitude. Significant statistical difference was observed between the level of knowledge and attitude of cesarean delivery (P< 0.0001, but no significant statistical difference was observed between the level of knowledge and attitude of vaginal delivery (P=0.19. Conclusion: According to the result there was significant relationship between knowledge and attitude toward cesarean delivery. Education strategies are suggested for improvement knowledge and positive attitude toward methods of delivery. It can decrease interest of pregnant women toward cesarean delivery.

  4. The tip of the tail needle affects the rate of DNA delivery by bacteriophage P22.

    Directory of Open Access Journals (Sweden)

    Justin C Leavitt

    Full Text Available The P22-like bacteriophages have short tails. Their virions bind to their polysaccharide receptors through six trimeric tailspike proteins that surround the tail tip. These short tails also have a trimeric needle protein that extends beyond the tailspikes from the center of the tail tip, in a position that suggests that it should make first contact with the host's outer membrane during the infection process. The base of the needle serves as a plug that keeps the DNA in the virion, but role of the needle during adsorption and DNA injection is not well understood. Among the P22-like phages are needle types with two completely different C-terminal distal tip domains. In the phage Sf6-type needle, unlike the other P22-type needle, the distal tip folds into a "knob" with a TNF-like fold, similar to the fiber knobs of bacteriophage PRD1 and Adenovirus. The phage HS1 knob is very similar to that of Sf6, and we report here its crystal structure which, like the Sf6 knob, contains three bound L-glutamate molecules. A chimeric P22 phage with a tail needle that contains the HS1 terminal knob efficiently infects the P22 host, Salmonella enterica, suggesting the knob does not confer host specificity. Likewise, mutations that should abrogate the binding of L-glutamate to the needle do not appear to affect virion function, but several different other genetic changes to the tip of the needle slow down potassium release from the host during infection. These findings suggest that the needle plays a role in phage P22 DNA delivery by controlling the kinetics of DNA ejection into the host.

  5. 剖宫产术后影响母乳喂养的因素及护理对策%Affect Factors of Breastfeeding and Nursing Countermeasures after cesarean section

    Institute of Scientific and Technical Information of China (English)

    杨凤先

    2013-01-01

    目的剖宫产后切口疼痛,活动不便;产妇喂奶姿势不正确以及产妇及家庭成员对母乳喂养知识缺乏等原因,使得相当一部分产妇对产后母乳喂养信心不足,态度不积极,影响了母乳喂养的实施。针对这种情况,我们采取了术前早宣教,术中早接触,术后早吸吮,选择舒适哺乳体位等护理对策,使97%的产妇成功实施了母乳喂养。%Because of incision pain after cesarean section, moving difficultly, uncorrect feeding posture and lack of knowledge of breastfeeding , that always make part of puerperant be short of confidenc and produce passive attitude. Aimed at this situation, we adopt preoperative early propagate, intraoperative premature contact , postoperative early suck and comfortable breastfeeding posture and so on which makes 97% of maternal realize breastfeeding sucessfully.

  6. Transvaginal ultrasonography compared with Bishop score for predicting cesarean section after induction of labor

    OpenAIRE

    Bastani P; Hamdi K; Abasalizadeh F; Pourmousa P; Ghatrehsamani F

    2011-01-01

    Parvin Bastani, Kobra Hamdi, Fatemeh Abasalizadeh, Parisa Pourmousa, Fatemeh GhatrehsamaniWomen's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Reproductive health researchers are interested in finding better methods for predicting an unwanted type of delivery after induction of labor. The aim of this study was to compare the value of transvaginal ultrasonography findings and the Bishop score in predicting cesarean section after in...

  7. Transfusion Related Acute Lung Injury after Cesarean Section in a Patient with HELLP Syndrome

    OpenAIRE

    Moon, Kyoung Min; Han, Min Soo; Rim, Ch'ang Bum; Kim, So Ri; Shin, Sang Ho; Kang, Min Seok; Lee, Jun Ho; Kim, Jihye; Kim, Sang Il

    2016-01-01

    Transfusion-related acute lung injury (TRALI) is a serious adverse reaction of transfusion, and presents as hypoxemia and non-cardiogenic pulmonary edema within 6 hours of transfusion. A 14-year-old primigravida woman at 34 weeks of gestation presented with upper abdominal pain without dyspnea. Because she showed the syndrome of HELLP (hemolysis, elevated liver enzymes, and low platelet count), an emergency cesarean section delivery was performed, and blood was transfused. In the case of such...

  8. Successful vaginal birth after prior cesarean section in a patient with pyoderma gangrenosum

    OpenAIRE

    Park, Jee Yoon; Lee, JoonHo; Park, Joong Shin; Jun, Jong Kwan

    2016-01-01

    Pyoderma gangrenosum is an extremely rare chronic cutaneous disease causing severe ulceration. It can be developed after minor trauma or surgical procedure. The typical features mimic acute infection site, however the treatment methods are opposing since pyoderma gangrenosum is improved with the use of corticosteroids, not antibiotic therapy. We here report a patient who had been diagnosed for acute infection after cesarean delivery in 2011 and treated with a number of antibiotics, but failed...

  9. Características relacionadas ao primeiro e último parto por cesárea Characteristics related to the first and last cesarean delivery among women from a Campinas University Hospital

    Directory of Open Access Journals (Sweden)

    Arlete Maria dos Santos Fernandes

    2007-02-01

    Full Text Available OBJETIVO: Estudar a associação entre a primeira e a última cesáreas e laqueadura tubária; determinar tempo de vida reprodutivo após o primeiro parto. MÉTODOS: Foram entrevistadas 653 mulheres com pelo menos duas gestações, de fevereiro a outubro de 2001 em hospital universitário, 172 com primeira e 294 com última cesárea. As variáveis foram sociodemográficas, obstétricas e características do primeiro e último partos e da laqueadura. Utilizou-se análise bivariada, posteriormente regressão múltipla com cálculo do odds ratio ajustado. Mulheres laqueadas foram separadas em grupos de 25 a 44 e > 45 anos, distribuídas em percentis e aplicou-se o teste de Wilcoxon para análise da idade na laqueadura e tempo de vida reprodutivo após o último parto. O estudo teve aprovação do Comitê de Ética. RESULTADOS: Do total de mulheres, 89% tinham escolaridade 5 salários (OR=2,41, IC 95% 1,42 a 4,08 e idade no primeiro parto > 25 anos (OR=1,80, IC 95% 1,01 a 3,22. A idade média na laqueadura foi de 29 e 33,2 anos nas mulheres com 25 a 44 anos e > 45 anos, respectivamente (pOBJECTIVE: To study the association between first and last caesarian sections with tubal sterilization; to determine length of reproductive life after the first delivery. METHODS: From February to October 2001 in a university hospital, interviews were carried out with 653 women having had at least two pregnancies. Of these women, 172 had a first caesarian section; 294 had a last caesarian section. Variables were social demographic characteristics, obstetric history and characteristics of the first and last deliveries and tubal sterilization. Bivariate analysis was performed, followed by multiple regression analysis calculating the adjusted odds ratio. Women who had undergone tubal sterilization were divided into age groups of 25 to 44 and >45 years in a percentile distribution. The Wilcoxon test was used to analyze age at tubal sterilization and length of

  10. Relationship Between Delivery Type and Successful Breastfeeding

    Directory of Open Access Journals (Sweden)

    Motahhareh Golestan

    Full Text Available Objective: Exclusive breastfeeding has a major effect on decreasing the mortality of the children, particularly in developing countries. The aim of this survey was to study the effect of type of delivery on success of exclusive breastfeeding.Methods: In a case-control study, 344 women including two equal groups of 172 cases were chosen based on the type of delivery, vaginal or by cesarean section, and followed for 6 months the way of feeding their infants and the rate of exclusive breastfeeding among them.Findings: The rate of exclusive breastfeeding was significantly lower in the mothers delivered by cesarean section than who delivered vaginally (13.4% vs. 41.8%. The average duration of breastfeeding among the women with vaginal delivery was significantly longer than the cases with cesarean delivery (4.5±1.7 months vs. 4.0±1.5 months. The rate of the onset of breastfeeding in the first hour of delivery was significantly higher among the group with vaginal delivery than the group with cesarean section (82 % vs. 38 % and finally the rate of formula feeding among the infants of the mothers with cesarean section was higher than in the infants of the mothers with vaginal delivery (33% vs. 22%.Conclusion: Cesarean section decreases the exclusive breastfeeding and hence attempts should be made to encourage the mothers for vaginal delivery and breastfeeding as well. Besides, discussing the benefits of breastfeeding for both mother and infant, supports the fact that mothers should be advised to attain executive breastfeeding.

  11. Youssef’s Syndrome following Cesarean Section

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    Ozer Birge

    2015-01-01

    Full Text Available Youssef’s syndrome is characterized by cyclic hematuria (menouria, absence of vaginal bleeding (amenorrhea, and urinary incontinence due to vesicouterine fistula (VUF, the least common of the urogynecological fistulas. Youssef’s syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

  12. Mode of delivery after obstetric anal sphincter injury and the risk of long-term anal incontinence

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne; Sakse, Abelone

    2016-01-01

    BACKGROUND: Primiparous women have an increased risk of obstetric anal sphincter injury; because most of these patients deliver again, there are major concerns about mode of delivery: the risk of recurrent obstetric anal sphincter injury and the risk of long-term symptoms of anal incontinence....... Although an elective cesarean delivery protects against recurrent obstetric anal sphincter injury, it is uncertain how the second delivery affects the risk of long-term anal incontinence. OBJECTIVE: The purpose of this study was to evaluate whether the mode of delivery for a second pregnancy, after a...... documented obstetric anal sphincter injury at the time of first delivery, had a significant impact on the prevalence of anal and fecal incontinence in the long term. STUDY DESIGN: We performed a population-based questionnaire cohort study that evaluated anal and fecal incontinence, fecal urgency, and...

  13. Effects of epidural lidocaine analgesia on labor and delivery: A randomized, prospective, controlled trial

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    Nafisi Shahram

    2006-12-01

    Full Text Available Abstract Background Whether epidural analgesia for labor prolongs the active-first and second labor stages and increases the risk of vacuum-assisted delivery is a controversial topic. Our study was conducted to answer the question: does lumbar epidural analgesia with lidocaine affect the progress of labor in our obstetric population? Method 395 healthy, nulliparous women, at term, presented in spontaneous labor with a singleton vertex presentation. These patients were randomized to receive analgesia either, epidural with bolus doses of 1% lidocaine or intravenous, with meperidine 25 to 50 mg when their cervix was dilated to 4 centimeters. The duration of the active-first and second stages of labor and the neonatal apgar scores were recorded, in each patient. The total number of vacuum-assisted and cesarean deliveries were also measured. Results 197 women were randomized to the epidural group. 198 women were randomized to the single-dose intravenous meperidine group. There was no statistical difference in rates of vacuum-assisted delivery rate. Cesarean deliveries, as a consequence of fetal bradycardia or dystocia, did not differ significantly between the groups. Differences in the duration of the active-first and the second stages of labor were not statistically significant. The number of newborns with 1-min and 5-min Apgar scores less than 7, did not differ significantly between both analgesia groups. Conclusion Epidural analgesia with 1% lidocaine does not prolong the active-first and second stages of labor and does not increase vacuum-assisted or cesarean delivery rate.

  14. Patient Involvement in Safe Delivery: A Qualitative Study

    Science.gov (United States)

    Olfati, Forozun; Asefzadeh, Saeid; Changizi, Nasrin; Keramat, Afsaneh; Yunesian, Masud

    2016-01-01

    Introduction: Patient involvement in safe delivery planning is considered important yet not widely practiced. The present study aimed at identifythe factors that affect patient involvementin safe delivery, as recommended by parturient women. Methods: This study was part of a qualitative research conducted by content analysis method and purposive sampling in 2013. The data were collected through 63 semi-structured interviews in4 hospitalsand analyzed using thematic content analysis. The participants in this research were women before discharge and after delivery. Findings were analyzed using Colaizzi’s method. Results: Four categories of factors that could affect patient involvement in safe delivery emerged from our analysis: patient-related (true and false beliefs, literacy, privacy, respect for patient), illness-related (pain, type of delivery, patient safety incidents), health care professional-relatedand task-related factors (behavior, monitoring &training), health care setting-related (financial aspects, facilities). Conclusion More research is needed to explore the factors affecting the participation of mothers. It is therefore, recommended to: 1) take notice of mother education, their husbands, midwives and specialists; 2) provide pregnant women with insurance coverage from the outset of pregnancy, especially during prenatal period; 3) form a labor pain committee consisting of midwives, obstetricians, and anesthesiologists in order to identify the preferred painless labor methods based on the existing facilities and conditions, 4) carry out research on observing patients’ privacy and dignity; 5) pay more attention on the factors affecting cesarean. PMID:26755469

  15. The Fisher Discriminant of Pregnancies after Cesarean Section%剖宫产术后再次妊娠分娩方式的 Fisher 判别

    Institute of Scientific and Technical Information of China (English)

    沈素娟; 董云; 郑帅英; 杨丽

    2014-01-01

    Objective To classify the pregnancies after cesarean section by using Fisher discriminant in order to provide a reference mode of delivery in pregnant women with the history of cesarean section ( PCS ) . Methods 216 cases of PCS pregnant women with vaginal delivery were applied in this study .Age, occupation , labor before the body mass index ( BMI) , the time from a previous cesarean section , complications of pregnan-cy, fetal abdominal circumference , fetal biparietal diameter , the lower uterine segment thickness , the sex of a fetus, the Bishop cervical ripening score , and the application of contraction agent were collected .Results ①The mode of delivery:Vaginal delivery was successful in 66 cases.Vaginal midwifery delivery was successful in 58 cases.Cesarean section delivery was successful in 92 cases.②Single factor analysis showed:The three kinds of mode of delivery has statistically significantat in occupation , preclinical BMI , fetal abdominal circum-ference , biparietal diameter , application , tocolytic agents from the previous cesarean section time , lower uter-ine segment thickness and Bishop score , P<0.05.③The selected discriminant factors were the fetal abdomi-nal circumference ( X1 ) , the lower uterine segment thickness ( X2 ) , Bishop score ( X3 ) and the application of of oxytocin ( X4 ) by stepwise Fisher discriminant function .Fisher discriminant function: Function 1 =-0. 101X1+2.202X2 +0.649X3 +0.289X4 -9.243;Function 2=0.258X1 -0.156X2 +0.593X3 +0.409X4 -14 .384 .④The sensitivity of spontaneous vaginal delivery , vaginal delivery and cesarean section is respectively 80.30%, 56.90%and 78.26% by Function prediction.Overall compliance rate was 73.15%.Conclusion Fetal abdominal circumference , the lower uterine segment thickness , Bishop score and application of tocolytic agents are the main factors affecting the success of PCS pregnant women with vaginal delivery .It can provide a moderate diagnostic efficacy for PCS pregnant women

  16. Clinical Analyses of 66 Cases of Mid-trimester Pregnancy Termination in Women with Prior Cesarean

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    Ping Peng

    2015-01-01

    Full Text Available Background: The rate of cesarean delivery has significantly increased in China in the last decade. Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in mid-trimester than those without such a history. The aim of our study was to evaluate the influences of the potential risk factors on uterine rupture in women with prior cesarean. Methods: We conducted this retrospective study of women with prior cesarean section, who underwent mid-trimester pregnancy termination between January 2006 and December 2013 in Peking Union Medical College Hospital. The protocol was oral administration of mifepristone and misoprostol for the patients with the gestational ages below 16 weeks or intra-amniotic injection of ethacridine lactate (EL for those with at least 16 weeks of gestational ages. The thickness of the lower uterine segment (LUS was measured before the termination of pregnancy. Logistic regression was used to study the risk factors of uterine rupture. Results: The total rate of successful abortion was 93.9% (62/66. Four patients failed in induction, and one of them received curettage, whereas the other three experienced uterine rupture (4.5%. The successful rates of abortion were 85.7% (30/35 for women treated with mifepristone-misoprostol and 86.1% (31/36 for those treated with EL. There was a significant difference in the mean LUS thickness between the uterine rupture group (3.0 ± 2.0 mm and the nonrupture group (7.0 ± 3.0 mm (P < 0.05. The LUS thickness of <3 mm was associated with uterine rupture during mid-trimester pregnancy termination in women with prior cesarean (odds ratio, 94.0; 95% confidence interval 4.2-2106.1 after adjusted maternal age, gestational age, interdelivery interval and prior cesarean section. Severe bleeding that required transfusion occurred in one case (1.5%. Conclusions: Both the mifepristone-misoprostol and the EL regimens were effective and safe for the

  17. Educational strategies in performing cesarean section

    DEFF Research Database (Denmark)

    Madsen, Kristine; Grønbeck, Lene; Larsen, Christian Rifbjerg;

    2012-01-01

    section, it is recommended that trainees perform 10-15 to 40 supervised cesarean sections prior to operating independently. Surgical technical skills of trainees/residents may be assessed by Objective Structured Assessment of Technical skills (OSATS), which provides a foundation for constructive feedback...

  18. Abdominal Wall Desmoid Tumor in a Pregnant Woman and Cesarean Section Managment

    Directory of Open Access Journals (Sweden)

    M Mojibian

    2013-08-01

    Full Text Available Increased risk of sporadic desmoid tumor occurs in increased estrogen level (pregnancy and surgical incisions (abdominal and thorasic. The frequency of desmoid tumors in the general population is 2.4 to 4.3 cases. The case is 30 year old woman with history of previous cesarean section. In fourth month of pregnancy,ultrasonography revealed a 5×7 cm mass in lower segment of the uterus(leiomyoma. The tumor diameter was 20 cm in term gestation. The time of cesarean , incision of skin was done above the umbilicus and below the sternum and incision of uterus was done from fondus vertically down. After delivery, the mass which was separated from uterus and located in the abdominal wall was extracted. The histological investigation diagnosed a desmoid tumor.

  19. Changes in vaginal breech delivery rates in a single large metropolitan area.

    LENUS (Irish Health Repository)

    Hehir, Mark P

    2012-06-01

    Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after the publication of the TBT.

  20. Intra-operative maternal complications of emergency cesarean section done in advanced labor

    International Nuclear Information System (INIS)

    Background: Emergency cesarean section done in advanced labor is a big challenge in obstetrics due to increased risk of intraoperative complications. In the last decade, a rapid increase in cesarean section done in advanced labor has been observed. Difficult deli-very of the fetal head during cesarean section carries a high risk of intraoperative complications like cervical and uterine tears, intra operative hemorrhage and trauma to the baby. Objectives: The purpose of this study is to find out the frequency and risk factors for intra-operative complications in emergency cesarean section done in advanced labor, so that appropriate management protocols can be planned to reduce these complications. Study Design: Prospective cohort study. Materials and Methods: This prospective study was carried out in Obstetrics and Gynecology Unit - 2 of Services Institute of Medical Sciences, Services Hospital, Lahore; from 1st January 2007 to 31st December 2007. All patients undergoing emergency cesarean sections done on laboring mothers were included in the study. The sample was divided into two groups; emergency C-section done in advanced labor as the study group and emergency C-section in early labor as the control group. Data were collected regarding age, parity, booked or unbooked status, indications for cesarean section, level of competence of operating surgeon, intra-operative complications and the risk factors for these complications. Data were recorded on a structured proforma and compared between the two groups. Statistical Analysis: Data were analyzed using computer programme SPSS Version 14 for windows applying student t-test for quantitative and chai square test for qualitative parameters. A p-value < 0.05 was used as statistically significant. Results: Out of 2064 total deliveries in the year 2007, 1290 (62.5%) were vaginal deliveries and 774 (37.5%) were C-Sections. Out of 774 C-Section, 174 (23%) were elective and 600 (77%) were emergency. Out of 600 emergency C

  1. Severity of Acute Pain After Childbirth, but not Type of Delivery, Predicts Persistent Pain and Postpartum Depression

    OpenAIRE

    Eisenach, James C.; Pan, Peter H.; Smiley, Richard; Lavand'homme, Patricia; Landau, Ruth; Houle, Timothy T.

    2008-01-01

    Cesarean delivery rates continue to increase, and surgery is associated with chronic pain, often co-existing with depression. Also, acute pain in the days after surgery is a strong predictor of chronic pain. Here we tested if mode of delivery or acute pain played a role in persistent pain and depression after childbirth. In this multicenter, prospective, longitudinal cohort study, 1288 women hospitalized for cesarean or vaginal delivery were enrolled. Data were obtained from patient interview...

  2. Fetomaternal hemorrhage in women undergoing elective cesarean section

    DEFF Research Database (Denmark)

    Perslev, Anette; Jørgensen, Finn Stener; Nielsen, Leif Kofoed; Berkowicz, Adela; Dziegiel, Morten Hanefeld

    2010-01-01

    presence of fetal red blood cells (fRBCs) using flow cytometry. FMH associated with cesarean section was defined as the difference between the volumes of fRBCs in the two samples. Main Outcome Measures. The frequency and volume of FMH caused by elective cesarean section. Results. 207 women were included in...... with elective cesarean section, provided guidelines such as the current Danish guidelines for Rhesus prophylaxis are followed....

  3. [The Misgav Ladach method for cesarean section].

    Science.gov (United States)

    Habek, Dubravko; Kulas, Tomislav; Karsa, Matija

    2007-04-01

    The Misgav Ladach method for cesarean section is based on the principles of surgical minimalism. This is based on the Joel Cohen laparotomy, somewhat higher than the Pfannenstiel incision. Subcutaneous tissue is left undisturbed apart from the midline, rectus muscles are separated by pulling. The peritoneum is opened by stretching with index fingers. The hysterotomy is closed with one layer extraendometrial continuous absorbable stitches (Vicryl), and the visceral and parietal peritoneal layers are left open. Fascia is stitched with a continuous synthetic absorbable stitch. The skin is closed with intracutaneous resorptive suture or metallic stapler sutures. The Misgav Ladach method is restrictive in the use of sharp instruments preferring manual manipulation: it gives faster recovery, shorter period to normal bowel function, less peritoneal adhesions and less scarring in the abdominal layers, less use of postoperative antibiotics, analgesics and antipyretics, and a shorter anesthetic and operative time. It is ideal for emergency and planned cesarean section. PMID:17585470

  4. Prospective cohort study on effect of elective cesarean section on physical and intellectual development in children%社会因素剖宫产儿体格与智力发育的前瞻性队列研究

    Institute of Scientific and Technical Information of China (English)

    刘达美; 赵勇; 关蕴良; 李廷玉; 李少芳; 刘永芳; 张勇; 刘平

    2009-01-01

    目的:探讨社会因素剖宫产对儿童体格与智力发育的影响.方法:采用前瞻性队列研究,确定社会因素剖宫产和顺产产妇队列(社会因素剖宫产组68例、顺产组65例),分别于出生时、18月龄、24月龄、30月龄、36月龄、42月龄时体格检查,24月龄时智力测验(采用Gesell评分).结果:两队列均衡性较好(P>0.05),两组儿童在身高、体重、头围以及智力发育方面差异均无统计学意义.结论:社会因素剖宫产对42月龄以下的儿童体格发育未见显著性影响,社会因素剖宫产智力发育并不优于顺产,远期影响仍需扩大样本量以及继续随访研究.%To explore the effect of elective cesarean section on physical and intellectual development in children. Methods: Using the prospective cohort study, a 133 newborn sample composed by 68 newborns delivered by cesarean section and 65 newborns by spontaneous delivery in a county of Chongqing was established from March to May, 2002. Physical development index such as length, head circumference and body weight were measured at birth and on the 18, 24, 30, 36 and 42-month-old, respectively. Intel-lectual development was tested by Gesell mark at 2 years old. Results: The factors had equilibrium in two cohorts (P>0. 05) . There had no significant difference of weight, height or length, head circumference and Intellectual development between the two groups. Conclusion: There's no significant effect of cesarean section on physical growth of children below 4 years old. Intellectual development of the children de-livered by cesarean section is no better than that of spontaneous delivery. Forward affect needs more samples and continual follow-up.

  5. 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 ...

  6. MR imaging findings in cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To analyze MRI findings of cesarean scar pregnancy (CSP). Methods: The MR findings in 18 patients who were diagnosed as CSP by surgery from March 2010 to November 2011 were retrospectively analyzed, and comparison was made between the MRI findings and surgical results. Results: All Gestational sacs (18) were clearly detected by MRI. Among the 18 cases,gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 16 cases. In 2 of the 16 cases, gestational sac was found within the myometrium, whereas in the remaining 14 cases, gestational sac was found partially within the myometrium with extension into the uterine cavity. The anterior wall of isthmus uteri became thinner. In the remaining 2 of the 18 cases, gestational sac presented as irregular, multilobolated mass, growing deep into the myometrium as well as into the uterine cavity. On T2WI, the mass showed heterogeneous signal intensity. A small amount of hemorrhage within the mass and uterine cavity could be seen on T1WI. An enhancing solid component with a heterogeneous mass could be seen. All gestational sacs in 18 cases were located at or adjacent to the previous cesarean scar. In the area of cesarean scar,the signal of the uterine wall was disconnected, with focal indentation or thinning and the previous cesarean scar exhibited hypointensity on both T1WI and T2WI. Conclusion: CSP has its unique findings on MRI, these specific features can provide useful information in the management of CSP. (authors)

  7. Cesarean Section - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Portuguese (português) ... Partie 2 - français (French) Multimedia Healthy Roads Media Hindi (हिन्दी) Your Recovery After Cesarean Birth हि ...

  8. Epidural anesthesia in repeated cesarean section.

    Directory of Open Access Journals (Sweden)

    Rolando T. Espín González

    2003-04-01

    Full Text Available Background: A spectacular development has been experimented in the Anesthesiology branch in the last few years in the different areas of its competence in which the attendance activity on obstetric patients as well as every aspect related with its adequate practice is of a great importance. Objective: to evaluate the efficacy of epidural anesthesia in repetitive cesarean. Methods: a descriptive retrospective study of a series of cases (112in which epidural anesthesia in repetitive cesarean was applied from January 2001 to December 2001 in the surgical unit of the Gynecological obstetric service at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ in Cienfuegos city, Cuba. Some variables such as fixation time of the anesthesia, its duration, transurgical and postsurgical hemodynamic behavior, complications related with the anesthesia, evaluation of the new born baby and, the level of satisfaction of the patients were analyzed. Results: The immediate transurgical and postsurgical hemodynamic behavior was stable predominating normotension and the normal cardiac frequency. The complications related to anesthesia were minimal. The level of satisfaction of the patients was elevated. No alterations in new born babies were presented. As a conclusion, it may be stated that epidural anesthesia in repetitive cesarean is a safety and reliable anesthetic method.

  9. Application of Mini-abdominoplasty after Conservative Excision of Extensive Cesarean Scar Endometriosis

    Directory of Open Access Journals (Sweden)

    Eui Tai Lee1

    2012-09-01

    Full Text Available Endometriosis is defined as the presence of functioning endometrial tissue outside the uterinecavity, and the standard treatment is extensive surgical excision. Cesarean scar endometriosisis a type of cutaneous endometriosis arising on or near a Cesarean section scar. A 44-year-oldwoman presented with a 9×6 cm sized dark-brown, stony-hard, irregular, lower abdominalmass of four years duration. The patient had a history of two Cesarean deliveries, 14 and16 years ago. Suspecting endometriosis, we excised the tumor conservatively rather thanextensively to prevent incisional hernia considering the benign nature of the tumor andthe low possibility of recurrence because the patient’s age was near menopause, alongwith simultaneous bilateral salpingo-oophorectomy that was performed in this case. Onreconstruction, mini-abdominoplasty was adopted to avoid possible wound complicationsand cosmetic deformities. The patient was satisfied with the cosmetic results, and neitherrecurrence nor functional problems occurred during the 1-year follow-up period. Plasticsurgeons should keep in mind the possibility of cutaneous endometriosis in an abdominalmass of a female of reproductive age with a previous history of pelvic or intra-abdominalsurgery. An optimal result from oncological, functional, and cosmetic standpoints can beachieved with conservative excision followed by mini-abdominoplasty of extensive Cesareanscar endometriosis.

  10. Effect of Skin to Skin Contact on Maternal State Anxiety in a Cesarean Section Ward

    Directory of Open Access Journals (Sweden)

    Hamid Haghani

    2011-01-01

    Full Text Available Introduction: This study aimed at investigating the effect of skin to skin contact (SSC on maternal state anxiety (MSA in cesarean section unit in Akbarabadi Hospital in Tehran. Methods: In a randomized controlled trial, 60 Iranian mothers with at least one record of cesarean section delivery were assigned to two intervention (SSC and control groups. In the morning shift and two hours after the operation, as a routine postoperative care, pain-killers were given to all mothers. Then the mothers’ pain scores were measured using visual analog scale (VAS. If VAS was≤3, MSA was measured by using the State-Trait Anxiety Inventory (STAI Scale (Spiel Berger. Thirty minutes of SSC intervention was done for mothers in the intervention group. Six hours later, in case VAS was ≤ 3, MSA was re-measured by using the Spiel Berger Scale for all mothers. Results: Six hours after implementing the intervention, there were no meaningful statistical differences between the MSA mean scores of the two groups, but severity of MSA in intervention group was less than that of the control group (P=0.037. Six hours after the intervention, there was a significant decrease in the MSA mean score in SSC group (P=0.002. Conclusion: As regards the important role of constant anxiety in developing postpartum depression, and as the results of this study indicate, SSC is recommended in postpartum and especially cesarean section wards.

  11. How health insurance affects the delivery of health care in developing countries

    OpenAIRE

    Kutzin, Joseph; Barnum, Howard

    1992-01-01

    Financial crisis is a common state of affairs in the government health sector of many developing countries, and an increasing number are considering implementing user charges and insurance programs to shift some of the financial burden for health services away from direct budget allocations by a health ministry. Although they are often implemented as ways of mobilizing additional resources, prices and insurance also affect the allocation of health resources by changing the signals sent to pro...

  12. Cesarean section on maternal request: a societal and professional failure and symptom of a much larger problem.

    Science.gov (United States)

    Klein, Michael C

    2012-12-01

    The scientific literature was silent about a relationship of pelvic floor, urinary, and fecal incontinence and sexual issues with mode of birth until 1993, when Sultan et al's impressive rectal ultrasound studies were published. They showed that perirectal fibers were damaged in many vaginal births, but not as a result of a cesarean section. These findings helped to pioneer a new area of research, ultimately leading to increasing support among health professionals and the public that maternal choice of cesarean delivery could be justified-even that maternal choice and autonomous decision-making trump other considerations, including evidence. A growing number of birth practitioners are choosing cesarean section for themselves-usually on the basis of concerns over pelvic floor, urinary incontinence, and sexual issues. Behind this choice is a training experience that focuses on the abnormal, interprets the literature through a pathological lens, and lacks sufficient opportunity to see normal childbirth. Cesarean section on maternal request is a complex issue based on fear and misinformation that is a symptom of a system needing reform, that is, a major change in community and professional education, governmental policy making, and creation of environments emphasizing the normal. Systemic change will require the training of obstetricians mainly as consultants and the education of a much larger cadre of midwives and family physicians who will provide care for most pregnant women in settings designed to facilitate the normal. Tinkering with the system will not work-it requires a complete refit. PMID:23281950

  13. Factors Affecting Nitrate Delivery to Streams from Shallow Ground Water in the North Carolina Coastal Plain

    Science.gov (United States)

    Harden, Stephen L.; Spruill, Timothy B.

    2008-01-01

    An analysis of data collected at five flow-path study sites between 1997 and 2006 was performed to identify the factors needed to formulate a comprehensive program, with a focus on nitrogen, for protecting ground water and surface water in the North Carolina Coastal Plain. Water-quality protection in the Coastal Plain requires the identification of factors that affect the transport of nutrients from recharge areas to streams through the shallow ground-water system. Some basins process or retain nitrogen more readily than others, and the factors that affect nitrogen processing and retention were the focus of this investigation to improve nutrient management in Coastal Plain streams and to reduce nutrient loads to coastal waters. Nitrate reduction in ground water was observed at all five flow-path study sites in the North Carolina Coastal Plain, although the extent of reduction at each site was influenced by various environmental, hydrogeologic, and geochemical factors. Denitrification was the most common factor responsible for decreases in nitrate along the ground-water flow paths. Specific factors, some of which affect denitrification rates, that appeared to influence ground-water nitrate concentrations along the flow paths or in the streams include soil drainage, presence or absence of riparian buffers, evapotranspiration, fertilizer use, ground-water recharge rates and residence times, aquifer properties, subsurface tile drainage, sources and amounts of organic matter, and hyporheic processes. The study data indicate that the nitrate-reducing capacity of the buffer zone combined with that of the hyporheic zone can substantially lower the amount of ground-water nitrate discharged to streams in agricultural settings of the North Carolina Coastal Plain. At the watershed scale, the effects of ground-water discharge on surface-water quality appear to be greatly influenced by streamflow conditions and the presence of extensive riparian vegetation. Streamflow statistics

  14. Maternal morbidity and mortality associated with delivery after intrauterine death

    International Nuclear Information System (INIS)

    To determine the maternal morbidity and mortality associated with delivery after intrauterine fetal death (IUFD) and to find out the place of fetal destructive procedures and cesarean section. All women were included in the present study who presented before the onset of labour pains, after intrauterine fetal death at 26 weeks or onward with singleton pregnancy. Assessment of maternal demographic characteristics, gestational age at fetal demise, delivery-IUFD interval, mode of delivery; vaginal with or without fetal destructive procedures/cesarean section and maternal complications were the main outcome measures. There were 1834 live birth and 63 deliveries with intrauterine fetal death. Mode of delivery was vaginal in 87.4% and cesarean section in 12.6% of the cases. Twelve (21%) of the vaginal deliveries were complicated by lower urogenital tract injuries in certain cases, whereas 75% (6/8) of patients delivered by cesarean section developed major postoperative complications like postpartum haemorrhage, shock, endometritis, peritonitis and wound dehiscence. No maternal death was identified. Rate of delivery with intrauterine fetal death was 34.3/1000 live-birth deliveries. (author)

  15. Cancer antigen 125 after delivery in women with a normal pregnancy

    DEFF Research Database (Denmark)

    Szecsi, Pal B; Andersen, Malene R; Bjørngaard, Brian;

    2014-01-01

    , Denmark. POPULATION: Eight hundred and one women with expected normal pregnancies were investigated. Of these, 640 delivered vaginally, 82 by emergency cesarean section, and 79 by elective cesarean section; 720 women had uncomplicated pregnancies. METHODS: Samples were collected at gestational weeks 13...... gestational period and around delivery. RESULTS: CA-125 was fairly stable below 35 U/mL during pregnancy but increased markedly during vaginal delivery, to a minor degree during emergency cesarean section, and only slightly during elective cesarean section. In the early postpartum period, CA-125 decreased......OBJECTIVE: To establish reference intervals for cancer antigen 125 (CA-125) in women with expected normal pregnancy, delivery, and early postpartum period. DESIGN: Prospective observational study. SETTING: Department of Clinical Biochemistry and Obstetrics, Copenhagen University Hospital, Gentofte...

  16. SUCCENTURIATE PLACENTA: AN INCIDENTAL FINDING DURING CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Unmesh

    2015-12-01

    Full Text Available A 30 years, 4th Gravida with 3 abortions with history of 8 months amenorrhea was admitted to the hospital with chief complaints of leaking per vagina since 4 hours and was not associated with pain abdomen or bleeding per vaginum. Perceiving decreased fetal movements since 6 hours. She had 3 previous missed abortions followed by D and E. In the present pregnancy, gestational age was 32 weeks at the time of admission. Patient’s general condition was stable, all other investigation were found to be normal her pulse was 100 beats/min, tachycardia present, BP -100/70mmHg. On obstetric examination, uterus was 30 weeks size, 1-2 contraction lasting for 15- 20 seconds, Breech presentation, FHR was 124 per minute, regular, decreased liquor clinically. On vulvovaginal examination- Frank leaking per vagina present. Ultrasound showed single live intrauterine pregnancy of 29 weeks 3 days with breech presentation with oligohydramnios, Placenta was at fundal region, Biophysical profile was 6/8, FHR 124 bpm. After taking high risk consent in view of fetal prematurity, patient was posted for Emergency LSCS. And extracted a single live preterm female baby of weight of 1.45 kg by breech. During the cesarean section, on opening abdomen lower segment was found to be congested with torturous vessels. So we suspected missed diagnosis of placenta previa. After delivery of the baby, we found succenturiate lobe of the placenta occupying lower uterine segment with vessels running across the membrane.

  17. Mode of delivery and subsequent reproductive patterns. A national follow-up study

    DEFF Research Database (Denmark)

    Fussing-Clausen, Caroline; Geirsson, Reynir T; Hansen, Thomas;

    2014-01-01

    % CI 0.76-0.787) decreased likelihood for subsequent delivery. Emergency cesarean section meant 16% fewer (95% CI 0.84-0.85), and vaginal instrumental delivery 4% fewer subsequent deliveries (95% CI 0.95-0.96). Hazard ratios were largely unchanged after controlling for parity and year of birth. Small...

  18. Patterns of deliveries in a Brazilian birth cohort: almost universal cesarean sections for the better-off Padrones de partos en una cohorte de nacimientos: cesáreas casi universales para los riesgos Padrões dos partos em uma coorte de nascimentos: cesarianas quase universais para os ricos

    Directory of Open Access Journals (Sweden)

    Aluísio J D Barros

    2011-08-01

    Full Text Available OBJECTIVE: To describe the patterns of deliveries in a birth cohort and to compare vaginal and cesarean section deliveries. METHODS: All children born to mothers from the urban area of Pelotas, Brazil, in 2004, were recruited for a birth cohort study. Mothers were contacted and interviewed during their hospital stay when extensive information on the gestation, the birth and the newborn, along with maternal health history and family characteristics was collected. Maternal characteristics and childbirth care financing - either private or public healthcare (SUS patients - were the main factors investigated along with a description of C-sections distribution according to day of the week and delivery time. Standard descriptive techniques, Χ² tests for comparing proportions and Poisson regression to explore the independent effect of C-section predictors were the methods used. RESULTS: The overall C-section rate was 45%, 36% among SUS and 81% among private patients, where 35% of C-sections were reported elective. C-sections were more frequent on Tuesdays and Wednesdays, reducing by about a third on Sundays, while normal deliveries had a uniform distribution along the week. Delivery time for C-sections was markedly different among public and private patients. Maternal schooling was positively associated with C-section among SUS patients, but not among private patients. CONCLUSIONS: C-sections were almost universal among the wealthier mothers, and strongly related to maternal education among SUS patients. The patterns we describe are compatible with the idea that C-sections are largely done to suit the doctor's schedule. Drastic action is called for to change the current situation.OBJETIVO: Describir el padrón de los partos en una cohorte de nacimientos, comparando partos normales y cesáreos. MÉTODOS: Todos los recién nacidos de moradoras de área urbana de Pelotas (Sur de Brasil en 2004 fueron reclutados para una cohorte de nacimientos. Las madres

  19. Expectant management of heterotopic cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    BAI Xiao-xia; GAO Hui-juan; YANG Xiao-fu; DONG Ming-yue; ZHU Yi-min

    2012-01-01

    Background Heterotopic cesarean scar pregnancy (HCSP) is a very rare but life-threatening entity and there is no optimal management strategy.Here we report a successfully managed case of HCSP with expectant treatment in a tertiary referral hospital.@@Methods A woman with HCSP after in vitro fertilization-embryo transfer opted for expectant treatment after five days of mild bleeding and ultrasound demonstrated cardiac activity disappearance of the scar pregnancy at 8+4 weeks of gestation.@@Results The patient had mild to moderate bleeding during close monitoring.Three days later,speculum examination revealed the gestational mass was partly protruding at the os of the cervix and it was removed with forceps without massive hemorrhage.A healthy male baby was delivered by cesarean section at gestational age of 36+4 weeks.@@Conclusions The expectant method might be an alternative option for a HCSP with loss of cardiac activity of the scar pregnancy,when applied under supportive management and with available emergency surgery facilities.

  20. Demand and supply factors affecting the rising overmedicalization of birth in India

    OpenAIRE

    Leone, Tiziana

    2014-01-01

    Objective To understand the interaction between health systems and individual factors in determining the probability of a cesarean delivery in India. Methods In a retrospective study, data from the 2007–2008 District Level Household and Facility Survey was used to determine the risk of cesarean delivery in six states (Punjab, Delhi, Maharashtra, Andhra Pradesh, Kerala, and Tamil Nadu). Multilevel modeling was used to account for district and community effects. Results Afte...

  1. Factors Affecting the Involvement of Day Centre Care Staff in the Delivery of Physiotherapy to Adults with Intellectual Disabilities: An Exploratory Study in One London Borough

    Science.gov (United States)

    Middleton, M. -J.; Kitchen, S. S.

    2008-01-01

    Background: Physiotherapists for adults with intellectual disabilities often work in day centres, relying on care staff to support programmes. This study investigates factors affecting physiotherapy delivery in 4 day centres in one London borough. Materials and Method: Semi-structured interviews were carried out with day centre care staff,…

  2. Identification of multiple cellular uptake pathways of polystyrene nanoparticles and factors affecting the uptake: relevance for drug delivery systems.

    Science.gov (United States)

    Firdessa, Rebuma; Oelschlaeger, Tobias A; Moll, Heidrun

    2014-01-01

    Nanoparticles may address challenges by human diseases through improving diagnosis, vaccination and treatment. The uptake mechanism regulates the type of threat a particle poses on the host cells and how a cell responds to it. Hence, understanding the uptake mechanisms and cellular interactions of nanoparticles at the cellular and subcellular level is a prerequisite for their effective biomedical applications. The present study shows the uptake mechanisms of polystyrene nanoparticles and factors affecting their uptake in bone marrow-derived macrophages, 293T kidney epithelial cells and L929 fibroblasts. Labeling with the endocytic marker FM4-64 and transmission electron microscopy studies show that the nanoparticles were internalized rapidly via endocytosis and accumulated in intracellular vesicles. Soon after their internalizations, nanoparticles trafficked to organelles with acidic pH. Analysis of the ultrastructural morphology of the plasma membrane invaginations or extravasations provides clear evidence for the involvement of several uptake routes in parallel to internalize a given type of nanoparticles by mammalian cells, highlighting the complexity of the nanoparticle-cell interactions. Blocking the specific endocytic pathways by different pharmacological inhibitors shows similar outcomes. The potential to take up nanoparticles varies highly among different cell types in a particle sizes-, time- and energy-dependent manner. Furthermore, infection and the activation status of bone marrow-derived macrophages significantly affect the uptake potential of the cells, indicating the need to understand the diseases' pathogenesis to establish effective and rational drug-delivery systems. This study enhances our understanding of the application of nanotechnology in biomedical sciences. PMID:25224362

  3. 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.

  4. Estado neurológico e cardiorrespiratório de filhotes de cães nascidos de parto normal ou de cesariana sob anestesia geral inalatória com sevofluorano Neurological and cardiocirculatory investigation of dog neonates born by normal parturition or cesarean section on sevoflurane inhalation anesthesia

    Directory of Open Access Journals (Sweden)

    Daniela Tozadore Gabas

    2006-10-01

    Full Text Available A anestesia obstétrica possibilita um procedimento mais seguro para a mãe e para os fetos. Em medicina veterinária, no entanto, a literatura científica a respeito do assunto é deficiente. Este trabalho teve como objetivo avaliar o grau de depressão neurológica, hemodinâmica e respiratória fetais provocado pelo agente anestésico, em que as mães foram submetidas ao parto normal ou à cesariana, utilizando-se sevofluorano como agente de manutenção anestésica, comparando-o com o parto normal. Foram realizados seis partos normais (GN e seis cesarianas (GC, avaliando-se um total de 36 filhotes. As cesarianas foram realizadas utilizando-se acepromazina, propofol e sevofluorano (GC e os neonatos foram avaliados clinicamente ao primeiro, quinto e décimo minuto de nascimento, nos dois grupos. Observou-se maior depressão respiratória nos filhotes nascidos de cesariana. Contudo, apesar dessa depressão, o protocolo anestésico empregado não comprometeu de maneira importante a viabilidade e a saúde das mães e dos filhotes, demonstrando ser seguro em cadelas gestantes.The obstetric anesthesia must be safe for mother and puppies and about this, the literature is pour. This study was aimed at evaluating the neurological, hemodinamic and respiratory changes in neonates provoked by the anestesic agent as a result of normal parturition and cesarean section employing sevoflurane as the maintenance agent. Six deliveries (GN and six cesarean sections (GC were performed. The cesarean sections were performed under general anesthesia using acepromazina maleate, propofol and sevoflurane. Thirty six puppies were evaluated and the neurologic reflexes were worse in that were born through cesarean section. However, we concluded that despite the anesthetic depression, the protocol employed didn,t affect in any important way the viability and health of the mothers and puppies, being suitable for cesarean sections.

  5. Maternal demand for cesarean section: perception and willingness to request by Nigerian antenatal clients

    Directory of Open Access Journals (Sweden)

    Okonkwo NS

    2012-03-01

    likely than those at the SHC or the PHCs to request cesarean section and to favor a woman’s right of autonomy to choose her mode of delivery.Conclusion: The decision for MDCS is a difficult one, because willingness is low and criticism by partners of those who choose MDCS is high. Provision of epidural anesthesia and improved safety of vaginal delivery is recommended. This may prevent Nigerian women from making a difficult choice for MDCS based on fear of pain and poor labor outcome. The role of the male partner should be taken into consideration in order to make sustainable policies or guidelines for MDCS in developing countries.Keywords: maternal demand cesarean section, perception, antenatal, clients, Nigeria

  6. Survey of Accepted Practice following Failed Intubation for Emergency Caesarean Delivery

    Directory of Open Access Journals (Sweden)

    Daniel Soltanifar

    2015-01-01

    Full Text Available Background. There is no consensus on the optimum management of failed tracheal intubation in emergency cesarean delivery performed for fetal compromise. The decision making process on whether to wake the patient or continue anesthesia with a supraglottic airway device is an underexplored area. This survey explores perceptions and experiences of obstetric anesthetists managing failed intubation. Methods. Anesthetists attending the Group of Obstetric Anaesthetists London (GOAL Meeting in April 2014 were surveyed. Results. Ninety-three percent of anesthetists surveyed would not always wake the patient in the event of failed intubation for emergency cesarean delivery performed for fetal compromise. The median (interquartile range of perceived acceptability of continuing anesthesia with a well-fitting supraglottic airway device, assessed using a visual analogue scale (0–100; 0 completely unacceptable; 100 completely acceptable, was 90 [22.5]. Preoperative patient consent regarding the use of a supraglottic airway device for surgery in the event of failed intubation would affect the decision making of 40% of anaesthetists surveyed. Conclusion. These results demonstrate that a significant body of anesthetists with a subspecialty interest in obstetric anesthesia in the UK would not always wake up the patient and would continue with anesthesia and surgery with a supraglottic airway device in this setting.

  7. Pain relief following cesarean section : short and long term perspectives

    OpenAIRE

    Niklasson, Boel

    2015-01-01

    Background Postoperative pain treatment in women undergoing cesarean section (CS) needs to be effective to enable fast and smooth recovery without adverse outcomes and to improve breastfeeding and bonding between mother and child. It is also important that pain treatment should have minimal impact on the newborn. The overall aim The overall aim of this thesis was to investigate how to improve pain management in women undergoing cesarean section. Specific aims were: *...

  8. The use of midwives as first assistants in cesarean section.

    Science.gov (United States)

    Marks; Thacher; Camargo

    1998-07-01

    Introduction: In 1997, medical insurance gives limited financial reimbursement to physicians who first assist cesarean sections. Therefore, a formal program was developed at our community teaching hospital using midwives in place of physicians as first assistant in cesarean section. Midwives on the midwifery service were taught the principles and procedures of obstetrical anesthesia, anatomy, and physiology of the gravid abdomen.A team approach using obstetrician/gynecologist, anesthesiologist, midwives, and operating nurses performed the tracking in a 1-day course. A 28-minute video was developed to depict the role of the midwife as first assistant. Additionally, the principles of operation room set-up and instrumentation were taught.Result: All 24 midwives on the midwifery service were involved in the teaching of first assisting an attending obstetrician. After taking the course, nurse-midwives received formal certification from the department of obstetrics and gynecology and were approved by risk management. They also received clinical privileges outlining these guidelines. Their malpractice rates have not increased. The time to complete a cesarean section has not increased for the physician, and an emergency cesarean section is no longer delayed by waiting for an assistant to arrive. Patient satisfaction has increased because of decreased waiting time for a cesarean section and increased familiarity with the entire operating team.Discussion: Midwives can be trained to first assist the obstetrician/gynecologist in a cesarean section. Since the duration of a cesarean section is not prolonged, the patient will not experience increased blood loss or infection secondary to a prolonged procedure. The patient is more relaxed since they know that their provider during labor is also one of their surgeons for the cesarean section. PMID:10838393

  9. Neonatal and Maternal Temperature Regulation During and After Delivery.

    Science.gov (United States)

    Perlman, Jeffrey; Kjaer, Klaus

    2016-07-01

    An important goal of obstetric anesthesia is to provide for the safety and comfort of the mother as well as to optimize physiologic outcomes for the neonate. Markers of neonatal physiologic outcome include cord umbilical artery pH and Apgar scores. Neonatal temperature has often been overlooked by anesthesiologists as an important physiologic outcome measure, but it may be significantly affected by operating room conditions and obstetric anesthesia technique at cesarean delivery. There is a dose-dependent increase in mortality with decreasing body temperature as well as an increased likelihood for more severe early respiratory distress. Multiple neonate-focused strategies have been shown to decrease the incidence of neonatal hypothermia. Because fetal temperature is affected by maternal temperature, strategies to mitigate maternal hypothermia at the time of delivery may also be important in preventing neonatal hypothermia. This focused review will examine the importance of neonatal temperature and discuss its relationship to maternal temperature as well as strategies for maintaining neonatal normothermia after delivery. PMID:27314693

  10. Effects of Bifidobacterium Breve Feeding Strategy and Delivery Modes on Experimental Allergic Rhinitis Mice.

    Directory of Open Access Journals (Sweden)

    Jian-jun Ren

    Full Text Available Different delivery modes may affect the susceptibility to allergic diseases. It is still unknown whether early intervention with probiotics would counteract this effect.The effect of different delivery modes on immune status and nasal symptoms was investigated on established allergic rhinitis (AR mouse model. In addition, the immunoregulatory effects and mechanisms of different feeding manners with Bifidobacterium breve(B. breve were examined.Live lyophilized B. breve was orally administered to BALB/c mice born via vaginal delivery(VD or cesarean delivery (CD for 8 consecutive weeks, after which they were sensitized by ovalbumin(OVA to establish experimental AR. Nasal symptoms, serum immunoglobulins, cytokines, splenic percentages of CD4(+CD25(+Foxp3(+ regulatory T(Treg cells and nasal eosinophil infiltration were evaluated.Compared with VD mice, mice delivered via CD demonstrated more serious nasal symptoms, higher concentrations of OVA-specific immunoglobulin (Ig E, more nasal eosinophils and lower percentages of splenic CD4(+CD25(+Foxp3(+Treg cells after establishing experimental AR. These parameters were reversed by administering B. breves hortly after birth. However, the effect of B. breve did not differ between different delivery modes.CD aggravates the nasal symptoms of AR mice compared to VD. This is the first report that oral administration of B. breve shortly after birth can significantly alleviate the symptoms of AR mice born via both deliveries, probably via activation of the regulatory capacity of CD4(+CD25(+Foxp3(+Treg cells.

  11. Women's Decision-Making And Factors Affecting Their Choice Of Place Of Delivery: Systematic Review And Qualitative Study

    OpenAIRE

    Madi, Banyana Cecilia

    2001-01-01

    The aim of the thesis is to explore pregnant women's decision-making and major influences on their preferences for a place of delivery. The study was prompted by the UK government's policy of a woman centred maternity service (Department of Health 1993b), and the observation that studies had concentrated on professionals' rather than women's views about the place of delivery. Two factors were considered to have potential influence in decision making, one being the individual woman's risk perc...

  12. 如何有效降低剖宫产率的实践与探索%Practice and Exploration of Reducing the Rate of Cesarean Birth Effectively

    Institute of Scientific and Technical Information of China (English)

    彭振耀

    2013-01-01

    Reasons of high cesarean section rate was briefly analyzed .Main measures taken to reduce the rate of cesarean section and to promote natural delivery, as well as primary achievement in Haidian maternal and children hospital (MCH) Hospital were made detailed description.Strategies and proposals were provided in order to communicate with the national counterparts and to make efforts to promote natural delivery in our country effectively.%分析了剖宫产率高发的原因,详细阐述了海淀区妇幼保健院在有效降低剖宫产率,促进自然分娩方面采取的主要措施及取得的初步成效,并对如何促进该项工作的有效开展提出了策略措施.

  13. Anesthetic Implications of Emergent Cesarean Section in a Parturient with Marfan Syndrome Complicated by Ascending Aortic Aneurysm and Heart Failure

    Directory of Open Access Journals (Sweden)

    Young Sung Kim

    2014-07-01

    Full Text Available Cardiovascular comorbidities to the Marfan syndrome may induce hemodynamic instability especially in the parturients during labor or delivery. For anesthesiologists, it is challenging to maintain hemodynamic stability during Cesarean section in those patients with Marfan syndrome. Remifentanil is an ultra-short-acting opioid with rapid onset and offset of action which provides cardiovascular stability during surgery. Together with remifentanil, the use of a laryngeal mask airway can reduce the risk of hypertensive response followed by tracheal intubation. We describe the successful administration of remifentanil and application of laryngeal mask airway for emergent Cesarean section performed under general anesthesia in a patient with Marfan syndrome complicated by ascending aortic aneurysm and heart failure. The use of remifentanil (loading dose of 1 μg/kg for 1 min, 2 min before induction; thereafter continuous infusion dose of 0.1 μg/kg/min was useful to maintain hemodynamic stability of the parturient throughout the surgery without neonatal respiratory depression.Keywords: Ascending Aortic Aneurysm; Cesarean section; Laryngeal mask airway; Marfan syndrome; Remifentanil

  14. 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.

  15. 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

  16. Dose de bupivacaína subaracnóidea necessária para cesariana é semelhante em mulheres obesas e com peso normal Las dosis de bupivacaína intratecal necesarias para cesáreas en mujeres obesas son similares a las usadas en mujeres con peso normal Dose requirement of intrathecal bupivacaine for cesarean delivery is similar in obese and normal weight women

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    Yung Lee

    2009-12-01

    mujeres obesas y con peso normal. MÉTODO: Evaluamos embarazadas con peso normal (IMC 30 kg.m-2, con feto único a término, sometidas a cesáreas de elección. Ese fue un estudio mono ciego y de ubicación secuencial, usando el método up-down (modificado por la regla de Narayana. Todas las pacientes recibieron bloqueo combinado raquiepidural con administración intratecal de dosis variables de bupivacaína hiperbárica a 0.75% más 10 µg de fentanil y 100 µg de morfina. La primera paciente recibió 9 mg de bupivacaína. La anestesia se suplementó cuando fue necesario, a través de un catéter epidural. El éxito de la anestesia, definido como bloqueo sensitivo hasta por lo menos T6, sin necesidad de anestesia suplementaria, fue el objetivo primario. La ED95 para un resultado satisfactorio fue determinada por un modelo logístico sin transformación logarítmica de las dosis. RESULTADOS: Veinte y cuarto embarazadas con peso normal y dieciséis embarazadas obesas participaron en este estudio. La ED95 estimada para todas las pacientes fue de 12,92 mg (IC 95%: 11,49 a 34,77. La ED95 estimada para las embarazadas con peso normal y las embarazadas obesas fue similar, 12,78 mg (IC 95%: 10,75 a + infinito y 11,86 mg (CI 95%: 11,31 a 15,61, respectivamente. CONCLUSIONES: Si la anestesia raquídea con inyección única es utilizada en cesáreas, las pacientes con peso normal y obesas deben recibir dosis parecidas de bupivacaína hiperbárica. A pesar de que no fuimos capaces de determinar con exactitud la ED95 en nuestro estudio, sí que podemos afirmar que es de por lo menos 11,49 mg.BACKGROUND AND OBJECTIVES: The effect of BMI on the spread of intrathecal bupivacaine is controversial. This study assessed the ED95 of intrathecal bupivacaine for elective cesarean delivery in obese and normal weight women. METHODS: We studied normal weight (BMI 30 kg.m-2 women with singleton term pregnancies undergoing elective cesarean delivery. The study was conducted as a single blinded, up

  17. A retrospective study of the outcome of cesarean section for women with severe pre-eclampsia in a third world setting

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    Obinna V Ajuzieogu

    2011-01-01

    Full Text Available Objective: To compare the outcome of subarachnoid block (spinal anesthesia and general anesthesia in Cesarean delivery for women with severe pre-eclampsia. Methods: A retrospective study of women with severe pre-eclampsia requiring Cesarean section from January 2005 to June 2009 was carried out. Maternal age, parity, gestational age at delivery, booking status, Apgar scores, maternal and perinatal mortality of the sub-arachnoid block group were compared with those of general anesthesia group using c2 , Student t-test and Fischer exact test. Results: There were no significant difference between the two groups in overall maternal mortality (5.4% vs. 11.9%, P=0.5 and perinatal mortality (2.7% vs. 11.9%, P=0.15. The general anesthesia group had significantly more birth asphyxia than the spinal group (55.9% vs. 27.0%, P=0.0006. Conclusion: There was no significant difference in the maternal and perinatal mortality outcome of cesarean delivery between women with severe pre-eclampsia who had regional anesthesia and those that had general anesthesia. There was significantly higher proportion of birth asphyxia in babies of women who received general anesthesia.

  18. Sagittal venous sinus thrombosis after cesarean section: a case report

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    Farideh Keypour

    2013-07-01

    Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

  19. 多沙普仑联合曲马多治疗剖宫产腰硬联合麻醉后寒战临床分析%CLINIC ANALYSIS OF TREATMENT OF SHIVERING AFTER DOXAPRAM CESAREAN DELIVERY TRAMADOL COMBINED SPINAL EPIDURAL ANESTHESIA

    Institute of Scientific and Technical Information of China (English)

    薛华; 吕国义

    2011-01-01

    [目的]探讨多沙普仑联合曲马多治疗剖宫产腰硬联合麻醉后寒战的临床效果.[方法]选择2009年6月~2010年6月我院收治的在剖宫产术中腰硬联合麻醉后发生寒战反应的产妇72例,按数字随机表法分为观察组和对照组各36例.对照组静脉注射曲马多1mg/kg,观察组加用多杀普伦0.5 mg/kg.[结果]两组治疗前后MAP、HR、SPO:均无明显变化,差异无统计学意义(P>0.05);观察组总有效率为97.2% (35/36),高于对照组的91.7% (33/36),差异无统计学意义(P>0.05);观察组寒战复发率为2.8% (1/36),明显低于对照组的22.2%(8/36),差异有统计学意义(P<0.05) ;观察组并发症发生率为16.7%(6/36),高于对照组的11.1%(4/36),差异无统计学意义(P>0.05).[结论]多沙普仑联合曲马多治疗剖官产腰硬联合麻醉后寒战,能够产生协同作用,提高疗效,明显降低复发率,值得临床推广应用.%[Objective]To investigate the treatment of shivering after doxapram tramadol combined spinal epidural anesthesia after cesarean section.[Methods]From June 2009 to June 2010, we collected 72 cases with shivering after doxapram tramadol combined spinal epidural anesthesia after cesarean section, and we randomly divided into observation group and control group, and each group had 36 cases.The controls were administrated with intravenous tramadol lmg/kg, and the observation group was added doxapram 0.5mg/kg.[Results]Both before and after treatment, MAP, HR, SpO2 did not showed significant changes, there was no significant difference (P> 0.05); The total effective rate of observation group was 97.2% (35/ 36), which was higher than controls of 91.7% (33/36) (P > 0.05); The shivering relapse rate of observation group was 2.8% (1/36), which was significantly lower than the control group of 22.2% (8/36) (P < 0.05); The complication rate of observation group was 16.7% (6/36), which was higher than controls of 11.1% (4/36), there was no

  20. Transfusion Related Acute Lung Injury after Cesarean Section in a Patient with HELLP Syndrome.

    Science.gov (United States)

    Moon, Kyoung Min; Han, Min Soo; Rim, Ch'ang Bum; Kim, So Ri; Shin, Sang Ho; Kang, Min Seok; Lee, Jun Ho; Kim, Jihye; Kim, Sang Il

    2016-01-01

    Transfusion-related acute lung injury (TRALI) is a serious adverse reaction of transfusion, and presents as hypoxemia and non-cardiogenic pulmonary edema within 6 hours of transfusion. A 14-year-old primigravida woman at 34 weeks of gestation presented with upper abdominal pain without dyspnea. Because she showed the syndrome of HELLP (hemolysis, elevated liver enzymes, and low platelet count), an emergency cesarean section delivery was performed, and blood was transfused. In the case of such patients, clinicians should closely observe the patient's condition at least during the 6 hours while the patient receives blood transfusion, and should suspect TRALI if the patient complains of respiratory symptoms such as dyspnea. Furthermore, echocardiography should be performed to distinguish between the different types of transfusion-related adverse reactions. PMID:26885326

  1. Desigualdades sociais nas complicações da cesariana: uma análise hierarquizada Social inequalities in post-cesarean complication rates: a hierarchical analysis

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    Paulo Fontoura Freitas

    2011-10-01

    Full Text Available Com objetivo de investigar associações entre fatores socioeconômicos e complicações da cesariana, uma amostra de 604 puérperas cujos partos ocorreram em duas maternidades no Sul do Brasil foi entrevistada 24 horas pós-parto e na segunda semana do puerpério, por meio de entrevistas hospitalares e domicilio. Regressão de Cox foi aplicada ao modelo hierárquico dos fatores associados ao tipo de parto e às complicações no pós-parto. Complicações foram duas vezes mais frequentes após cesariana, independentemente das condições socioeconômicas. Contudo, a maneira como o parto cesáreo se associou ao risco de complicações mostrou-se mediada pelas circunstâncias socioeconômicas representadas pela categoria do pré-natal e parto, ter ou não o mesmo profissional no pré-natal e parto e ter sua cesariana decidida intraparto. Resultados do estudo evidenciam que complicações pós-cirúrgicas da cesariana têm impacto adverso, principalmente, entre aquelas mulheres vivendo em condições sociais e de saúde menos privilegiadas, as quais, após o parto, retornam para um ambiente de menor suporte, com uma cicatriz abdominal.This study focused on the association between social factors and complications following cesarean sections. A sample of 604 women delivering in the two main maternity hospitals in a city in southern Brazil were interviewed 24 hours after delivery and two weeks postpartum, using in-hospital and home interviews. Cox regression was applied, using a hierarchical framework of factors associated with post-cesarean complications. Post-partum complications were twice as frequent after cesareans as compared to vaginal delivery, independently of socioeconomic conditions. However, the increased the risk of complications associated with cesarean section proved to be mediated by socioeconomic circumstances, as represented by prenatal and childbirth care in the public health system, not having the same physician throughout

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

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    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. Using Amniotic Membrane as Wound Covering After Cesarean Section Operation

    International Nuclear Information System (INIS)

    Early mobilization and good wound operation healing are the other aim of all treatment for cesarean section operation. Especially for wound healing we can use amniotic membrane which is soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient transparency which allows wound control without secondary redressing. From July 1999 until December 1999 total of 196 patients undergoing cesarean section with amnion as would covering were evaluated for injection of amnion, sign of wound injection, and duration of wound healing. Amniotic membrane gives best results in wound healing, no sing of rejection and there is no different results between emergency operation and elective operation, clean and dirty operation

  4. Clinical analysis of the late postpartum hemorrhage after cesarean section%剖宫产术后晚期产后出血临床分析

    Institute of Scientific and Technical Information of China (English)

    徐艳明

    2014-01-01

    目的:探讨引起剖宫产术后晚期产后出血的临床原因。方法:对2003-2013年收治的剖宫产分娩后发生晚期产后出血16例产妇的记录资料进行回顾性分析。结果:本院剖宫产后晚期产后出血发生率0.12%。剖宫产术后晚期产后出血的主要原因是胎盘胎膜残留、子宫切口感染,与剖宫产术式及操作技巧、产妇的全身状况有关。结论:剖宫产术后晚期产后出血的治疗方式以清宫为主,对急性出血者可行血管介入治疗,不得已情况下才考虑行子宫切除术。%Objective:To investigate the cause of the postpartum hemorrhage after cesarean section.Methods:We retrospectively analyzed the record datas of 16 cases of maternal postpartum hemorrhage uterine after delivery from 2003 to 2013.Results:The incidence of late postpartum hemorrhage after cesarean section was 0.12% in our hospital.The main cause of late postpartum hemorrhage after cesarean section is retained placenta,and uterine incision infection.It is associated with cesarean section and operating skills,and maternal body condition.Conclusion:The most treatment of late postpartum hemorrhage after cesarean section was curettage.We can take interventional therapy to treat the acute hemorrhage.No case was considered a hysterectomy.

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

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    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

  6. Neonatal viability evaluation by Apgar score in puppies delivered by cesarean section in two brachycephalic breeds (English and French bulldog).

    Science.gov (United States)

    Batista, M; Moreno, C; Vilar, J; Golding, M; Brito, C; Santana, M; Alamo, D

    2014-05-01

    This study tried to define neonatal viability after cesarean section in brachycephalic breeds and the efficacy of an adapted Apgar test to assess newborn survival. Data from 44 cesarean sections and 302 puppies were included. Before surgery (59-61 days after ovulation), an ultrasound evaluation defined the fetal biparietal diameter (BPD). Immediately after the uterine delivery, the pups were evaluated to detect birth defects and then, a modified Apgar score (range: 0-10) was used to define neonatal health at 5min (Apgar 1) and 60min (Apgar 2) after neonatal delivery; puppies were classified into three categories: critical neonates (score: 0-3), moderate viability neonates (score: 4-6) and normal viability neonates (score: 7-10). Mean (±SEM) value of BPD was 30.8±0.1mm and 28.9±0.1mm in English and French Bull-Dog fetus, respectively. The incidence of spontaneous neonatal mortality (4.98%, 14/281) and birth defects (6.95%) were not influenced by the sex; however, congenital anomalies and neonatal mortality were higher (pbrachycephalic breed puppies. PMID:24703805

  7. Cesarean Section: One of the Oldest and Controversial Surgical Procedures

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    Liliana Strat

    2015-05-01

    Full Text Available The idea of the possibility of childbirth in another route than natural still exists from mythology. The name derives from the Latin “caedere” – cut, sever. For many centuries, ever since the Roman Empire, the operation was performed only rarely and women who died in childbirth. Indications that cesarean would be performed even women are living since 1040 in Rabbi Gershon to Metz, Talmud's comment. In 1581 the first paper appears in France dedicated caesarean women live, but the first successful Caesarean operation are reported in France, only in 1689 from surgeon Jean Rulau, in Ireland 1748 from midwife Marie Donaly and in 1794 in Virginia (USA from the country doctor Jesse Bennett. Mortality after cesarean on women living it was still very high. A significant decrease occurred in the 19th century it when decline spectacular after improvements are made of the operation. Mainly this is due to Frank E. Polin in US, Alfred Kehrer in Heidelberg, Max Sänger in Leipzig and Eduardo Porro in Milan. Their refinements of the technique were essential cesarean bringing a lot of one that is currently running. Classical caesarean is practiced today after Stark technique, method Joel Cohen. After a long and controversial trend for nearly two millennia, marked for centuries by almost prohibitive mortality, the current cesarean operation is a great success in perseverance deeply humanitarian attempts to save two lives, a mother and child.

  8. Comparison of Subcuticular Suture Materials in Cesarean Skin Closure

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    Pınar Solmaz Hasdemir

    2015-01-01

    Full Text Available Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.

  9. Relationship between prenatal psychological status and delivery mode%孕妇产前心理状况与分娩方式的关系研究

    Institute of Scientific and Technical Information of China (English)

    赵生英; 曹夕辉

    2012-01-01

    indication of cesarean section ( t = 2. 751, P = 0. 009 ), and the differences in expected value, educational level and occupation between two groups were statistically significant (X2=6. 582-7. 339,all P<0. 05 ). Age, occupation and expectation were related with some psychological agents scores at different stages ( r = 0. 042-0. 605, all P < 0. 05 ). Conclusion Psychological status such as fear, anxiety and depression will affect the final mode of delivery. The intervention of these adverse psychological conditions is expected to reduce cesarean section rate.

  10. How different modes of child delivery influence abdominal muscle activities in the active straight leg raise.

    Science.gov (United States)

    Kwon, Yu-Jeong; Hyung, Eun-Ju; Yang, Kyung-Hye; Lee, Hyun-Ok

    2014-08-01

    [Purpose] The purpose of this study was to examine the activities of the abdominal muscles of women who had experienced vaginal delivery in comparison with those who had experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal delivery, 7 Cesarean section) performed an active straight leg raise to 20 cm above the ground, and we measured the activities of the internal oblique abdominal muscle, the external oblique abdominal muscle, and the rectus abdominal muscle on both sides using electromyography. The effort required to raise the leg was scored on a Likert scale. Then, the subjects conducted maximum isometric contraction for hip joint flexion with the leg raised at 20 cm, and maximum torque and abdominal muscle activities were measured using electromyography. [Results] During the active straight leg raise, abdominal muscle activities were higher in the Cesarean section subjects. The Likert scale did not show a significant difference. The activities of the abdominal muscles and the maximum torque of the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater recruitment for maintaining pelvic stability during the active straight leg raising, but were relatively weaker when powerful force was required. Therefore, we consider that more abdominal muscle training is necessary for maintaining pelvic stability of Cesarean section subjects. PMID:25202194

  11. Emergency cesarean section as a result of acute eosinophilic pneumonia during pregnancy.

    Science.gov (United States)

    Kotani, Yasushi; Shiota, Mitsuru; Umemoto, Masahiko; Nakai, Hidekatsu; Tobiume, Takako; Tsuritani, Hiromitsu; Shimaoka, Masao; Doh, Kunihiko; Hoshiai, Hiroshi

    2009-11-01

    Acute eosinophilic pneumonia is a disease of unknown etiology characterized by peripheral blood eosinophilia and pulmonary infiltrative shadows on radiography. Acute eosinophilic pneumonia follows an acute course within 1 week and the symptoms include fever, dyspnea, and cough. Acute eosinophilic pneumonia has a good prognosis and responds promptly to steroid treatments. Here we present a critical case of acute eosinophilic pneumonia during pregnancy, which led to emergency cesarean section because of fetal distress. The patient was a 24-year-old gravida at 34 + 6 weeks gestation, with fever, and an elevated CRP; thus antibiotics were started. At 35 + 1 weeks gestation, cardiotocography (CTG) revealed late decelerations, fetal distress was diagnosed, and an emergency cesarean section was performed. The pre-operative maternal blood gas analysis showed a low PaO(2) of 55.7 mmHg and a chest X-ray revealed ground-glass opacities and pleural effusions in the middle lower lung fields bilaterally. A male of 2,336 g in weight was delivered with Apgar scores of 8 and 8 at 1 and 5 min, respectively. Due to the clinical progress and the elevated eosinophil count (532/microl) in the peripheral blood differential leukocyte count, the diagnosis of acute eosinophilic pneumonia was made. With the administration of oxygen and steroid treatment, the patient's general condition recovered. Both the mother and the baby were discharged on the 10(th) post-operative day and the patient has been leading a normal life with no recurrence for > 3 years since delivery. PMID:19851054

  12. Transvaginal ultrasonography compared with Bishop score for predicting cesarean section after induction of labor

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    Bastani P

    2011-08-01

    Full Text Available Parvin Bastani, Kobra Hamdi, Fatemeh Abasalizadeh, Parisa Pourmousa, Fatemeh GhatrehsamaniWomen's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, IranBackground: Reproductive health researchers are interested in finding better methods for predicting an unwanted type of delivery after induction of labor. The aim of this study was to compare the value of transvaginal ultrasonography findings and the Bishop score in predicting cesarean section after induction of labor.Methods: Two hundred women with singleton pregnancies undergoing induction of labor at 37–42 weeks were enrolled in this prospective study. Transvaginal investigation was done for all participants prior to induction. To compare the predictive value of the methods, receiver-operating characteristic (ROC curves were plotted and equality of the area under curve (AUC was tested.Results: The mean age of the participants was 29.9 years, mean gestational age was 39.6 weeks, and mean gravid was 1.5. The AUC calculated for Bishop score was 0.39 (95% confidence interval [CI] 0.3–0.48. The AUC for cervical length measured by ultrasonography was 0.69 (95% CI 0.6–0.77. The AUC for the posterior cervical angle measured by ultrasonography was 0.38 (95% CI 0.29–0.47. Testing equality of the ROC curves for these three methods showed the ROC for cervical length to be statistically different from both Bishop score and posterior cervical angle (P < 0.001. However, the difference in ROC area compared between Bishop score and posterior cervical angle was not statistically significant.Conclusion: Based on our findings and available information in the literature, it seems that cervical length measured by transvaginal ultrasonography has the potential to replace the traditional Bishop score, provided that such a facility is available when needed.Keywords: induction of labor, Bishop score, transvaginal ultrasonography, cesarean section, diagnostic value

  13. Differing Levels of Forestry Best Management Practices at Stream Crossing Structures Affect Sediment Delivery and Installation Costs

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    Brian C. Morris

    2016-03-01

    Full Text Available Forestry best management practices (BMPs are used to reduce sedimentation from forest stream crossings. Three BMP treatments (BMP−, BMP-std, and BMP+ were applied to three forest road stream crossings (bridge, culvert, and ford. BMP− did not meet existing BMP guidelines, BMP-std met standard recommendations, and BMP+ treatments exceeded recommendations. Following BMP applications, three simulated rainfall intensities (low, medium, and high were applied in order to evaluate sediment delivery from crossing type and BMP level. During rainfall simulation, sediment concentrations (mg/L were collected with automated samplers and discharge (L/s was estimated to calculate total sediment loading. Costs of stream crossings and BMP levels were also quantified. Mean sediment associated with the three stream crossings were 3.38, 1.87, and 0.64 Mg for the BMP−, BMP-std, and BMP+ levels, respectively. Ford, culvert, and bridge crossings produced 13.04, 12.95, and 0.17 Mg of sediment during construction, respectively. BMP enhancement was more critical for sediment control at the culvert and ford crossings than at the bridge. Respective costs for BMP−, BMP-std, and BMP+ levels were $5,368, $5,658, and $5,858 for the bridge; $3,568, $4,166 and $4,595 for the culvert; and $180, $420 and $1,903 for the ford. Costs and sediment values suggest that current standard BMP levels effectively reduce stream sediment while minimizing costs.

  14. No relationship between mode of delivery and neonatal mortality and neurodevelopment in very low birth weight infants aged two years

    Institute of Scientific and Technical Information of China (English)

    Jia-Jun Zhu; Ying-Ying Bao; Guo-Lian Zhang; Li-Xin Ma; Ming-Yuan Wu

    2014-01-01

    Background: To compare neonatal mortality and neurodevelopmental outcomes at two years of age in very low birth weight infants (≤1500 g) born by cesarean with those by vaginal delivery. Methods: In this retrospective, case-control study, we evaluated neonatal mortality, medical conditions and neurodevelopmental outcomes at two years of corrected age in 710 very low birth weight (VLBW) infants born between January 2005 and December 2010. Of the 710 infants, 351 were born by the cesarean and 359/710 by vaginal route. Results: There were no significant differences in neonatal mortality between the cesarean delivery group and vaginal delivery group [56/351 (15.9%) vs. 71/359 (19.8%), P=0.20]. VLBW infants delivered by the cesarean procedure had a higher incidence of respiratory distress syndrome than those born by the vaginal route [221/351 (63.0%) vs. 178/359 (49.6%), P Conclusions: In neither neurodevelopment nor neonatal mortality did cesarean birth offered significant advantages to VLBW infants. Moreover, the operation might be associated with an increased risk of respiratory distress syndrome for VLBW infants. The mode of delivery of VLBW infants should be largely based on obstetric indications and maternal considerations rather than perceived better outcomes for the neonate.

  15. Study on Modification of the Misgav Ladach Method for Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    李敏; 邹丽; 朱剑文

    2001-01-01

    172 cases of pregnant women scheduled for delivery by cesarean section were randomly assigned to 59 cases in modification group with modified Misgav Ladach technique, 57 cases in Misgav Ladach group with Misgav Ladach technique and 56 cases in Pfannenstiel group with Pfannenstiel technique from May to Dec. 1999. The modified points included: transversely incising the fascia 2 to 3 cm, then dividing it bluntly; without opening and dissociating the visceral peritoneum; two layers suturing of low transverse uterine incision; closing the skin by continuous suturing. Results showed the average delivery time in the modification group was (3.6±2.6) min and (5.7±2.9) min in the Misgav Ladach group (P0.05). Average blood loss was (128±35) ml in modification group compared with (212±147) ml in the Pfannenstiel group (P<0.05). It was concluded that the modified Misgav Ladach technique not only preserved all advantages of Misgav Ladach method, but also had additional advantages, such as faster in delivering the fetus, less damage, easier mastering for obstetricians.

  16. Surgical Management of the Cesarean Scar Ectopic Pregnancy: A Case Report

    OpenAIRE

    Anisodowleh Nankali; Mina Ataee; Haleh Shahlazadeh; Sara Daeichin

    2013-01-01

    Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of cesarean scar pregnancy (CSP) is challenging. The authors reported here a case of cesarean scar pregnancy (CSP) with hypovolemic shock that underwent emergency laparotomy with resection of ectopic mass. The patient was discharged from the hospital without any complications.

  17. Association of maternal and neonatal plasma interleukin-6 levels in relation to model of delivery

    Directory of Open Access Journals (Sweden)

    Mahmoud Imani

    2011-07-01

    Full Text Available Background: Cytokines play an important role during labor of full – or pretern delivery. In umbilical cord blood, Interleukin-6 (IL-6 was thought to be a marker of defense to stress, surgery and infection. The aim of this study was to investigate the cytokine IL-6 concentrations in the mother and neonate depends on the mode of the delivery.Materials and Method: This study was done on mothers and neonates in 80 single term deliveries (vaginal and cesarean in Mahdieh Hospital in Tehran. Age of mothers was 21-39 years old, parity was 1 and 2. There wasn't history of underlying disease and drug usage in mothers and neonate was AGA and apgar was more than 8. There wasn't clinical evidence of infection in neonate and mothers. IL-6 was evaluated by enzyme-immunoassays in maternal serum and neonatal umbilical cord. Data were analyzed with SPSS and were applied fishers exact test for compare means.Results: There were 37 vaginal deliveries and 43cesarean section. The mean (±standard error of maternal IL-6 concentration in vaginal delivery (0.18±0.02 was significantly (P=0.000 higher than cesarean section (0.1±0.02 and neonatal IL-6 concentration in vaginal delivery (0.17±0.03 was significantly (P=0.000 higher than cesarean section (0.07±0.01.Conclusion: Results show that vaginal delivery cause to increase IL-6 compared to cesarean section in mother and neonate

  18. Maternal and neonatal effects of nalbuphine given immediately before induction of general anesthesia for elective cesarean section

    Directory of Open Access Journals (Sweden)

    Sabry M Amin

    2011-01-01

    Full Text Available Background: Although nalbuphine was studied extensively in labour analgesia and was proved to be acceptable analgesics during delivery, its use as premedication before induction of general anesthesia for cesarean section is not studied. The aim of this study was to evaluate the effect of nalbuphine given before induction of general anesthesia for cesarean section on quality of general anesthesia, maternal stress response, and neonatal outcome. Methods: Sixty full term pregnant women scheduled for elective cesarean section, randomly classified into two equal groups, group N received nalbuphine 0.2 mg/kg diluted in 10 ml of normal saline (n=30, and group C placebo (n=30 received 10 ml of normal saline 1 min before the induction of general anesthesia. Maternal heart rate and blood pressure were measured before, after induction, during surgery, and after recovery. Neonates were assisted by using APGAR0 scores, time to sustained respiration, and umbilical cord blood gas analysis. Result: Maternal heart rate showed significant increase in control group than nalbuphine group after intubation (88.2±4.47 versus 80.1±4.23, P<0.0001 and during surgery till delivery of baby (90.8±2.39 versus 82.6±2.60, P<0.0001 and no significant changes between both groups after delivery. MABP increased in control group than nalbuphine group after intubation (100.55±6.29 versus 88.75±6.09, P<0.0001 and during surgery till delivery of baby (98.50±2.01 versus 90.50±2.01, P<0.0001 and no significant changes between both groups after delivery. APGAR score was significantly low at one minute in nalbuphine group than control group (6.75±2.3, 8.5±0.74, respectively, P=0.0002 (27% of nalbuphine group APGAR score ranged between 4-6, while 7% in control group APGAR score ranged between 4-6 at one minute. All neonates at five minutes showed APGAR score ranged between 9-10. Time to sustained respiration was significantly longer in nalbuphine group than control group (81.8

  19. 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。

  20. Color doppler ultrasound diagonosis in cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To study the sonographic characteristics of cesarean scar pregnancy(CSP), and the value of color Doppler in the diagnosis of CSP. Methods: Twelve cases of CSP were all confirmed by transabdominal and transvaginal ultrasound. Results: The ultrasonogram of CSP could be divided into gestational sac type and mixed mass type. Conclusion: Color Doppler can give guidance to the early diagnosis, treatment and following-up of CSP because of the sonographic specifity of CSP. (authors)

  1. Classic metaphyseal lesion following external cephalic version and cesarean section.

    Science.gov (United States)

    Lysack, John T; Soboleski, Don

    2003-06-01

    We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. PMID:12709748

  2. Classic metaphyseal lesion following external cephalic version and cesarean section

    Energy Technology Data Exchange (ETDEWEB)

    Lysack, John T.; Soboleski, Don [Department of Diagnostic Radiology, Queen' s University, Kingston General Hospital, 76 Stuart Street, K7L 2V7, Kingston, Ont. (Canada)

    2003-06-01

    We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)

  3. Research article Role of uterine compression suture techniques as an alternative to obstetric hysterectomy for severe post partum haemorrhage during cesarean section

    Directory of Open Access Journals (Sweden)

    Sapana Shah

    2014-07-01

    Full Text Available Objectives: To assess the efficacy of a transmural uterine compression suturing technique in reducing primary postpartum haemorrhage(PPPH due to severe uterine atony, which does not respond to manual compression, ecbolics or bilateral uterine artery ligation. This study evaluated the effectiveness of CHO (multiple square suturing technique for uterine compression in patients with PPPH after cesarean section to conserve uterus. Design: Prospective study. Methods: Between January 2008 and December 2012, 9748 women underwent cesarean section. Out of them 65 cases had PPPH, of which fifteen patients underwent uterine compression with CHO sutures after PPPH. The medical records of patients with PPPH after cesarean section who had undergone this treatment, and results of follow-up and our experience with this method were analyzed. Results: Uterine compression suturing was sufficient to stop the bleeding in all women. The technique was simple to perform in an emergency situation. One of the women developed uterine synechie. Normal menstruation patterns returned in all the women except one. One patient lost for follow up. Since uterine compression suturing, six women tried to conceive and four (66.7% have had a term delivery. Conclusion: Uterine compression with CHO sutures is a simple conservative procedure to control post partum haemorrhage in case of failure of the usual management. It is highly effective and straightforward emergency procedure which conserves the uterus in these patients and can be performed by each and every gynecologist.

  4. Evaluation of the Use and Effectiveness of Antibiotics for Prophylactic in Patients with Cesarean Section at Hospitals in Surakarta in 2010

    Directory of Open Access Journals (Sweden)

    Nurul Mutmainah

    2014-06-01

    Full Text Available The use of antibiotics for prophylactic in sectio cesarean can reduce the risk of infection-related complications and postoperative infections. This study aims to describe and evaluate the usage and the effectiveness of prophylactic antibiotics in cesarean section patients in two hospitals in Surakarta in year 2010. The study used retrospective data from medical records. The analysis was then conducted on the use of antibiotic including the appropriateness of antibiotic (compare to the standard of WHO, the appropriateness of dose and the time of administration. The data from two hundred of patients showed that 76% of patients were between 20–35 years old and the patients with aterm pregnancy were 90.5%, 46.5% of patients had the length of stay in hospital more than 5 days and 29% of cesarean delivery indicated by amniotic premature rupture. Antibiotics that used for prophylactic were ampicillin (24%, ampicillin-sulbactam (23%, ceftriaxone (19.5%, cefotaxime (16%, amoxicillin-clavulanate (11%, and cefazolin (6.5%. It was found that 30,5% of drugs were selected based on standard, 6.5% of drugs were given in the appropriate dose and 52% of drugs were administrated on-time. In conclusion, the antibiotics are 100% effective to prevent the incidence of surgical wound infection.

  5. [Urgent cesarean section in a pregnant woman with carbon monoxide poisoning].

    Science.gov (United States)

    Gara, Edit; Gesztes, Éva; Doroszlai, Richárd; Zacher, Gábor

    2014-06-01

    Recognition of carbon monoxide is difficult due to its plain physical-chemical properties. Carbon and gas operating heating systems may cause severe poisoning. Carbon-monoxide intoxication may generate severe hypoxic damage and it may cause death. The authors present the case of severe carbon monoxide poisoning affecting one young child and five adults, including a pregnant woman. Because the availability of hyperbaric oxygen therapy is limited in Hungary, urgent cesarean section was performed to avoid intrauterine hypoxic damage. The authors note that there are no standardized non-invasive methods for measuring fetal carbon-monoxide level and that the level of carbon monoxide accumulation is higher and the clearance is longer in the fetus than in the mother. The pathophysiology of carbon monoxide intoxication and therapeutic options in pregnancy are discussed. PMID:24860052

  6. Clinical analysis of 70 cases of cesarean scar pregnancy%剖宫产瘢痕妊娠70例临床分析

    Institute of Scientific and Technical Information of China (English)

    汤雅玲; 汪燕; 邱娜璇

    2016-01-01

    Objective To investigate the clinical diagnosis , treatment and outcomes of cesarean scar pregnancy .Methods The clinical data of 70 cases of cesarean scar pregnancy women treated in the first affiliated hospital of Xiamen University from January 2012 to December 2014 were analyzed retrospectively .Results 70 cases of cesarean scar pregnancy patients were diagnosed between 5~16 gestational weeks .65 patients whose gestational weeks less than or equal to 12 weeks chose pregnancy termination , in which 24 cases were treated by uterine artery embolization (UAE) and curettage,6 cases received transvaginal lesion resection , 3 cases received hysteroscopic surgery ,4 cases received laparoscopic surgery ,20 cases were treated by drug and curettage ,8 cases were treated by drug only.All these patients were cured,none received hysterectomy.The other 5 patients diagnosed between 14 ~16 gestational weeks continued the pregnancies .One case had hysterectomy due to placenta accrete bleeding and stillbirth in 23 gestational weeks .Four cases were treated by cesarean delivery between 27 to 32 weeks, in which three newborns survived .Conclusion Cesarean scar pregnancy is one kind of serious complications of cesarean delivery .Every case should receive individualized treatment .Though continuing the cesarean scar pregnancy is possible to have a live newborn ,but the risk of hysterectomy due to placenta accrete bleeding increases.%目的:探讨剖宫产瘢痕妊娠( cesarean scar pregnancy ,CSP)临床诊治方法及结局。方法收集2012年1月至2014年12月厦门大学附属第一医院70例CSP患者的临床资料并作回顾性分析。结果70例诊断为CSP的患者孕周为5~16周,孕周≤12周的65例患者选择终止妊娠,其中24例行子宫动脉栓塞+刮宫术,6例行经阴道病灶切除术,3例行宫腔镜手术,4例行腹腔镜手术,20例药物治疗配合刮宫术,8例单纯药物治疗,均达到治愈目的,无1

  7. 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

  8. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Science.gov (United States)

    Auler, José Otavio C.; Torres, Marcelo L. A.; Cardoso, Mônica M.; Tebaldi, Thais C.; Schmidt, André P.; Kondo, Mario M.; Zugaib, Marcelo

    2010-01-01

    BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia. PMID:20835557

  9. Clinical evaluation of the flotrac/vigileo™ system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study

    Directory of Open Access Journals (Sweden)

    José Otavio Costa Auler Junior

    2010-06-01

    Full Text Available BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo™ system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo™ system in patients undergoing spinal anesthesia for elective cesarean section. METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements, after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia, at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis. RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01. Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001 and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time. DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.

  10. Abruptio Placentae in Subsequent Pregnancy after Conservative Management of Hemorrhagic Cesarean Scar Pregnancy by Transcatheter Arterial Chemoembolization

    OpenAIRE

    Akihiro Takeda; Sanae Imoto; Hiromi Nakamura

    2013-01-01

    Introduction Cesarean scar pregnancy is a rare but dangerous type of ectopic pregnancy in which implantation occurs within the fibrous tissue of a cesarean scar defect. Conservative management of cesarean scar pregnancy is challenging, especially when future fertility preservation is a significant concern. Furthermore, reports on significant maternal morbidity in subsequent pregnancies after successful conservative management of cesarean scar pregnancy are limited. Case report A 31-year-old w...

  11. Risk of postpartum urinary incontinence associated with pregnancy and mode of delivery

    DEFF Research Database (Denmark)

    Foldspang, Anders; Hvidman, Lone; Mommsen, Søren;

    2004-01-01

    Aim.  The aim was to estimate the postpartum urinary incontinence (PP UI) impact of precursory UI during pregnancy (PR UI) and delivery performed by cesarean section (CS) vs. vaginal childbirth (VC). Methods.  Among the members of two population samples, in total 8610 women aged 20–59 years, 1232...

  12. Obstetrical Mode of Delivery and Childhood Behavior and Psychological Development in a British Cohort

    Science.gov (United States)

    Curran, Eileen A.; Cryan, John F.; Kenny, Louise C.; Dinan, Timothy G.; Kearney, Patricia M.; Khashan, Ali S.

    2016-01-01

    The association between mode of delivery [specifically birth by Cesarean section (CS)] and induction of labor (IOL) psychological development at age 7 was assessed [including autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and behavioral difficulties]. The Millennium cohort study, a nationally representative UK…

  13. The effects of delivery type and gender on intraocular pressure and central corneal thickness in newborns

    Directory of Open Access Journals (Sweden)

    Zeynep Gursel Ozkurt

    2016-04-01

    Full Text Available ABSTRACT Purpose: To analyze intraocular pressure (IOP and central corneal thickness (CCT in newborns during the first 12 h of life. Methods: Forty-three newborns born by vaginal delivery (VD and 30 newborns born by cesarean section (CS were evaluated. IOP and CCT were measured using Tono-Pen and handheld pachymeter, respectively, at both the 5th minute after delivery and at the 12th h of life. Results: The mean IOP for the VD group was significantly higher than that of the CS group at both the 5th minute and 12th h (p =0.042 and p =0.018, respectively. In both groups, the IOP decreased by the 12th h, but the decrease was only significant for the CS group (p =0.020. The decrease in CCT over the 12 h was significant for both groups (p <0.001. In the VD and CS groups, the IOP values of the males were significantly higher than those of the females at the fifth minute only (p =0.024 and p =0.043, respectively. No other values were significantly different between the genders. Conclusions: Newborn IOP is affected by the mode of delivery and gender. A higher IOP was found in vaginally delivered newborns than in CS newborns for at least 12 h postpartum. CCT showed a significant decline within 12 h. Male newborns have significantly higher IOP values in the first minutes of life.

  14. Delivery type not associated with global methylation at birth

    Directory of Open Access Journals (Sweden)

    Virani Shama

    2012-06-01

    Full Text Available Abstract Background Birth by cesarean delivery (CD as opposed to vaginal delivery (VD is associated with altered health outcomes later in life, including respiratory disorders, allergies and risk of developing type I diabetes. Epigenetic gene regulation is a proposed mechanism by which early life exposures affect later health outcomes. Previously, type of delivery has been found to be associated with differences in global methylation levels, but the sample sizes have been small. We measured global methylation in a large birth cohort to identify whether type of delivery is associated with epigenetic changes. Methods DNA was isolated from cord blood collected from the University of Michigan Women’s & Children Hospital and bisulfite-converted. The Luminometric Methylation Assay (LUMA and LINE-1 methylation assay were run on all samples in duplicate. Results Global methylation data at CCGG sites throughout the genome, as measured by LUMA, were available from 392 births (52% male; 65% CD, and quantitative methylation levels at LINE-1 repetitive elements were available for 407 births (52% male; 64% CD. LUMA and LINE-1 methylation measurements were negatively correlated in this population (Spearman’s r = −0.13, p =0.01. LUMA measurements were significantly lower for total CD and planned CD, but not emergency CD when compared to VD (median VD = 74.8, median total CD = 74.4, p = 0.03; median planned CD = 74.2, p = 0.02; median emergency CD = 75.3, p = 0.39. However, this association did not persist when adjusting for maternal age, maternal smoking and infant gender. Furthermore, total CD deliveries, planned CD and emergency CD deliveries were not associated with LINE-1 measurements as compared to VD (median VD = 82.2, median total CD = 81.9, p = 0.19; median planned CD = 81.9, p = 0.19; median emergency CD = 82.1, p = 0.52. This lack of association held when adjusting for maternal age

  15. Disclosing doubtful indications for emergency cesarean sections in rural hospitals in Tanzania

    DEFF Research Database (Denmark)

    Maaløe, Nanna; Bygbjerg, Ib Christian; Onesmo, Rwakyendela;

    2012-01-01

    To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice.......To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice....

  16. A discussion of key values to inform the design and delivery of services for HIV-affected women and couples attempting pregnancy in resource-constrained settings

    Directory of Open Access Journals (Sweden)

    Renee Heffron

    2015-12-01

    Full Text Available Introduction: HIV-affected women and couples often desire children and many accept HIV risk in order to attempt pregnancy and satisfy goals for a family. Risk reduction strategies to mitigate sexual and perinatal HIV transmission include biomedical and behavioural approaches. Current efforts to integrate HIV and reproductive health services offer prime opportunities to incorporate strategies for HIV risk reduction during pregnancy attempts. Key client and provider values about services to optimize pregnancy in the context of HIV risk provide insights for the design and implementation of large-scale “safer conception” programmes. Discussion: Through our collective experience and discussions at a multi-disciplinary international World Health Organization–convened workshop to initiate the development of guidelines and an algorithm of care to support the delivery of services for HIV-affected women and couples attempting pregnancy, we identified four values that are key to the implementation of these programmes: (1 understanding fertility care and an ability to identify potential fertility problems; (2 providing equity of access to resources enabling informed decision-making about reproductive choices; (3 creating enabling environments that reduce stigma associated with HIV and infertility; and (4 creating enabling environments that encourage disclosure of HIV status and fertility status to partners. Based on these values, recommendations for programmes serving HIV-affected women and couples attempting pregnancy include the following: incorporation of comprehensive reproductive health counselling; training to support the transfer and exchange of knowledge between providers and clients; care environments that reduce the stigma of childbearing among HIV-affected women and couples; support for safe and voluntary disclosure of HIV and fertility status; and increased efforts to engage men in reproductive decision-making at times that align with

  17. Study on the Indications for and Factors Related to Cesarean Section at Three District Hospitals in Shanghai

    Institute of Scientific and Technical Information of China (English)

    Hong LIANG; Li-feng ZHOU; Bing-shun WANG; Ye ZHONG

    2006-01-01

    Objective To understand the indications for and factors related to cesarean section(CS).Methods Pregnant women who attended health examination at three selected district hospitals were investigated from May 2001 to February 2003.Results Among 933 puerperas, the CS rate was 37. 62%. The top four indications for CS were fetal distress (36.5%), social factors (35.9%), relative cephalopelvic disproportion (18.5%) and pregnancy complications (6.3%) respectively. The result of regression analysis showed that puerperas who were overweight before pregnancy,had no confidence in vaginal delivery and had macrosomia were more likely to have CS.Conclusion At present, the CS rate in Shanghai was rather high. The main indications for CS were fetal distress and social factors. The high CS rate was associated with the psychological factor and some demographic factors such as birth weight and puerperas' weight before pregnancy.

  18. 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.

  19. Neurogenic Pulmonary Edema Developing After Cesarean Section

    OpenAIRE

    Güleç, Handan; Babayigit, Münire; Kurtay, Aysun; Tutal, Zehra; Dereli, Necla; Sahin, Saziye; Horasanli, Eyup

    2015-01-01

    Neurogenic pulmonary edema (NPE) is a pathogenesis of pulmonary edema which occurs often in the early period following the acute neurologic changes affecting the central nervous system and proceeds with respiratory failure. It causes respiratory problems requiring intubation in the patient. When evaluated in general terms, the pathophysiology of NPE includes cardiopulmonary dysfunction caused by catecholamines that are secreted rapidly and abundantly. This case study will examine the respirat...

  20. Cesarean scar pregnancy treated by curettage and aspiration guided by laparoscopy

    Directory of Open Access Journals (Sweden)

    Shu S

    2015-08-01

    Full Text Available Shan-rong Shu, Xin Luo, Zhi-xin Wang, Yu-hong Yao Department of Obstetrics and Gynecology, The First Affiliated Hospital of JiNan University, HuangPu Road West, Guangzhou, People’s Republic of China Abstract: Pregnancy in a cesarean scar is the rarest form of an ectopic pregnancy. The treatment for cesarean scar pregnancy mainly includes systemic methotrexate and uterine artery embolization. Here, we reported a case of cesarean scar pregnancy treated by curettage and aspiration guided by laparoscopy. The treatment plan included two phases. Three days after a combination of methotrexate and mifepristone was administered, the gestational sac was removed under laparoscopy, which enabled a successful treatment for the unruptured ectopic pregnancy in a previous cesarean scar and made it possible to preserve the reproductive capability of the patient. Keywords: cesarean scar pregnancy, laparoscopy, curettage and aspiration 

  1. Representações e experiências das mulheres sobre a assistência ao parto vaginal e cesárea em maternidades pública e privada Women's representations and experiences with vaginal and cesarean delivery in public and private maternity hospitals

    Directory of Open Access Journals (Sweden)

    Andréa de Sousa Gama

    2009-11-01

    Full Text Available Este estudo analisa as diferentes representações e experiências quanto ao parto vaginal e cesárea de mulheres de diferentes estratos sócio-econômicos, bem como a natureza das relações profissionais de saúde/usuárias no contexto institucional em que estão inseridas. A pesquisa de natureza qualitativa foi desenvolvida em três maternidades do Município do Rio de Janeiro, Brasil, sendo uma pública, uma conveniada com o SUS e uma particular, com mulheres que tiveram os dois tipos de parto. Os resultados revelam que o modelo de organização dos serviços público e privado apresentam variações que produzem diferentes tipos de assistência e de relação entre os profissionais de saúde e as usuárias, dando forma a experiências distintas entre as mulheres pesquisadas. Todavia, ao empreendermos uma crítica assentada nas relações de gênero, podemos verificar que o modelo de assistência ao parto permanece submetendo quem deve ser sujeito e reproduzindo o projeto da medicalização - mesmo que este processo se manifeste de formas diferenciadas entre os grupos estudados -, o que reduz o campo da assistência e inviabiliza um lugar de poder diferenciado das usuárias.This study analyzes the different representations and experiences of women from different social classes, including issues related to their relations with hospital staff in different institutional settings. This qualitative study focused on women who had experienced both types of delivery, in three maternity hospitals in Rio de Janeiro, Brazil (one public, one fully private, and another private under an outsourcing agreement with the public health system. The study showed that variations in public and private service models result in different types of delivery care and different relations with staff, and are reflected in different birthing experiences for the women. However, a critical gender perspective shows that in both cases, the service models reproduce the

  2. Abdominal Incisional Endometriosis Following Cesarean Section: Report of 2 Cases

    Directory of Open Access Journals (Sweden)

    Azam Azargoon

    2008-06-01

    Full Text Available Endometriosis is described as the presence of functioning endometrial tissue (glands and stroma outside the uterine cavity. The most common location is within the pelvis. However, extra pelvic endometriosis is a fairly uncommon disorder and difficult to diagnose. It can sometimes occur in a surgical scar. Scar endometriosis is a rare condition and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. It presents as a painful, slowly growing mass in or near a surgical scar. We report two cases of abdominal wall endometriosis following hysterotomy and cesarean section. Consequently the pathogenesis, diagnosis and treatment are discussed.

  3. Responding to refusal of recommended cesarean section: Promoting good parenting.

    Science.gov (United States)

    Malek, Janet

    2016-06-01

    Consideration of what a "good parent" would do in controversial perinatal cases has been largely absent from to ethics literature. This article argues when a cesarean section is required to prevent death or serious disability for a fetus, the pregnant woman has an ethical (although not legal) obligation to undergo that procedure even when she has concerns or conflicting commitments. Further, a clinician may be justified in using persuasive counseling when there is grave harm at stake that the patient has a moral obligation to prevent. This conclusion is tested by exploring its implications in several other analogous controversial contexts. PMID:26803168

  4. [Anesthetic Management of Cesarean Section in a Pregnant Woman with Advanced Tongue Cancer].

    Science.gov (United States)

    Kojima, Mikiko; Yoshie, Kazuka; Shimazaki, Azusa; Ohtsuka, Naoki; Otake, Hiroshi; Koide, Keiko; Sato, Youko

    2016-06-01

    It is very difficult to decide the best time to deliver the baby for a pregnant woman with advanced cancer. We experienced the perioperative and perinatal management of a 39-year-old pregnant woman with advanced tongue cancer. The cancer had already metastasized to the lung and lymph nodes. Furthermore a recurrent thumb-sized tumor was found in her mouth. She had firmly desired to discontinue all anticancer treatment for protecting the fetus. On the other hand, her family could not accept her determination yet. Therefore the medical team was organized with doctors and co-medicals from multiple departments such as gynecology, pediatrics, radiology, oncology, midwife, psychotherapy and anesthesiology. After several conferences including herself and family, finally cesarean section was scheduled for the 30th gestational week. Prepared for unexpected emergency delivery, airway stenosis was ruled out by fiberoptic laryngoscopy and the consent for emergency tracheostomy was obtained. The operation was performed successfully under spinal anesthesia without any severe troubles. Medical care as a team from early phase enabled elaborate observation and preparation through the perioperative and perinatal period. Furthermore, it was efficient to provide satisfaction to the patient and her family as well. PMID:27483663

  5. Investigating the Choice of Delivery Method Type and Its Related Factors in Pregnant Women in Maragheh

    Directory of Open Access Journals (Sweden)

    Asghar Mohammadpourasl

    2009-01-01

    Full Text Available Introduction: In recent years there has been an increase in the trend for cesarean section. Due to surgical complications financial costs and mothers long period of hospitalization vaginal delivery is preferred as a favorite procedure. However womens requests for and tendency toward cesarean is one of the main reasons for this increase. The aim of the present study was to study the choice of the delivery method type and its related factors in pregnant women in Maragheh. Method: In this deh1ive cross - sectional study 250 pregnant women were interviewed in three primary health care centers in Maragheh in September 2006. The questionnaire used in the study included items seeking demographic characteristics fertility history selection of the labor type and its reasons. Chi square and independent t– test were used to analyze the collected data through SPSS software. Results: From 250 women who were selected for the study 179(71.8% selected the natural delivery and 71(28.4% preferred cesarean section. Having a history of cesarean section and referral place for control of pregnancy were significantly associated with selection of the labor type (P

  6. Trinidadian women’s knowledge, perceptions, and preferences regarding cesarean section: How do they make choices?

    Directory of Open Access Journals (Sweden)

    K Mungrue

    2010-11-01

    Full Text Available Kameel Mungrue, C Nixon, Y David, D Dookwah, S Durga, K Greene, H MohammedFaculty of Medical Sciences, Department of Paraclinical Sciences, Public Health & Primary Care Unit, The University of the West Indies, St Augustine, Trinidad and TobagoObjectives: The objective of this study is to determine the awareness of perception and attitude toward cesarean section (CS in a high-user setting.Design and methods: A cross-sectional design using multistage sampling methods was used to select participants from antenatal and postnatal clinics in a primary health care setting in north Trinidad. A multi-item structured questionnaire was designed and administered by in-depth interviews. Sociodemographic data and data about history of previous pregnancies and outcomes and about knowledge and perceptions of CSs were collected from women aged 16 years and older.Results: Of the women who were eligible for entry into the study, 368 participated. However, participants chose not to respond to some questions. The majority of women (46.2% were found to have very little information from which to make informed decisions about selecting CS as the preferred choice of delivery. Their preference was significantly associated with the perception of safety (maternal or fetal death, P = 0.001, difficulty (complications to mother and baby, P = 0.001, and pain (P = 0.001. Notwithstanding, persons who received information from health care professionals (odds ratio [OR], 1.9; confidence interval, 1.50–2.33 were more likely to have high or adequate levels of information about CSs. Data were analyzed using SPSS software, and ORs were calculated using logistic regression.Conclusion: The majority of women attending antenatal and postnatal clinics in north Trinidad were not sufficiently knowledgeable about CS to enable them to make informed choices. In addition, the information obtained was from an unreliable source, emphasizing the need for information on CS to form a component of a

  7. No Pain Labor & Delivery: A Global Health Initiative's Impact on Clinical Outcomes in China.

    Science.gov (United States)

    Hu, Ling-Qun; Flood, Pamela; Li, Yunping; Tao, Weike; Zhao, Peishan; Xia, Yun; Pian-Smith, May C; Stellaccio, Francis S; Ouanes, Jean-Pierre P; Hu, Fengling; Wong, Cynthia A

    2016-06-01

    The availability of labor analgesia is highly variable in the People's Republic of China. There are widespread misconceptions, by both parturients and health care providers, that labor epidural analgesia is harmful to mother and baby. Meanwhile, China has one of the highest cesarean delivery rates in the world, exceeding 50%. The goal of the nongovernmental No Pain Labor & Delivery (NPLD) is to facilitate sustainable increases in vaginal delivery rates by increasing access to safe neuraxial labor analgesia, thereby decreasing the cesarean delivery rate. NPLD was launched in 2008 with the stated goal of improving labor outcome in China by increasing the absolute labor epidural analgesia rate by 10%. NPLD established 10 training centers over a 10-year period. We hypothesized that increased availability of labor analgesia would result in reduced requests for cesarean delivery and better labor outcomes for mother and baby. Multidisciplinary teams of Western clinicians and support staff traveled to China for 8 to 10 days once a year. The approach involved establishing 24/7 obstetric anesthesia coverage in Chinese hospitals through education and modeling multidisciplinary approaches, including problem-based learning discussions, bedside teaching, daily debriefings, simulation training drills, and weekend conferences. As of November 2015, NPLD has engaged with 31 hospitals. At 24 of these sites, 24/7 obstetric anesthesia coverage has been established and labor epidural analgesia rates have exceeded 50%. Lower rates of cesarean delivery, episiotomy, postpartum blood transfusion, and better neonatal outcomes were documented in 3 impact studies comprising approximately 55,000 deliveries. Changes in practice guidelines, medical policy, and billing codes have been implemented in conjunction with the modernization of perinatal practice that has occurred concurrently in China since the first NPLD trip in 2008. PMID:27195636

  8. 定额付费对剖宫产率影响的实验研究%Experimental Research on the Impact of the Quota Payment on Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    盛红旗

    2012-01-01

    目的:当前剖宫产率过高已成为严重的公共卫生问题.通过该实验来验证定额付费对医院降低剖宫产率的作用,为新医改政策的落实提供实证依据.方法:对参合孕产妇住院分娩实行定额付费,即:不论平产、阴道助产、剖宫产均支付同等数额的住院费用.将定额付费作为实验因素,观察干预组与对照组、干预组实施前后剖宫产率、平均住院费用和死亡率等指标变化.结果:干预地区实施该方法后剖宫产率降低14.08个百分点,平均住院费用降低33.96%.结论:改革付费机制,可以有效改变医院的行为,达到降低剖宫产率、控制费用和提高医疗质量三重目的.%Objective: At present, the high cesarean section rate has become a serious public health problem. In order to decrease it, the research talks about the childbirth payment system reform in some of the fixed hospitals to bring some empirical references for the new health reform. Methods: The research explores to implement the quota payment of childbirth in some hospitals with New Rural Cooperative Medical System. No matter what kinds of child delivery, such as eutocia, vanigal delivery or cesarean section, all adopt designated hospitals, quota payment and compensation, should be charged in the same hospitalization expenses so that medical institutions would be able to reduce the cesarean section without indications to happen to reduce the cesarean section rate and control medical fee increase. Results: After the research, by comparing the data between the experimental and the control group, the cesarean section rate has decreased by 14.08%, and mean hospitalization cost decreased by 33.96%. Conclusion: The payment system reform can be more effective to reduce the cesarean section rate, to balance the interests of patients and hospital, and to increase medical quality.

  9. A comparison of three vasopressors for tight control of maternal blood pressure during cesarean section under spinal anesthesia: Effect on maternal and fetal outcome

    Directory of Open Access Journals (Sweden)

    Neerja Bhardwaj

    2013-01-01

    Results: The umbilical pH was comparable in all the three groups (P > 0.05. The mean SBP from spinal block until delivery was similar over time for all the three groups. The incidence of reactive hypertension was more in group M (P < 0.05 than in group E and group P. Total drug consumption to meet target blood pressure till delivery was 39.3 ± 14.6 mg in group E, 1.7 ± 0.9 mg in group M, and 283.6 ± 99.8 mcg in group P. The incidence of nausea and vomiting was comparable in the three groups. Conclusion: All the three vasopressors were equally effective in maintaining maternal blood pressure as well as umbilical pH during spinal anesthesia for cesarean section without any detrimental effects on fetal and maternal outcome.

  10. Intraperitoneal bladder rupture after normal vaginal delivery, case report

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    S. Peyvandi

    2006-01-01

    Full Text Available Injuries to the genitourinary organs are complications of vaginal delivery. We report a patient with no history of surgery presented 4 days postpartum with distended tender abdomen and peritoneal sign and renal failure. Abdominal X-Ray showed a large amount of ascites. In laparotomy 3.5 liter of urine was in cavity and laceration of 3 cm in the dome of bladder was seen. Repair was done. By reviewing the record, this is the fourth case of bladder rupture after normal vaginal delivery without previous history of cesarean section. In the postpartum patient presenting with ascites and azotemia, intraperitoneal bladder rupture should be suspected.

  11. Pregnancy and Delivery in Ehlers-Danlos Syndrome (Hypermobility Type: Review of the Literature

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    Indranil Dutta

    2011-01-01

    Full Text Available Ehlers-Danlos syndrome (EDS is a group of connective tissue disorders which are divided into various distinguishable phenotypes. The type of EDS determines the potential obstetric complications. Due to the spectrum of clinical manifestation and overlap between phenotypes, there are no standardised obstetric management guidelines. Existing literature illustrates different obstetric management in hypermobility type of EDS, including uneventful term vaginal deliveries as well as preterm cesarean section deliveries. This paper discusses obstetric management of a woman with EDS hypermobility type. Cesarean section was deemed the most appropriate delivery method in this patient due to the possible complications including risk of joint dislocation and pain morbidity. No obstetric complications were experienced, and good maternal and neonatal outcomes were achieved.

  12. Pregnancy and delivery in ehlers-danlos syndrome (hypermobility type): review of the literature.

    Science.gov (United States)

    Dutta, Indranil; Wilson, Helen; Oteri, Odiri

    2011-01-01

    Ehlers-Danlos syndrome (EDS) is a group of connective tissue disorders which are divided into various distinguishable phenotypes. The type of EDS determines the potential obstetric complications. Due to the spectrum of clinical manifestation and overlap between phenotypes, there are no standardised obstetric management guidelines. Existing literature illustrates different obstetric management in hypermobility type of EDS, including uneventful term vaginal deliveries as well as preterm cesarean section deliveries. This paper discusses obstetric management of a woman with EDS hypermobility type. Cesarean section was deemed the most appropriate delivery method in this patient due to the possible complications including risk of joint dislocation and pain morbidity. No obstetric complications were experienced, and good maternal and neonatal outcomes were achieved. PMID:21765833

  13. Interobserver variation in measurements of Cesarean scar defect and myometrium with 3D ultrasonography

    DEFF Research Database (Denmark)

    Madsen, Lene Duch; Glavind, Julie; Uldbjerg, Niels; Dueholm, Margit

    Objectives: To evaluate the Cesarean scar defect depth and the residual myometrial thickness with 3-dimensional (3D) sonography concerning interobserver variation. Methods: Ten women were randomly selected from a larger cohort of Cesarean scar ultrasound evaluations. All women were examined 6......-16 months after their first Cesarean section with 2D transvaginal sonography and had 3D volumes recorded. Two observers independently evaluated “off-line” each of the 3D volumes stored. Residual myometrial thickness (RMT) and Cesarean scar defect depth (D) was measured in the sagittal plane with an interval...... of 1mm across the entire width of the endometrium. RMT was defined as the shortest distance from the scar defect to the uterine serosa among all RMT measures, and D was defined similarly as the largest depth of the scar defect extending from the uterine cavity. The median value for RMT and D for each...

  14. Accidental intrathecal injection of magnesium sulfate for cesarean section

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    Mehryar Taghavi Gilani

    2014-01-01

    Full Text Available Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.

  15. Clear cell carcinoma arising in a Cesarean section scar endometriosis: a case report.

    OpenAIRE

    Park, S W; Hong, S. M.; Wu, H. G.; Ha, S W

    1999-01-01

    Endometriosis of a surgical scar is rare and occurs mainly when a hysterectomy or Cesarean section was performed. We describe a 54-year-old woman with a large suprapubic mass as a definite case of a endomerioid carcinoma developing within the scar endometriosis following Cesarean section. Scar endometriosis, as well as endometriosis at other sites, can turn malignant. Endometrioid carcinoma is the most common histological pattern of malignant tumor arising in endometriosis. But clear cell car...

  16. Mixed endometrioid and serous carcinoma developing in abdominal wall endometriosis following Cesarean section

    Energy Technology Data Exchange (ETDEWEB)

    Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc (Dept. of Radiology and Medical Imaging, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)), email: ddaines@chu-clermontferrand.fr; Bourdel, Nicolas; Canis, Michel (Dept. of Obstetrics and Gynecology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)); Charpy, Cecile (Dept. of Pathology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France))

    2011-06-15

    Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease

  17. Mixed endometrioid and serous carcinoma developing in abdominal wall endometriosis following Cesarean section

    International Nuclear Information System (INIS)

    Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease

  18. Laparoscopic repair of wide and deep uterine scar dehiscence after cesarean section.

    OpenAIRE

    Donnez, Olivier; Jadoul, Pascale; Squifflet, Jean; Donnez, Jacques

    2008-01-01

    OBJECTIVE: To propose a new laparoscopic technique for repair of scar dehiscence after cesarean section. DESIGN: The dehiscent scars were evaluated by ultrasound, hysterography, hysteroscopy, and magnetic resonance imaging. The results were correlated with those after laparoscopic repair. SETTING: University hospital. PATIENT(S): Three patients underwent cesarean section and presented with symptomatic dehiscence at the level of the incision. INTERVENTION(S): Laparoscopic repair of the dehisce...

  19. The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential Oil on Cesarean Postoperative Pain

    OpenAIRE

    Olapour, Alireza; Behaeen, Kaveh; Akhondzadeh, Reza; Soltani, Farhad; al Sadat Razavi, Forough; Bekhradi, Reza

    2013-01-01

    Background Pain is a major problem in patients after cesarean and medication such as aromatherapy which is a complementary therapy, in which the essences of the plants oils are used to reduce such undesirable conditions. Objectives In this study, the effect of aromatherapy using Lavender (Lavandula) essential oil on cesarean postoperative pain was assessed. Materials and Methods In a triple blind, randomized placebo-controlled trial study, 60 pregnant women who were admitted to a general hosp...

  20. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Larsen, Marcus M.; Bharati, Pratyush

    2013-01-01

    This article examines antecedents and performance implications of global delivery models (GDMs) in global business services. GDMs require geographically distributed operations to exploit both proximity to clients and time-zone spread for efficient service delivery. We propose and empirically show...... that service providers who differentiate based on speed of service delivery are likely to set up GDM structures, and that these structures positively affect deal renewal rates if speed is important for clients in selecting vendors. Findings imply that, as co-location becomes less necessary for providing...... digitalized services, time zones increasingly affect....

  1. Chewing Sugar-Free Gum Reduces Ileus After Cesarean Section in Nulliparous Women: A Randomized Clinical Trial

    OpenAIRE

    Mohsenzadeh Ledari, Farideh; Barat, Shanaz; Delavar, Mouloud Agajani; Banihosini, Seyed Zahra; Khafri, Soriya

    2013-01-01

    Background Gum chewing after cesarean section may stimulate bowel motility and decrease duration of postoperative ileus. Objectives The current study assessed the effect of chewing sugar-free gum on the return of bowel function, where cesarean section had been performed in nulliparous women. Materials and Methods In a randomized clinical trial, 60 patients, scheduled for cesarean section were randomly divided in to 2 groups gum-chewing group (n = 30) and control group (n = 30) postoperatively...

  2. Comparison of Adnexal Mass in Women Undergoing Mass Excision During the Antepartum Period and Cesarean Section

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    Nafiseh Saghafi

    2016-05-01

    Full Text Available Objectives: The frequency of adnexal masses in pregnant women ranges from 0.1% to 4%. Selecting the right approach to manage the subsequent intervention remains one of the most controversial challenges among gynecologists. Our aim in this cross-sectional study was to clarify the clinical-pathological differences among the adnexal masses that are excised during either the antepartum period or cesarean section (CS. Methods: In this study, we assessed 11,000 pregnancy cases referred to the Qaem Hospital in the Mashhad University of Medical Sciences, Iran, between 2010 and 2014. In total, 53 pregnant women with adnexal masses (other than non-gynecological mass and ectopic pregnancy were selected for further investigation. We divided patients into two groups (group A and group B. Patients of group A had a diagnosed tumor that was excised antepartum while patients in group B had a mass taken out during CS. We then assembled data based on maternal age, parity, gestational age, surgery type, delivery mode, size and location of the tumor, complications, presentations, histopathological diagnosis, and ultrasonography findings for further analysis. Results: The major proportion of masses (62.3% were excised during CS whereas the remainder (37.7% were removed antepartum. The mean size of the detected tumor for benign and malignant cases was 10.0 cm and 13.8 cm in group A, and 8.0 cm and 9.3 cm in group B, respectively. There was a statistically significant difference observed between patients in the two groups regarding the benign/malignant status of the mass (p = 0.008, its size (p = 0.019 and simplicity/complexity (p = 0.004. Conclusions: The rate of malignant tumors was considerably higher in women who had antepartum mass excision compared to those with mass resection during CS. Also, tumors were larger (and more complex in patients in group A compared to group B.

  3. Evaluation of risk factor and complication of umbilical cord prolapsed in cesarean section

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    Zahra Rezaee

    2015-03-01

    Full Text Available Objectives: Considering the rarity of umbilical cord prolapse (UCP and lack of accurate data about the risk factors and health outcomes, we aimed to evaluate cases of cesarean section (CS due to UCP in order to reduce treatment costs and provide information about the mortality and morbidity associated with this condition. Patients & Methods: Of 35,259 cases of CS performed in four hospitals during 2004-2012, 103 cases of UCP were selected as the case group; on the other hand, 318 cases without UCP were classified as the control group. Information was extracted from patients' records and analyzed by SPSS version 18. Results: Prevalence of UCP was estimated at 0.2%. In the case group, the active phase of labor was reported 1.4 times (81% vs 57%-P<0.00, engagement 8 times (14% vs 2% -P<0.001, transverse presentation 8 times (6% vs 2%-P<0.002, grand multiparity 3.9 times (4% vs 0-P<0.001, oligohydramnios 4.7 times (5% vs. 0-P<0.0001, and polyhydramnios 5.9 times (6% vs 0 - P<0.001. UCP was more prevalent in post-term deliveries (P<0.043. One-minute Apgar score < 7 was 3 times more prevalent in neonates of the case group (P<0.00. Prepartum vaginal bleeding was 4 times more common in the case group, compared to the control group; also, decreased fetal movement and heart rate drop were more prevalent in the case group. Mortality rate was 5.2% in the case group and 1.7% in the control group. Overall, the control group had a better general health at discharge, compared to the case group. Conclusion: A statistically significant correlation was detected between UCP and gestational age, active phase of labor, fetal presentation, engagement, parity, and amniotic fluid volume.

  4. Medical students’ personal choice for mode of delivery in Santa Catarina, Brazil: a cross-sectional, quantitative study

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    Watanabe Tatiane

    2012-07-01

    Full Text Available Abstract Background The increase in overall rates of cesarean sections (CS in Brazil causes concern and it appears that multiple factors are involved in this fact. In 2009, undergraduate students in the first and final years of medical school at the University of Santa Catarina answered questionnaires regarding their choice of mode of delivery. The aim of the study was to evaluate whether the education process affects decision-making regarding the waay of childbirth preferred by medical students. Methods A cross-sectional, quantitative study was conducted based on data obtained from questionnaires applied to medical students. The questions addressed four different scenarios in childbirth, as follows: under an uneventful pregnancy; the mode of delivery for a pregnant woman under their care; the best choice as a healthcare manager and lastly, choosing the birth of their own child. For each circumstance, there was an open question to explain their choice. Results A total of 189 students answered the questionnaires. For any uneventful pregnancy and for a pregnant woman under their care, 8.46% of the students would opt for CS. As a healthcare manager, only 2.64% of the students would recommend CS. For these three scenarios, the answers of the students in the first year did not differ from those given by students in the sixth year. In the case of the student’s own or a partner’s pregnancy, 41.4% of those in the sixth year and 16.8% of those in the first year would choose a CS. A positive association was found between being a sixth year student and a personal preference for CS according to logistic regression (OR = 2.91; 95%CI: 1.03–8.30. Pain associated with vaginal delivery was usually the reason for choosing a CS. Conclusions A higher number of sixth year students preferred a CS for their own pregnancy (or their partner’s compared to first year students. Pain associated with vaginal delivery was the most common reason given for haven chosen

  5. Blood Glucose Alterations in Spinal versus General anesthesia in those undergoing Cesarean Section Delivery

    OpenAIRE

    Alireza Manafi; Habibollah Zakeri; Fatemeh Salahyan; Marzieh Tavassoli; Fahimeh Shekoohi; Roya Kokabi; Sahar Khazforoosh

    2015-01-01

    Introduction: Major body injury or surgery is associated with reproducible metabolic and hormonal responses. Alteration of blood glucose levels is one of the necessary metabolic changes to surgical stress. Surgical techniques and different methods of anesthesia are factors that can help to control and balance the body’s hormones. One of the most effective ways for decline the endocrine-metabolic response is local anesthesia. We conducted this study to compare the measurement of blood glucose ...

  6. Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011

    Science.gov (United States)

    ... 42 or more completed weeks of gestation. Data source and methods This report contains preliminary data from the Natality Data File from the National Vital Statistics System. The vital statistics Natality File includes information ...

  7. Anesthesia of Obese Pregnant Women Undergoing Cesarean Section%肥胖孕妇行剖宫产术的麻醉问题研究

    Institute of Scientific and Technical Information of China (English)

    王丛慧

    2014-01-01

    With the development of social economy and the changing structure of diet, obesity has become a serious threat to human health, and pregnant women are no exception. This kind of patients face more risk and probability of abnormal conditions in the process of completing delivery.This article carries on an elaboration to the pathophysiology of obesity maternal cesarean section anesthesia, anesthetic selection, and perioperative complications to improve this kind of maternal cesarean section anesthesia.%随着社会经济的发展和饮食结构的变化,肥胖已经成为威胁人类健康的一大严重问题,孕妇也不例外。这类患者在分娩过程中,所面临的风险及出现异常情况导致严重并发症的几率大大超出体重正常范围内增加的产妇。文章对肥胖产妇行剖宫产术时麻醉的病理生理改变、麻醉方式的选择、围术期并发症等方面进行了阐述,以期全面探讨此类产妇的剖宫产麻醉问题。

  8. Teaching surgical skills in obstetrics using a cesarean section simulator – bringing simulation to life

    Directory of Open Access Journals (Sweden)

    Venkata Sujatha Vellanki

    2010-12-01

    Full Text Available Venkata Sujatha Vellanki1, Sarath Babu Gillellamudi21Department of Obstetrics and Gynaecology 2Department of General Surgery Kamineni Institute of Medical Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, IndiaPurpose: Cesarean section is the most common surgery performed in obstetrics. Incorporating a simulation model into training provides a safe, low-stress environment in which students can gain skills and receive feedback. The purpose of this study was to determine the effectiveness of obstetrics simulator training for medical students doing their internship.Methods: Twenty-five students posted in the Department of Obstetrics and Gynecology received a formal lecture on cesarean section and demonstration of the procedure on a mannequin in the first week of their internship, The study group (n = 12 practiced their skills on an obstetrics simulator under the direct supervision of a faculty member. The control group received no simulator-based training (n = 13 or further instruction. All students were asked to complete a prevalidated questionnaire to assess their level of confidence in performing the procedure after the educational session.Results: Compared with their peers in the study, students in the simulator group were significantly more likely to define the steps of cesarean section (91% vs 61.5%, and were comfortable in assisting cesarean section (100% vs 46.15% as they were able to identify the layers of abdomen opened during cesarean section. All 12 students reported this as an excellent experience.Conclusion: We were able to construct an inexpensive cesarean section trainer that facilitates instruction in cesarean section technique in a low-stress environment.Keywords: simulation, obstetrics, medical students

  9. 早期干预对剖宫产产妇母乳喂养自我效能的影响%Effect of Early Intervention on Cesarean Section Maternal Breastfeeding Self-efficacy

    Institute of Scientific and Technical Information of China (English)

    赵赞利; 曾娟

    2014-01-01

    Objective To investigate the factors of early intervention after cesarean section on the ef ects of maternal breastfeeding self-ef icacy. Methods Using the questionnaire form to our hospital 290 primiparas were investigated,through "the breastfeeding self ef icacy scale (Chinese version)" (BSES) assessment of maternal self-ef icacy, whether there is difference between vaginal delivery and cesarean section. At the same time through self-designed maternal postpartum questionnaire, analysis the factors of maternal breastfeeding self-ef icacy influence of cesarean section. Results The experimental group of maternal breastfeeding self-ef icacy is higher than that of control group. Conclusion Cesarean section maternal breastfeeding self-efficacy than vaginal delivery; the main influence factors after cesarean section maternal breastfeeding self-ef icacy has the appetite is good or bad, since that insuf icient milk and sleep time.%目的探讨早期干预对剖宫产术后影响产妇母乳喂养自我效能的因素。方法采用调查问卷的形式对我院290例初产妇进行调查,通过叶母乳喂养自信心量表(中文版)》(BSES)评估产妇的自我效能,比较阴道分娩产妇与剖宫产产妇是否存在差异。同时通过自行设计的产妇产后情况调查表,分析影响剖宫产产妇母乳喂养自我效能的因素。结果实验组产妇母乳喂养自我效能高于对照组。结论剖宫产产妇母乳喂养自我效能低于阴道分娩产妇;剖宫产术后产妇母乳喂养自我效能的主要影响因素有食欲的好坏、自认为乳汁不足及睡眠时间。

  10. Cesarean section scar measurements in non-pregnant women using three-dimensional ultrasound

    DEFF Research Database (Denmark)

    Glavind, J; Madsen, Lene Duch; Uldbjerg, N; Dueholm, M

    2016-01-01

    OBJECTIVE: To evaluate intra- and inter-observer agreement in measurements of the cesarean scar niche and the residual myometrial thickness (RMT) using 3-dimensional (3D) transvaginal ultrasonography. STUDY DESIGN: Fifty-eight uterine 3D volumes from women with deep cesarean scar niches were...... evaluated. 3D volumes were obtained six to fifteen months after a primary cesarean section. Evaluation of the 3D volume was performed in a standardized multiplanar view. Two observers independently obtained RMT, cesarean scar niche depth (D), length (L), width (W), and myometrium adjacent to the scar (M.......4 to 4.5. The inter-observer LOAs in mm were as follows: RMT: -3.2 to 4.1; D: -3.3 to 2.2; L: -3.4 to 4.2; W: -3.2 to 4.1; and M: -4.1 to 3.2. CONCLUSIONS: In non-pregnant women, we found rather wide limits of agreement measuring the cesarean section scar niche and myometrium using 3D volumes. Whether...

  11. Expectant management of cesarean scar pregnancy: a case report and a review of literature

    Institute of Scientific and Technical Information of China (English)

    Liu Hai-Yuan; Shi Hong-hui; Liu Zhu-Feng; Leng Jin-hua; Lang Jing-he

    2012-01-01

    Pregnancy in previous cesarean scar is the rarest form of ectopic pregnancy.Little is known about its natural history and optimal management.All literatures except one reported that the expectant treatments for such patients were unsuccessful or led to complication.This paper presents one case of cesarean scar pregnancy (CSP)with expectant management,and discusses the value of this expectant management.The paper also appears a glimpse of the natural courses of certain cesarean scar pregnancies.A 32-year-old woman with a history of cesarean section presented to our outpatient clinic with amenorrhea and bleeding.Sonography and magnetic resonance imaging (MRI) revealed the diagnosis of CSP without viable gestation sac.The patient opted for expectant treatment.We closely monitored the patient with a detailed plan.The patient had mild bleeding during monitoring and her serum β-hCG levels dropped quickly to normal range after seven weeks.She was fully recovered with total absorption of the mixed mass in the scar of the anterior wall of uterus.If patient with CSP has no viable gestation sac and serum β-hCG levels are rapidly decreased,she can be expectantly treated.Such cesarean scar pregnancies may be naturally demised.Patient with CSP should be followed up strictly.Medical or surgical therapy should be considered prior to rupture to remove the gestational sac and retain the patient future fertility.

  12. Effects of a Paternal Participation Program during Cesarean Section on Paternal Infant Attachment

    Directory of Open Access Journals (Sweden)

    Hyun Kyoung Kim

    2013-06-01

    Full Text Available PurposeIn this study effects of a paternal participation program during cesarean section on paternal infant attachment were investigate. The experimental treatment was an integrative nursing intervention to promote father to infant attachment.MethodsStudy design was a non-equivalent control group posttest design. The program consisted of emotional support to spouse and father towards infant attachment immediately following cesarean birth. Participants were 66 men, partners of women with normal full term pregnancy having a cesarean section with spinal or epidural anesthesia, (experimental group, 34; control group, 32. The experiment was carried out from August 1 to October 30, 2010. Control group data were obtained from May 1 to June 30, 2012. Posttest was performed 72 hours after cesarean birth. A self-report questionnaire including a paternal attachment instrument was used. Data were analyzed using t-test, propensity score matching, and analysis of covariance with the SPSS/WIN 18.0 program.ResultsTotal score for paternal infant attachment in the experimental group was significantly higher than the control group (p<.001. After matching, significant differences were found between the two groups through all subcategories. Adjusted mean score for paternal infant attachment verified experimental effects.ConclusionResults indicate that this paternal participation program during cesarean section is effective in improving paternal infant attachment.

  13. Implantation despite an extensive endometrial defect after hysteroscopic resection of symptom-free residual trophoblastic tissue 15 months after cesarean section.

    Science.gov (United States)

    Foth, Dolores; Nawroth, Frank; Isachenko, Eugenia; Valter, Markus; Mallmann, Peter; Schmidt, Torsten

    2002-11-01

    Successful implantation occurred after embryo transfer in the presence of an extensive endometrial defect after hysteroscopic resection of residual trophoblastic tissue 15 months after cesarean section. At the end of hysteroscopic surgery the anterior uterine wall seemed smooth, although ultimately no endometrium was left in that part and in parts of the fundus. Thus implantation is possible even with extensive endometrial defects. Interesting facts in this case were, first, the long symptom-free period with residual trophoblastic tissue in the uterus, and, second, successful implantation, pregnancy, and delivery despite at least 30% of endometrial surface being irreversibly destroyed. We suggest hysteroscopic resection as the method of choice for exact and minimally traumatic removal of especially older residual trophoblastic tissue. PMID:12386371

  14. Cesarean section on maternal request: should it be formally prohibited in Italy?

    Directory of Open Access Journals (Sweden)

    Ugo Indraccolo

    2015-06-01

    Full Text Available BACKGROUND: Cesarean section on maternal request (CSMR could represent an avoidable quota of cesareans. In Italy, this is a topical problem of health-policy, involving ethical, juridical and medical issues. AIM AND METHODS: A 5-questions questionnaire to quantitatively assess the perspectives of medical, juridical and ethical issues of planned CSMR was administered to obstetricians and gynecologists, midwives, lawyers and pregnant women. It was assessed to what extent those issues matter on the final decision of planning a CSMR. RESULTS: Non-homogeneous answers of stakeholders suggest different perspectives about issues on CSMR. The juridical issue seems to have the greatest impact on the final decision. CONCLUSION: Planning a CSMR associates overall with juridical issues in each group of respondents. Therefore, an obstetrician and gynecologist is unable to counsel a patient on CSMR from a medical point of view. The most direct way for reducing cesareans in Italy could be the formal prohibition of CSMR.

  15. Role of non-descent vaginal hysterectomy in previous cesarean section scar women

    Directory of Open Access Journals (Sweden)

    Naina Kumar

    2015-06-01

    Results: Total ten cases were selected for NDVH with history of one, two/ three cesarean sections. All successfully underwent NDVH, except one in which bladder injury occurred which was repaired at same time from below. Five patients had previous one Lower Segment Cesarean Section (LSCS, four had two LSCS and one had three LSCS. Commonest indication was leiomyoma of uterus followed by abnormal uterine bleeding. Mean duration of surgery was 50 +/- 20.5 min. Mean blood loss was 150 +/- 65 ml. Post-operative complications were minimal with no scar, patient mobility, resumption of daily activities was fast. Mean hospital stay was 4-5 days. Conclusions: Vaginal hysterectomy appears to be safe, cost effective alternative to abdominal hysterectomy in women with previous cesarean section scar requiring hysterectomy for benign conditions with fewer complications, shorter hospital stay. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 785-789

  16. Uterine arterial chemoembolization combined with curettage for the treatment of cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To evaluate uterine arterial chemoembolization combined with curettage in treating cesarean scar pregnancy. Methods: Super-selective bilateral uterine arterial catheterization and angiography was performed in 64 patients with cesarean scar pregnancy (duration of amenorrhea 43-84 days), which was followed by arterial infusion of MTX and embolization with Gelfoam particles. Then curettage was carried out. The technical success rate and the therapeutic results were observed and analyzed. Results: Technical success in catheterization and in performing chemoembolization was achieved in all 64 patients. The pregnant tissues were successfully cleared away in 62 patients. The average blood loss during curettage procedure was 21.4 ml. For the remaining two patients lesion resection together with repair of lower segment was employed. No severe complications occurred after the treatment. Conclusion: Uterine arterial chemoembolization combined with curettage is a safe,minimally-invasive and effective treatment for cesarean scar pregnancy. It is worth popularizing this technique in clinical practice. (authors)

  17. Perspectives of healthcare providers and HIV-affected individuals and couples during the development of a Safer Conception Counseling Toolkit in Kenya: stigma, fears, and recommendations for the delivery of services.

    Science.gov (United States)

    Mmeje, Okeoma; Njoroge, Betty; Akama, Eliud; Leddy, Anna; Breitnauer, Brooke; Darbes, Lynae; Brown, Joelle

    2016-06-01

    Reproduction is important to many HIV-affected individuals and couples and healthcare providers (HCPs) are responsible for providing resources to help them safely conceive while minimizing the risk of sexual and perinatal HIV transmission. In order to fulfill their reproductive goals, HIV-affected individuals and their partners need access to information regarding safer methods of conception. The objective of this qualitative study was to develop a Safer Conception Counseling Toolkit that can be used to train HCPs and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. We conducted a two-phased qualitative study among HCPs and HIV-affected individuals and couples from eight HIV care and treatment sites in Kisumu, Kenya. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) to assess the perspectives of HCPs and HIV-affected individuals and couples in order to develop and refine the content of the Toolkit. Subsequently, IDIs were conducted among HCPs who were trained using the Toolkit and FGDs among HIV-affected individuals and couples who were counseled with the Toolkit. HIV-related stigma, fears, and recommendations for delivery of safer conception counseling were assessed during the discussions. One hundred and six individuals participated in FGDs and IDIs; 29 HCPs, 49 HIV-affected women and men, and 14 HIV-serodiscordant couples. Participants indicated that a safer conception counseling and training program for HCPs is needed and that routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. They also reported that the Toolkit may help dispel the stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Additional research is needed to evaluate the Safer Conception Toolkit in order to support its implementation and use in HIV care and

  18. 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.

  19. 剖宫产术后腹壁切口愈合不良的原因分析并护理对策%Abdominal Incision Healing after Cesarean Cause Analysis and Nursing Countermeasures

    Institute of Scientific and Technical Information of China (English)

    孙琳

    2013-01-01

    随着我国科技的快速发展以及社会因素、剖宫产手术技术的提高,广大的孕妇对于剖宫产分娩出来胎儿的方法已普遍接受。随着剖宫产率的增高,人们关注的重点反而不是剖宫产,而是在剖宫产后相关并发症,这其中主要是剖宫产术后腹壁切口愈合不良,主要的症状有切口脂肪液化、切口裂开、切口感染等,这些并发症的产生对孕妇及其家属的精神上、身体上、工作上以及经济上都造成了不同程度的损害。如果并发症发生严重情况,甚至会对产妇的生命造成威胁。与此同时,产科的医生所受到的压力也增加起来,而且病床周转率也随之降低。笔者根据本院一些临床实例对剖宫产术后腹壁切口愈合不良的原因进行分析,以此为临床提供能够有效预防与控制剖宫产术后腹壁切口愈合不良以及对愈合不良切口的处理方法。%Along with our country the rapid development of science and technology and social factors,cesarean section operation technology improves,the majority of pregnant women for cesarean delivery out the fetus is widely accepted,with the increase of cesarean section rate. The focus instead of cesarean section,but in cesarean section postpartum complications became the focus of attention of the people and obstetrics. The priority among priorities is the abdominal wall after cesarean section incision healing bad,the main symptoms are incision fat liquefaction,incision dehiscence,infection of incisional wound,these complications of pregnant women and their families,the mental body,work and the economy have caused varying degrees of damage. If complications occur serious,even for the women’s lives impact. At the same time,obstetric doctors by the pressure increased,and the bed turnover rate decreased. The following according to the hospital clinical examples to analyze the cause of abdominal wall incision poor healing after cesarean

  20. Combined spinal-epidural analgesia in labour: its effects on delivery outcome

    Directory of Open Access Journals (Sweden)

    Suneet Kaur Sra Charanjit Singh

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n = 55 or Non-CSE (n = 55 group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%. The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5 min was similar in both groups. CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

  1. Successful management of maternal factor VII deficiency in a cesarean section.

    Science.gov (United States)

    Lee, Young-Jae; Ju, Da-Hye; Yi, Sang-Wook; Lee, Sang-Soo; Sohn, Woo-Seok

    2014-07-01

    Factor VII (FVII) deficiency is an infrequent hereditary bleeding disorder that can make excessive bleeding in surgical interventions, such as a postpartum hemorrhage in a cesarean section. Although a recombinant form of activated FVII has been applied for bleeding control in FVII-deficient patients, its applications in the field of obstetrics are still limited, especially in Korea. Replacement of blood products is still preferred as first-line therapy, with antifibrinolytic agents used as adjunctive therapy. We report herein the case of a successful cesarean section in an 18-year-old woman with FVII deficiency. PMID:25105106

  2. Giant uterine artery pseudoaneurysm after a missed miscarriage termination in a cesarean scar pregnancy

    OpenAIRE

    Mou, Yun; Xu, Yuezhen; Ying HU; Jiang, Tianan

    2014-01-01

    Background Uterine artery pseudoaneurysms are dangerous and can lead to severe hemorrhage. We report an uncommon cause of a giant pseudoaneurysm in a missed miscarriage in a woman with a cesarean scar pregnancy. Case presentation The patient was a 25-year-old Chinese woman with a missed miscarriage in a cesarean scar pregnancy. Curettage was performed under ultrasound monitoring. A uterine artery pseudoaneurysm measuring 71 × 44 × 39 mm was detected the next day by Doppler ultrasonography. Wh...

  3. [Anesthetic Management of a Patient with Langerhans Cell Histiocytosis during Cesarean section].

    Science.gov (United States)

    Ishii, Erika; Takaenoki, Yumiko; Shizukuishi, Masaaki; Fukuda, Isao; Kazama, Tomiei

    2015-04-01

    Langerhans cell histiocytosis is a rare disease, associated with histiocyte increases, and granuloma, in various organs. About 160 patients are reported in Japan. A pregnant patient with a pulmonary Langerhans cell histiocytosis underwent cesarean section under spinal anesthesia. She had repeated pneumothorax with bilateral pulmonary cysts rapidly becoming worse during pregnancy. She was treated with continuous oxygen after 28 weeks of the pregnancy. On 34 weeks of the pregnancy, spinal anesthesia with 0.5% hyperbaric bupivacaine (2 ml) and fentanyl (25 μg) for cesarean section was performed, and provided excellent analgesia without any side-effects. PMID:26419115

  4. Administration of a multistrain probiotic product (VSL#3) to women in the perinatal period differentially affects breast milk beneficial microbiota in relation to mode of delivery.

    Science.gov (United States)

    Mastromarino, Paola; Capobianco, Daniela; Miccheli, Alfredo; Praticò, Giulia; Campagna, Giuseppe; Laforgia, Nicola; Capursi, Teresa; Baldassarre, Maria E

    2015-01-01

    Probiotic supplementation to a mother during the perinatal period can have a positive impact on the breast milk composition. The aim of our study was to evaluate the effect of oral supplementation with the probiotic VSL#3, during late pregnancy and lactation, on breast milk levels of beneficial bacteria and some functional components (oligosaccharides and lactoferrin) potentially able to have a positive influence on the microbiota. Breast milk microbiota was analyzed by conventional and quantitative real-time PCR. In a double-blind, placebo-controlled, randomized trial, 66 women took daily either the probiotic (n=33) or a placebo (n=33). Intergroup analysis demonstrated that the amounts of both lactobacilli and bifidobacteria were significantly higher in the colostrum and mature milk of the mothers taking VSL#3 in comparison to those taking placebo. The analysis of bacterial strains and species present in breast milk of VSL#3 supplemented mothers indicated that the administered probiotic microorganisms did not pass from maternal gut to mammary gland. In women with vaginal delivery, significantly higher amounts of lactobacilli and bifidobacteria were detected in colostrum and mature milk of probiotic treated group in comparison to placebo group, whereas no significant difference was observed between groups in women who had caesarean section, neither in colostrum nor in mature milk. Milk levels of oligosaccharides and lactoferrin were similar in placebo and probiotic supplemented groups at all timepoints and regardless of the mode of delivery. Our results indicate a probiotic-dependent modulation of breast milk microbiota in vaginally delivering women, possibly exerted through a systemic effect. PMID:25836922

  5. Humerus Diaphysis Fracture in a Newborn during Vaginal Breech Delivery.

    Science.gov (United States)

    Kaya, Baris; Daglar, Korkut; Kirbas, Ayse; Tüten, Abdullah

    2015-01-01

    While most obstetricians are familiar with fracture of the clavicle in newborns during birth, an unlucky minority of obstetricians has encountered long-bone fractures in newborns as well. This complication is traumatic not only for the neonate, but also for the family and the obstetrician; it is also difficult to explain. Fortunately, the long-term prognosis for fracture of the long bones is excellent. Both vaginal and cesarean breech deliveries and maneuvers can be responsible for birth traumas, including long-bone fractures. This case report presents a newborn with breech presentation delivered vaginally that resulted in humerus diaphysis fracture. PMID:26770851

  6. Dexmedetomidine for an awake fiber-optic intubation of a parturient with Klippel-Feil syndrome, Type I Arnold Chiari malformation and status post released tethered spinal cord presenting for repeat cesarean section

    Directory of Open Access Journals (Sweden)

    Tanmay H. Shah

    2011-08-01

    Full Text Available Patients with Klippel-Feil Syndrome (KFS have congenital fusion of their cervical vertebrae due to a failure in the normal segmentation of the cervical vertebrae during the early weeks of gestation and also have myriad of other associated anomalies. Because of limited neck mobility, airway management in these patients can be a challenge for the anesthesiologist. We describe a unique case in which a dexmedetomidine infusion was used as sedation for an awake fiber-optic intubation in a parturient with Klippel-Feil Syndrome, who presented for elective cesarean delivery. A 36-yearold female, G2P1A0 with KFS (fusion of cervical vertebrae who had prior cesarean section for breech presentation with difficult airway management was scheduled for repeat cesarean delivery. After obtaining an informed consent, patient was taken in the operating room and non-invasive monitors were applied. Dexmedetomidine infusion was started and after adequate sedation, an awake fiberoptic intubation was performed. General anesthetic was administered after intubation and dexmedetomidine infusion was continued on maintenance dose until extubation. Klippel-Feil Syndrome (KFS is a rare congenital disorder for which the true incidence is unknown, which makes it even rare to see a parturient with this disease. Patients with KFS usually have other congenital abnormalities as well, sometimes including the whole thoraco-lumbar spine (Type III precluding the use of neuraxial anesthesia for these patients. Obstetric patients with KFS can present unique challenges in administering anesthesia and analgesia, primarily as it relates to the airway and dexmedetomidine infusion has shown promising result to manage the airway through awake fiberoptic intubation without any adverse effects on mother and fetus.

  7. Pregnancy and delivery in Leyden-Möbius muscular dystrophy. Case Report.

    Science.gov (United States)

    Vavrinkova, Blanka; Binder, Tomas

    2015-01-01

    Leyden-Möbius muscular dystrophy is an autosomal recessive hereditary disease of unknown aetiology; it is a congenital disorder of protein metabolism primarily affecting proximal muscle groups leading to progressive muscular dystrophy. It later spreads to the muscles of the pelvic floor and lower extremities. The estimated incidence is 1:200,000. This paper describe a case of pregnancy and delivery in woman with progressive Leyden-Moebius muscular dystrophy. Cesarean section was performed due to progression of the underlying disease. First postoperative day DIC occure and surgical revision of abdominal cavity was performed. Although the uterine suture was strong, diffuse bleeding was present. Blood was not coagulating. Supravaginal amputation of the uterus was performed including left-sided adnexectomy due to bleeding from the left ovarium. Due to the severity of the condition and assumed necessity of long-term controlled ventilation, the patient was transferred to the intensive medicine department. She was dismissed home after 91 days of hospitalisation. Gravidity in advanced muscular dystrophy is rare and associated with a high risk. Due to muscle weakness, diaphragm weakness, atrophy of individual muscle groups, spine deformities and often dislocation of thoracic organs, these patients cannot avoid the caesarean section to end their pregnancy, followed by prolonged intubation and controlled ventilation. During pregnancy, the growing uterus elevates the diaphragm and impairs breathing. Therefore, pregnancies in such patients will probably always have to be ended prematurely. PMID:26313391

  8. Clinical research of 70 cases of myomactomy performed during cesarean section%剖宫产术同期行子宫肌瘤剔除术70例临床研究

    Institute of Scientific and Technical Information of China (English)

    董英

    2011-01-01

    目的:探讨妊娠合并子宫肌瘤在剖宫产术中同时行肌瘤剔除术的可行性及安全性.方法:回顾性分析2006年2月~2010年1月我院收治的70例妊娠合并子宫肌瘤在剖宫产术时同期行肌瘤剔除术的患者,并与70例妊娠单纯剖宫产术患者的临床资料作对比.结果:剖宫产术时同期行肌瘤剔除术组手术时间较对照组延长(P<0.05).但两组平均术中估算出血量、产后48 h出血量、术后血红蛋白下降值、术后并发症、术后肠蠕动恢复时间、手术切口愈合时间等观察指标差异无统计学意义(P>0.05).结论:剖宫产术时同期行子宫肌瘤剔除术有必要且安全可行,解除了患者的生理疾病、心理压力,减轻了经济负担.%Objective: To approach the feasibility and safety myomactomy performed during cesarean section. Methods:Retrospective analysis of 70 pregnant women collected from February 2006 to January 2010 in our hospital. 70 women received myomactomy during cesarean section which were compared with 70 women with simple cesarean section. Results:Cesarean section group simultaneously myomectomy operation time longer than the control group (P<0.05), but the estimate blood loss, blood loss 48 hours of delivery, decreased postoperative hemoglobin value, postoperative complications, postoperative intestinal peristalsis time, the postoperative incision healing time was no significant difference (P>0.05). Conclusion: Myomactomy during cesarean section is safe and feasible, can relieve the patients' physical sickness and psychological distress, lessen the financial burden.

  9. Effects of LI4 Acupressure on length of delivery time, some of physiologic responseEffects of LI4 Acupressure on Length of Delivery Time, Mothers’ Physiologic Physiologic Responses and Newborn’s Apgar Scores s and Apgar scores in women during of labor

    OpenAIRE

    azam hamidzade; Farangis Shahpourian; Roohangiz Jamshidi- Orak; Mahbobe Pourheydar

    2010-01-01

    Introduction: Prolonged labor has been associated with cesarean delivery and low Ph cord blood. Furthermore, hemorrhage and infection, which are strongly associated with long labor, are leading causes of maternal death. Due to the importance of duration of labor, this study investigates the effects of Hego (LI4) acupressure on length of delivery time, mothers’ physiological responses i.e., respiration and pulse rates of mothers, and Apgar scores of newborns. Methods: In this randomized clinic...

  10. 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

  11. Thigh oxygen uptake at the onset of intense exercise is not affected by a reduction in oxygen delivery caused by hypoxia

    DEFF Research Database (Denmark)

    Christensen, Peter Møller; Nordsborg, Nikolai Baastrup; Nybo, Lars;

    2012-01-01

    the onset of intense exercise during acute exposure to hypoxia. Six healthy male subjects (25.8 ± 1.4 yr, 79.8 ± 4.0 kg, means ± SE) performed intense (100 ± 6 watts) two-legged knee-extensor exercise for 2 min in normoxia (NOR) and hypoxia [fractional inspired oxygen concentration (Fi(O(2))) = 0.......13; HYP]. Thigh Vo(2) was measured by frequent arterial and venous blood sampling and blood flow measurements. In arterial blood, oxygen content was reduced (P <0.05) from 191 ± 5 ml O(2)/l in NOR to 180 ± 5 ml O(2)/l in HYP, and oxygen pressure was reduced (P <0.001) from 111 ± 4 mmHg in NOR to 63 ± 4 mm...... accumulation during the first 25 s of exercise determined from muscle biopsy sampling was also similar (0.35 ± 0.07 and 0.36 ± 0.07 mmol·kg dry wt(-1)·s(-1) in NOR and HYP). Thus the increase in thigh Vo(2) was not attenuated at the onset of intense knee-extensor exercise despite a reduction in oxygen delivery...

  12. Dependent Prior: An Application in Spinal Anaesthesia Drug Therapy on SBP in Cesarean patients.

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    Atanu Bhattacharjee

    2013-12-01

    Full Text Available Cesarean section is widely used operation procedure in the world. The regional anesthesia is preferred than general anesthesia. The risk of fetus is higher in general than in regional anesthesia. The drug treatment effect on regional anesthesia plays an important role to control the systolic blood pressure (SBP during the surgery. The goal of this work is to know the effective drug to control the SBP among cesarean anesthetic patients. The dependent prior with Bayesian approach is applied in the binary response data set. The secondary data in anesthesia has been applied to compare the two drug treatments, viz. (1 Phenylephrine and (2 Ephedrine, in cesarean patients with spinal anesthesia. In both drug groups the mean of SBP has been found controlled over the duration of the surgery. No rapid changes of SBP level among the patients are observed. At the end of study it is found that the means of SBP cesarean anesthetic patients are found higher in Phenylephrine group. The Bayesian dependent prior is found to offer effective tool for drug treatment effect comparison. The drug treatment effect Ephedrine is found to be more effective to control the SBP over the duration of surgery than Phenylephrine.

  13. Prophylactic antibiotics for hysterectomy and cesarean section: amoxicillin-clavulanic acid versus cefazolin

    Directory of Open Access Journals (Sweden)

    Jyoti Malik

    2016-04-01

    Conclusions: Broad spectrum amoxicillin-clavulanic acid was not superior to cefazolin in prevention of post-operative infection when given as prophylaxis in hysterectomy and elective cesarean section. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 980-983

  14. Importance of transesophageal echocardiography in peripartum cardiomyopathy undergoing lower section cesarean section under regional anesthesia

    OpenAIRE

    Kapoor, Poonam Malhotra; Goyal, Sameer; Irpachi, Kalpana; Smita, Barya

    2014-01-01

    Peripartum cardiomyopathy is a relatively rare but life threatening disease. The etiology and pathogenesis of peripartum cardiomyopathy is generally centered upon viral and autoimmune mechanism. This case report describes the anesthetic management of a patient with term pregnancy suffering from dilated peripartum cardiomyopathy planned for cesarean section, successfully managed with epidural anesthesia after precipitate labour.

  15. CT finding of ruptured splenic artery aneurysm after cesarean section : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Chang Woo; Kim, Hee Jin [CHA Medical College, Pundang CHA Gerneral Hospital Sungnam, (Korea, Republic of)

    2000-03-01

    Spontaneous rupture of a splenic artery aneurysm during puerperium is rare and is due to the non-specific clinical appearance, diagnosis is difficult. We describe a case of spontaneous rupture of splenic artery aneurysm after a Cesarean section. CT showed high-density ascites localized in the lesser sac and left retroperitoneum.

  16. Preventive Analgesia with Intravenous Paracetamol for Post-cesarean section Pain Control

    Directory of Open Access Journals (Sweden)

    Simin Atashkhoyi

    2014-02-01

    Full Text Available Objectives: Effective pain therapy after cesarean section is essential for parturient comfort and to allow early ambulation to facilitate care of her infant. This study evaluated the analgesic effect of preventive 1gr intravenous paracetamol on postoperative pain and analgesic consumption during the 24 hours after cesarean section. Materials and Methods: One-hundred American Society of Anesthesiologists (ASA I or II status parturient scheduled for elective cesarean section under spinal anesthesia. Patients received 1gr iv paracetamol into 100 ml normal saline (study group; n=50 or normal saline alone (placebo group; n=50 20 minutes before the end of operation. Results: Pain scores were lower in the study group in the Post anesthesia care unit (PACU (p<0.001 and up to 4h after operation (p<0.001. Cumulative analgesic consumption was lower in the study group (p<0.001. Conclusion: Preventive administration of 1gr iv paracetamol reduces the intensity of pain in the PACU and until 4h after operation and analgesic consumption following cesarean section.

  17. 剖宫产后的妇科问题%Gynecologic Problem of the Cesarean Sections

    Institute of Scientific and Technical Information of China (English)

    鲁东红; 石一复

    2011-01-01

    目的:统计分析剖宫产后的妇科问题.方法:由专人回顾性调查某女职工集中的单位近20年剖宫产后的妇科问题.结果:176例剖宫产中近期产科情况7例,占3.98%;妇科变化142例,占80.68%,其中以月经变化、腹痛腰酸、泌尿系症状、子宫与腹壁粘连、子宫下段切口愈合不良和溃疡、腹壁子宫内膜异位症、肠粘连、异位妊娠和盆腔静脉瘀血症等为主.结论:应严格掌握剖宫产指征,防止剖宫产后的妇科疾病.%Objective:To analyze gynecologic problems after cesarean section. Methods:The gynecologic problems of women after cesarean section, who worked in the same workplace, were investigated retrospectively in 20 years. Results:In 176 cases after cesarean section, 7 cases(3.98%) showed obstetric problems in short-term and 142 cases (80.68%) showed gynecologic problems. The key problems were menstrual change, abdominal pain and lumbago, urologic symptoms, the adhesion between uterus and abdominal wall, infection and ulceration of the uterus incision, endometriosis in abdominal wall, intestinal adhesion, ectopic pregnancy and pelvic congestion syndrome. Conclusion:The indication of cesarean section should be strictly monitored to avoid the gynecologic complications after cesarean section.

  18. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, Tom

    1995-01-01

    scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply......BACKGROUND. The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other. METHODS....... Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...

  19. 50例剖宫产术后产后出血的临床分析%Clinical analysis of cesarean section in 50 cases of postpartum hemorrhage

    Institute of Scientific and Technical Information of China (English)

    班迎芝

    2014-01-01

    目的:探讨剖宫产手术后产后出血的发病时间、发病原因,并找出合适的防治措施。方法:对我院2012年1月-2013年1月收治的50例剖宫产手术后产后出血患者进行回顾性分析,探讨患者的病因和时间。结果:患者的发病原因包括:子宫收缩乏力(常见前置胎盘,胎盘早剥,巨大儿,子痫前期,羊水过多,多胎妊娠),胎盘粘连或胎盘植入等。结论:剖宫产出血多在手术后1-2小时内出现,医生应该在手术过程中减少患者的感染因素,在治疗后对患者进行全方位的护理干预,从而有效减少患者感染现象。%Objective: To investigate postpartum hemorrhage after cesarean delivery time of onset, etiology, and identify appropriate mitigation measures. Methods: Patients with postpartum hemorrhage after my hospital in January 2012 January 2013 50 cases were treated cesarean analyzed retrospectively investigate the cause and time of the patient. Results:The etiology of patients include: uterine atony (common placenta previa, placental abruption, great children, pre-eclampsia, polyhydramnios, multiple pregnancy), placenta accreta or placental implantation. Conclusion: cesarean bleeding within 1-2 hours after surgery, the doctor there should reduce infection factors in patients during surgery, in the treatment of patients with a ful range of nursing interventions, thus effectively reducing the phenomenon of infected patients.

  20. Three-dimensional volumetric gray-scale uterine cervix histogram prediction of days to delivery in full term pregnancy

    OpenAIRE

    Kim, Ji Youn; Kim, Hai-Joong; Hahn, Meong Hi; Jeon, Hye Jin; Cho, Geum Joon; Hong, Sun Chul; Oh, Min Jeong

    2013-01-01

    Objective Our aim was to figure out whether volumetric gray-scale histogram difference between anterior and posterior cervix can indicate the extent of cervical consistency. Methods We collected data of 95 patients who were appropriate for vaginal delivery with 36th to 37th weeks of gestational age from September 2010 to October 2011 in the Department of Obstetrics and Gynecology, Korea University Ansan Hospital. Patients were excluded who had one of the followings: Cesarean section, labor in...

  1. Diversified microbiota of meconium is affected by maternal diabetes status.

    Directory of Open Access Journals (Sweden)

    Jianzhong Hu

    Full Text Available This study was aimed to assess the diversity of the meconium microbiome and determine if the bacterial community is affected by maternal diabetes status.The first intestinal discharge (meconium was collected from 23 newborns stratified by maternal diabetes status: 4 mothers had pre-gestational type 2 diabetes mellitus (DM including one mother with dizygotic twins, 5 developed gestational diabetes mellitus (GDM and 13 had no diabetes. The meconium microbiome was profiled using multi-barcode 16S rRNA sequencing followed by taxonomic assignment and diversity analysis.All meconium samples were not sterile and contained diversified microbiota. Compared with adult feces, the meconium showed a lower species diversity, higher sample-to-sample variation, and enrichment of Proteobacteria and reduction of Bacteroidetes. Among the meconium samples, the taxonomy analyses suggested that the overall bacterial content significantly differed by maternal diabetes status, with the microbiome of the DM group showing higher alpha-diversity than that of no-diabetes or GDM groups. No global difference was found between babies delivered vaginally versus via Cesarean-section. Regression analysis showed that the most robust predictor for the meconium microbiota composition was the maternal diabetes status that preceded pregnancy. Specifically, Bacteroidetes (phyla and Parabacteriodes (genus were enriched in the meconium in the DM group compared to the no-diabetes group.Our study provides evidence that meconium contains diversified microbiota and is not affected by the mode of delivery. It also suggests that the meconium microbiome of infants born to mothers with DM is enriched for the same bacterial taxa as those reported in the fecal microbiome of adult DM patients.

  2. Successful Management of a Cesarean Scar Defect with Dehiscence of the Uterine Incision by Using Wound Lavage

    Directory of Open Access Journals (Sweden)

    Akinori Ida

    2014-01-01

    Full Text Available Cesarean scar defects (CSDs that can be visualized using transvaginal ultrasonography (TVUS may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4 had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months.

  3. A comparison between post-operative analgesia after intrathecal nalbuphine with bupivacaine and intrathecal fentanyl with bupivacaine after cesarean section

    Directory of Open Access Journals (Sweden)

    Hala Mostafa Gomaa

    2014-10-01

    Conclusion: Either intrathecal nalbuphine 0.8 mg or intrathecal fentanyl 25 μg combined with 10 mg bupivacaine provides good intra-operative and early post-operative analgesia in cesarean section.

  4. [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

  5. [The trend in pregnancies terminated by a cesarean operation in Mexico during 1991-1995].

    Science.gov (United States)

    Juárez Ocaña, S J; Fajardo Gutiérrez, A; Pérez Palacios, G; Guerrero Morales, R G; Gómez Delgado, A

    1999-07-01

    In the last decades has been a worldwide trend to increase the number of cesarean sections as an alternative of obstetric resolution, phenomenon for which it was proposed a variety of explanation, this fact remains practically unknown in the institutions of the National Health System (NHS) in Mexico. To identify the trend of the pregnancy to end for cesarean sections during the years of 1991-1995 in the 32 states of de country, as well as of all the institutions of the National Health System. Descriptive, cross sectional and retrospective. We use the data of the Bureau of Statistics and Informatics of de Health Ministry of each one of the 32 states of the country, of the years 1991 to 1995, and of the number of cesarean sections made in the hospitals of the different institutions of the NHS. We started off with a data-base, to calculate frequency tables, and the specific rate of the cesarean section for each year, for each one of the states and institutions of the NHS. We calculate the secular trends using the annual rates of cesarean section, for each one of the states and institutions of the NHS. We also made bivariate analysis and estimated the odds ratio (OR) and 95% Confidence Interval (95% IC); and the statistic X2 for trend, setting the two tailed statistic significance level of 0.05. During the study period, there was 7,503,817 births in all hospitals of the NHS, of these births 1,929,865 (25.72%) was resolved by cesarean section. For the whole period it there was a clear trend to increment of the cesarean section, the rate for 1991 was 20.44%, and by 1995 was 28.58%, the raise for the period was 39.82%, with values of the OR for trend of 1.56; 95% IC (1.55-1.57). "P" PEMEX) and the Marine Ministry (SECMAR), all trends were statistically significant. When the analysis of the cesarean section rates for the 32 states of the Mexican Republic was carried out, we found that in 1995, the national average rate was 28.58%, the lowest rate corresponded to the state

  6. Anesthetic management of parturient with thoracic kyphoscoliosis, malaria and acute respiratory distress syndrome for urgent cesarean section

    Science.gov (United States)

    Pandey, Ravindra Kr; Batra, Meenu M; Darlong, Vanlal; Garg, Rakesh; Punj, Jyotsna; Kumar, Sri

    2015-01-01

    The management of cesarean section in kyphoscoliotic patient is challenging. The respiratory changes and increased metabolic demands due to pregnancy may compromise the limited respiratory reserves in such patients. Presence of other comorbidities like malaria and respiratory tract infection will further compromise the effective oxygenation. We report a case of kyphoscoliosis along with malaria and acute respiratory distress syndrome for urgent cesarean section. PMID:26702219

  7. A Study on Attitude of Pregnant Women with Intention of Elective Cesarean Based on Theory of Planned Behavior

    OpenAIRE

    Fariba Shahraki-Sanavi; Fateme Rakhshani; Ali Navidiyan; Alireza Ansari-Moghaddam

    2012-01-01

    Background: The purpose of this research was to study the attitudes of pregnant women with intention of elective cesarean section, based on the theory of planned behavior. Materials and Methods: This cross-sectional study was carried out on 150 pregnant women in their third trimester of pregnancy with an intention or decision to elective cesarean section, who were selected through probability sampling. The collection tool of information was a questionnaire based on the theory of planned behav...

  8. New Views on Cesarean Section, its Possible Complications and Long-Term Consequences for Children’s Health

    OpenAIRE

    Kulas, Tomislav; Bursac, Danijel; Zegarac, Zana; Planinic-Rados, Gordana; Hrgovic, Zlatko

    2013-01-01

    Historical developments and advancements in cesarean section techniques and logistics have reduced the maternal and neonatal risks associated with the procedure, while increasing the number of operatively completed pregnancies for medically unjustifiable reasons. The uncritical attitude towards cesarean section and the fast emergence of ‘modern’ diseases such as obesity at a young age, asthma, type 1 diabetes mellitus and various forms of dermatitis have stimulated researches associating cesa...

  9. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    BACKGROUND: Preterm infants are at 8 times higher risk than term infants for pre- and perinatal brain damage, resulting in cerebral palsy. In this paper we have analysed the influence of prenatal and birth-related risk factors on cerebral palsy in preterm infants. METHODS: In a register-based study......, 175 preterm singleton infants with cerebral palsy, born in 1982-86, were compared with 687 controls matched by gestational age and year of birth. RESULTS: Statistically significant higher rates in cases were found in parity > or = 3 (22% vs. 16%, p < 0.05), Cesarean section (67% vs. 56%, p < 0...... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  10. The Effect of Vaginal Preparation with Povidone Iodine with Routine Abdominal Preparation on Post Cesarean Infection

    Directory of Open Access Journals (Sweden)

    M. Mirteimoori

    2009-04-01

    Full Text Available Introduction & Objective: The most common complications of cesarean section are post operative fever and endometritis. This study was undertaken to assess the effect of preoperative vaginal preparation with povidone iodine on these complications. Materials & Methods: A double blind clinical trial study was conducted on 430 term singleton pregnant women who referred to obstetric department of Ali Ebne Abitaleb Hospital in Zahedan city in 2006-2007 for elective cesarean. All patients received prophylactic antibiotic after umbilical cord clamping. In the control group (215 cases we did only abdominal scrub, but in the case group (215 cases we did additional vaginal preparation with povidone iodine solution before the beginning of cesarean. The exclusion criteria were: placenta previa, gestational or overt diabetes mellitus, corticosteroids usage, morbid obesity and fever before and at cesarean, presence of bloody or meconium-stained amniotic fluid or prolonged surgery. We investigated the patients after first post operative day until removing surgical sutures for development of febrile morbidity (temperature>38C, clinical symptoms and signs of endometritis (fever persisting in association with uterine tenderness and foul lochia, in the absence of physical or laboratory evidence of other infections, wound inflammation (erythematic or tenderness of wound edges, wound infection (signs of inflammation in association with purulent drainage. The statistical data were analyzed by the SPSS software and P.value <0.05 considered significant. Results: There was no significant differentiation between the two groups regarding socioeconomic situation, weight, age, length, parity and time of operation. The results of our study showed that preparation with povidone iodine in elective cesarean before the beginning of surgery, significantly reduces the post operative fever (13.9% in the control group and 2.3% in the case group, P=0.0001 and post operative

  11. Cesarean section under epidural anesthesia patient shivering in the surgical anesthetic experience to explore%硬膜外麻醉下剖宫产手术中患者寒战的麻醉体会探讨

    Institute of Scientific and Technical Information of China (English)

    姜珍华

    2013-01-01

    Objective To investigate the epidural anesthesia for cesarean delivery in patients with shivering and anesthetic experience. Methods 140 cases were treated in our hospital from March 2010 to March 2012 and epidural anesthesia for cesarean section shivering surgery patients as research subjects. Results Psychological stress too much heat,heat production increased drug toxicity and other main reason for the occurrence of shivering, through the adoption of appropriate measures to deal effectively control the chills. Conclusion The analysis of patients with chills,targeted to take the appropriate measures to control shivering effective measures to help prevent cesarean section under epidural anesthesia shivering.%  目的探讨硬膜外麻醉下剖宫产手术中患者发生寒战的原因及麻醉体会。方法选择该院2010年3月—2012年3月收治的140例硬膜外麻醉下剖宫产手术中出现寒战的患者作为研究对象。结果心理紧张、散热过多、产热增加、药物毒性反应等为发生寒战的主要原因,通过采取相应的处理措施,有效的控制了寒战。结论分析患者发生寒战的原因,有针对性的采取相应措施是控制寒战的有效措施,有助于预防硬膜外麻醉下剖宫产手术中寒战的发生。

  12. [Anesthetic Management of a Pregnant Woman Undergoing Cesarean Section and Intestinal Tract Perforation Restoration].

    Science.gov (United States)

    Takahashi, Kei; Nozawa, Mai; Hashimoto, Yuichi; Arai, Takero; Okuda, Yasuhisa

    2016-04-01

    We describe anesthetic management of a pregnant woman (weight 42 kg, height 147 cm) with ileus, requiring emergency cesarean section and ileus operation. Cesarean section was performed under spinal anesthesia and epidural anesthesia, and ileus operation was performed under total intravenous general anesthesia. During ileus operation, the blood pressure decreased to 60/30 mmHg and the heart rate increased to 140 beats x min, indicating the intestinal traction syndrome. Repeated injections of phenylephrine 0.1 mg and albumin preparation 5% 1,500 ml were required to restore blood pressure. After the operation, the patient's trachea was extubated. The last level of the spinal anesthesia was T6. PMID:27188113

  13. Obstructed Defecation Syndrome After Delivery Trauma

    Science.gov (United States)

    Mehrvarz, Shaban; Towliat, Seyed Mohsem; Mohebbi, Hassan Ali; Heydari, Soleyman; Farahani, Mahdi; Rasouli, Hamid Reza

    2015-01-01

    Background: Obstructed defecation syndrome (ODS) occurs in about 7% of adults; it seems that the etiology of pelvic floor disorders is multifactorial. Pregnancy and childbirth damage to the pelvic nerve and muscles are proposed causes for this condition. The precise role of vaginal delivery (VD) is not clearly defined, although in recent studies association of pelvic floor disorder with Operative vaginal delivery and episiotomy has been proposed. Objectives: In this prospective study, we assessed the outcome of stapled transanal rectal resection (STARR) in females with one of the two modes of delivery (VD or caesarean section (C/S). Patients and Methods: We used Longo’s ODS score for the assessment of the severity of pelvic floor malfunction. Stapled Trans Anal Rectal Resection (STARR) procedure was performed using two circular staplers. Follow-up was done 12 months after the discharge. To assess the role of episiotomy in patient with VD, we divided them into two subgroups; females who had VD with episiotomy (Vd + epi) and females who had VD alone. Data were analyzed using SPSS version 20 software. P values less than 0.05 were considered statistically significant. Results: In 30 consecutive females undergoing STARR for the treatment of ODS, who enrolled in this prospective study, 19 (63.3%) had Vaginal Delivery VD and 11 (36.7%) had Cesarean Section (C/S). The ODS score before the surgery was higher in females who had C/S, although there was no significant difference between VD and C/S groups in terms of the percentage of the ODS score improvement after the STARR surgery. Conclusions: Higher ODS score in females who had C/S showed that C/S could not protect the pelvic organ from pregnancy and delivery trauma. It seems that episiotomy has a protective effect during VD; it can reduce the severity of trauma in pelvic organs during childbearing. PMID:26839863

  14. Factors associated with cesarean sections in a public hospital in Rio de Janeiro, Brazil Fatores associados à realização de cesáreas em uma maternidade pública do Município do Rio de Janeiro, Brasil

    Directory of Open Access Journals (Sweden)

    Eleonora D'Orsi

    2006-10-01

    Full Text Available Brazil has one of the world's highest cesarean section rates. Contributing factors include the organization of obstetric practice, physicians' attitudes, and women's preferences and decisions. This study aimed to identify factors associated with cesarean sections in a public maternity hospital in Rio de Janeiro. A case-control study was conducted with 231 cesarean sections (cases and 230 vaginal deliveries (controls. Hierarchical logistic regression analysis was performed, based on a conceptual model. Factors associated with increased odds of cesarean section were: primiparity; mother's age 20-34; last birth by cesarean; cervical dilatation 41 weeks. Factors associated with lower odds of cesarean were: gestational age O Brasil apresenta uma das maiores proporções de cesáreas do mundo. Fatores contribuintes para este fenômeno incluem organização da prática obstétrica, atitudes dos obstetras, preferências e decisões das mulheres. Com o objetivo de identificar fatores associados à realização de cesáreas, foi realizado estudo de caso-controle em uma maternidade pública do Município do Rio de Janeiro. Incluíram-se 231 partos por cesárea (casos e 230 partos vaginais (controles. Utilizou-se análise multivariada com regressão logística, as variáveis foram incluídas no modelo obedecendo à ordem hierárquica definida em modelo conceitual. Fatores associados à maior chance de cesárea: primiparidade; idade 20-34 anos; último parto por cesárea; dilatação cervical 41 semanas. Fatores associados à menor chance de cesárea: prematuridade; sinais de trabalho de parto ao sair de casa; uso de ocitocina e amniotomia. Propostas de modificação nos fatores estudados podem contribuir para redução da proporção de cesáreas.

  15. 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...

  16. The Effect of Acupressure on Nausea and Vomiting after Cesarean Section Under Spinal Anesthesia

    OpenAIRE

    Heydar Noroozinia; Alireza Mahoori; Ebrahim Hasani; Mohsen Gerami-Fahim; Nariman Sepehrvand

    2013-01-01

    Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S) under spinal anesthesia. In a prospective rand...

  17. PREDICTORS OF ATTITUDE OF PARTURIENTS SELECTED FOR CESAREAN SECTION TOWARD SPINAL ANESTHESIA

    OpenAIRE

    M.R. Afhami; P. Hassanzadeh Salmasi J. Rahimi Panahea

    2004-01-01

    There are many factors contributing to success of regional anesthesia. Patients’ attitude toward spinal anesthesia is one of the most important of these factors. This is a descriptive study performed on 100 healthy parturient selected for elective cesarean section in Alzahra Obstetric Hospital,Tabriz, Iran. The aim of this study was to evaluate patients’ attitude and their knowledge about spinal anesthesia. Patients were selected randomly. Data collection was performed using a questionnaire. ...

  18. Non closure of parietal peritoneum at cesarean section and adhesion formation

    OpenAIRE

    Anjali Choudhary; Neeta Bansal

    2013-01-01

    Background: Cesarean section is the most commonly performed surgery worldwide. Recent times have seen rising trends in c-section rates, for a variety of reasons. Although the basic procedure remains same, some new techniques have been adopted like not closing the visceral or the parietal peritoneum. A large number of studies on merits and demerits of these practices have been published, generating even larger debates. Objective of this effort is to evaluate studies on either side of the argum...

  19. Transient unilateral brachial plexopathy and partial Horner′s syndrome following spinal anesthesia for cesarean section

    Directory of Open Access Journals (Sweden)

    Jonathan A Anson

    2014-01-01

    Full Text Available A healthy 21-year-old primigravida presented for elective cesarean section. At 45 min after intrathecal (IT injection of bupivacaine, morphine and fentanyl she developed dysphagia, right sided facial droop, ptosis and ulnar nerve weakness. This constellation of signs and symptoms resolved 2 h later. Based on the time course and laterality of her symptoms, as well as the pharmacologic properties of spinal opioids, we believe her symptoms can be attributed to the IT administration of fentanyl.

  20. Necrotizing fasciitis of anterior abdominal wall following cesarean section in a low-risk patient

    OpenAIRE

    Chhetry, Manisha; Banerjee, Basudeb; Subedi, Shanti; Koirala, Ashok

    2016-01-01

    We report a case of a mono-microbial post-cesarean necrotizing fasciitis caused by methicillin resistant Staphylococcus aureus, in a low-risk healthy woman who presented with acute fulminant infection, sepsis and features of multi-organ dysfunction syndrome on sixth post-operative day. Aggressive management with multiple surgical debridement and supportive therapy was the key to favorable outcome in this case.

  1. Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section

    OpenAIRE

    Maheshwari, Darshana; Ismail, Samina

    2015-01-01

    Background and Aims: We aimed to measure the frequency of preoperative anxiety in patients undergoing elective cesarean section (CS) and its impact on patients decision regarding the choice of anesthesia. Material and Methods: This cross-sectional study included 154 consecutive patients, who were scheduled for elective CS. Visual analog scale (VAS) for anxiety was the study tool, and VAS ≥50 was considered as significant anxiety. Enrolled patients were interviewed by the primary investigator ...

  2. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

    OpenAIRE

    Sayed Mohammad Reza Hadavi; Elaheh Allahyary; Saman Asadi

    2013-01-01

    Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S) because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS), end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/...

  3. A Comparison of Satisfaction; Spinal versus General Anesthesia for Cesarean Section

    International Nuclear Information System (INIS)

    Objective: To compare the patients satisfaction with spinal and general anesthesia after cesarean section at CMH Lahore. Study Design: Randomized controlled trials. Study Setting: The study was conducted at the department of Obstetrics and Gynaecology combined military Hospital, Lahore, for 6 months from July to Dec 2011. Patients and Methods: Total 70 patients were included in the study and randomly divided into two groups of 35 each using random numbers table. All patients between ages of 20-40 years admitted for elective cesarean section and presented for following up at day 5-7 who never had any type of anesthesia in the past. There included in the study patients with complaints of migraine, low backaches, positive history or any other medical disorder were excluded from the study. Results: A total number of patients included were 70. Out of these selected patients, 35 procedures were carried out under spinal anesthesia and 35 under general anesthesia. Insignificant difference was found in satisfaction level of both the groups (p=0.220). There is significant difference for the future choice between two groups (p<0.001). Conclusion: Spinal anesthesia provides equal satisfaction for patients of cesarean section than general anesthesia. (author)

  4. Comparative Study of Intrathecal Dexamethasone with Epinephrine as Adjuvants to Lidocaine in Cesarean Section

    Directory of Open Access Journals (Sweden)

    Fereshteh Naziri

    2013-09-01

    Full Text Available Background: Different additives have been used with local anesthetics to provide prolonged duration of sensory block in spinal anesthesia. The aim of present study was to evaluate the onset and duration of sensory block of intrathecal dexamethasone and epinephrine as adjuvants to lidocaine in patients who were candidate for cesarean section. Materials and Methods: This double-blind clinical trial research was conducted on 90 pregnant women candidate for cesarean section under spinal anesthesia. Patients were randomly allocated to receive intrathecally either 75 mg hyperbaric lidocaine plus 100 μg epinephrine or 75 mg hyperbaric lidocaine plus 4 mg dexamethasone or 75 mg hyperbaric lidocaine. The onset and duration of sensory block as well as postoperative analgesia were assessed. Results: The time to reach the peak sensory block in lidocaine group was shorter than that of other two groups (p<0.001. Duration of sensory block in the control group, dexamethasone group, and epinephrine group were 64.16±7.99 min, 74.79±12.78 min, and 99.30±10.93 min, respectively (p<0.001. Conclusion: The present research shows that intrathecal dexamethasone and intrathecal epinephrine as adjuvant to lidocaine increases sensory block duration in the women candidate for cesarean section.

  5. Comparison of Intrathecal Dexmedetomidine with Morphine as Adjuvants in Cesarean Sections.

    Science.gov (United States)

    Qi, Xiaofei; Chen, Daili; Li, Gehui; Huang, Xiaolei; Li, Yuantao; Wang, Xiaoguang; Li, Yong

    2016-09-01

    To compare the effects of intrathecal dexmedetomidine and intrathecal morphine as supplements to bupivacaine in cesarean sections under spinal anesthesia. Full-term parturients (n=120) undergoing elective cesarean sections under spinal anesthesia were randomly allocated into three groups: Group B received 10 mg bupivacaine, Group BD received 10 mg bupivacaine plus 5 µg dexmedetomidine, and Group BM received 10 mg bupivacaine plus 100 µg morphine. The onset and regression time of sensory and motor blockade, postoperative analgesia, and side effects were recorded. Group BD showed quicker onset time and a longer sensory and motor blockade than other groups (BD vs. B and BD vs. BM, pshivering was observed in group BD than in groups BM and B (p=0.009). So intrathecal dexmedetomidine (5 µg) prolonged the motor and sensory blockade, provided a similar analgesic effect and reduced pruritus and shivering compared with morphine (100 µg) in cesarean sections. PMID:27349272

  6. Evaluation of the analgesic effect of subcutaneous methadone after cesarean section

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2014-01-01

    Full Text Available Background: Inadequate pain control has a significant role in maternal and neonatal health in early post-partum period which interferes with breastfeeding and has a negative influence on child normal growth. The aim of this study is evaluation of subcutaneous methadone effectiveness on post-operative pain control. Materials and Methods: Double blind randomized prospective clinical trial involving 60 term pregnancy patients through 2008 to 2009 Undergo cesarean. Inclusion criteria: Prime gravid candidate of elective cesarean and spinal anesthesia class 1 or 2. Known case of drug allergy and methadone interaction, addiction, uncontrolled medical disease excluded. Case group injected 10 mg of subcutaneous methadone in the site of incision before final suture. Morphine was a pain reliever in follow up examination. Data include mean of pain, nausea and vomiting, MAP, etc., collected and analyzed by independent-T test and Man Whitney test. Results: Although mean usage of morphine between groups was not significant statistically but the mean pain severity (P value < 0.05 and mean satisfactory (P value = 0.02 was statistically significant between groups. Other parameters were not statistically significant. Conclusion: We suggest subcutaneous methadone as a safe pain reliever in post cesarean section patients.

  7. The application of uterine artery chemoembolization in treating cesarean section scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To discuss the feasibility and safety of uterine artery chemoembolization in treating cesarean section scar pregnancy. Methods: During the period of Jun. 2005-Jun. 2010, uterine artery chemoembolization was performed in 130 patients with cesarean section scar pregnancy in authors' hospital. Via bilateral uterine arteries 100-150 mg MTX and 80 000 u Gentamycin were infused separately, which was followed by the embolization of bilateral uterine arteries with Gelfoam. Of the total 130 patients,coexisted leiomyoma was found in 23 and embolization therapy with PVA microspheres was employed. Curettage of uterus was carried out within 24-72 hours after the procedure. Results: The success rate of bilateral uterine artery chemoembolization was 100%. The blood loss during curettage procedure was 12-110 ml (mean 28.5 ml). No serious complications occurred. Conclusion: The uterine artery chemoembolization is an effective and safe treatment for cesarean section scar pregnancy. This technique can greatly avoid unnecessary uterectomy and, thus, preserve the fertility of the female patients. (authors)

  8. 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

  9. Characteristics of childbearing women, obstetrical interventions and preterm delivery: a comparison of the US and France.

    Science.gov (United States)

    Zeitlin, Jennifer; Blondel, Béatrice; Ananth, Cande V

    2015-05-01

    Preterm delivery rates have remained consistently higher in the US than France, but the reasons for this excess remain poorly understood. We examined if differences in socio-demographic risk factors or more liberal use of obstetrical interventions contributed to higher rates in the US. Data on singleton live births in 1995, 1998 and 2003 from US birth certificates and the French National Perinatal Survey were used to analyze preterm delivery rate by maternal characteristics (age, parity, marital status, education, race (US)/nationality (France), prenatal care and smoking). We distinguished between preterm deliveries with a cesarean or a labor induction and those without these interventions. Unadjusted and adjusted risk ratios (RR) for the US compared to France were estimated using log-binomial regression. Preterm delivery rates were 7.9 % in the US and 4.7 % in France (risk ratio [RR] = 1.7, 95 % confidence interval [CI] 1.6-1.8). The US had more teen mothers and late entry to prenatal care, but fewer women smoked, although adjustment for these and other confounders did not reduce RR (1.8, 95 % CI 1.7-1.9). Preterm delivery rates associated with labor induction or cesarean were 3.3 % in the US and 2.1 % in France (RR 1.6, 95 % CI 1.5-1.7); the corresponding rates for preterm delivery without these interventions were 4.5 and 2.5 % (RR 1.8, 95 % CI 1.7-1.9), respectively. Key socio-demographic risk factors and more obstetric intervention do not explain higher US preterm delivery rates. Avenues for future research include the impact of universal access to health services (universal health insurance?) on health care quality and the association between more generous social policies, stress and the risks of preterm delivery. PMID:25119892

  10. Causation on Cesarean Section and Its Influencing Factors from a First Class Hospital%某三甲医院剖宫产原因及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    郭海玲

    2012-01-01

    section. Conclusion It is an effective control of the cesarean section rate to spread the knowledge of pregnancy and delivery, enhance the benefits of natural childbirth advocacy,reduce the social factors for cesarean section and strictly grasp the indications of caesarean section.

  11. Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

    International Nuclear Information System (INIS)

    To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the fi nal Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

  12. The Effect of Honey Gel on Abdominal Wound Healing in Cesarean Section: A Triple Blind Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Maryam Nikpour

    2014-07-01

    Full Text Available Objective: To assess whether honey can accelerate the wound healing in women undergoing cesarean section. Methods: This was a triple blinded randomized prospective clinical trial. Women with cesarean section were randomly designated as drug (37 cases and placebo (38 cases groups. The drug group received local honey gel 25% while the placebo group received similar free-honey gel on abdominal cesarean incision twice a day for 14 days. REEDA scale (Redness, Edema, Ecchymosis, Discharge and Approximation of wound edges was used to assess wound healing. Results: The mean REEDA was 2.27 ± 2.46 and 3.91 ± 2.74 (p=0.008 on the 7th day and 0.47 ± 0.84 and 1.59± 1.95 (p=0.002 on the 14th day for the drug and placebo groups, respectively. Redness, edema and hematoma in the drug group were significantly lower on the 7th and 14th days. Conclusion: Honey was effective in healing the cesarean section incision. Using topical honey is suggested as a natural product with rare side effects in order to reduce the complications of cesarean wounds.

  13. Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

    Energy Technology Data Exchange (ETDEWEB)

    Kim Ju Ree; Lee, Sang Hoon [Cheil General Hospital and Women' s Healthcare Center, Kwandong University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the fi nal Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

  14. Early clinical analysis of related factors of postpartum hemorrhage after ce-sarean section%剖宫产术后早期产后出血相关因素的临床分析

    Institute of Scientific and Technical Information of China (English)

    高英杰

    2015-01-01

    , according to the different modes of delivery, we selected the clinical data of 512 cases of maternal spontaneous vaginal delivery as the reference group, launches the analysis to explore induced early after cesarean section postpartum hemorrhage related factors. Results 435 cases of cesarean section in 90 cases of mothers appeared in the early postop-erative bleeding problems, accounting for 20.69%, in 90 cases of early bleeding after cesarean section patients, 72 cases of bleed-ing in 500 patients 1000ml, accounting for 80%, the amount of bleeding in 13 patients for 1000ml-2000nl, accounting for 14.4%, the amount of bleeding in 5 patients in 2000ml, accounting for 5.6%, after bleeding and other anti-inflammatory treatment, pa-tients were within 5-9d cured and no deaths; the main factors of postpartum hemorrhage postpartum uterine inertia, placenta, soft birth canal cracks and coagulation disorders and other factors, specifically postpartum uterine inertia 62 cases, accounting for 68.9%, of which 8 cases of twins great children 9 cases, 11 cases of gestational hypertension, placental abruption 7 cases, 10 cases of placenta previa, uterine scar six cases, six cases of drug factors, systemic factors in five cases; 16 cases of placental factors, ac-counting for 17.8%, of which 13 cases of placenta accreta, a little residual membranes three cases, seven cases of soft birth canal cracks, accounting for 7.8%, five cases of clotting disorders, accounting for 5.5%. Conclusion conclusion does not include data, but the research on data description of the problem or the conclusion]:cesarean section postpartum hemorrhage early induced fac-tors more, and postpartum hemorrhage after cesarean section rate and amount of bleeding than vaginal delivery mothers, so to en-hance the preoperative risk factors analysis, good hemostatic measures related to to ensure the safety of maternal life.

  15. The effect of small dose bupivacaine-fentanyl in spinal anesthesia on hemodynamic nausea and vomiting in cesarean section

    International Nuclear Information System (INIS)

    To compare the hemodynamic, nausea and vomiting with small dose bupivacaine-fentanyl spinal anesthetic versus a conventional dose of spinal bupivacaine in parturients undergoing cesarean section. Forty patients aged 17-35 years old which underwent cesarean section were randomized into two groups. Group-A received spinal anesthesia with 8 mg of bupivacaine and 10 microg fentanyl, group B received 12 mg bupivacaine. The mean dose of ephedrine needed was 4mg in group A and 11.75 mg in group B (P=0.006). The mean ratio of lowest systolic pressure to baseline systolic pressure was 0.75 for group A and 0.65 for group B (P=0.04). Nausea and vomiting was observed in 10% of group A versus 20% in group B. Small dose of bupivacaine and fentanyl provides good spinal anesthesia for cesarean section with less hypotension, nausea and vomiting. (author)

  16. Mucoadhesive drug delivery systems

    Directory of Open Access Journals (Sweden)

    Rahamatullah Shaikh

    2011-01-01

    Full Text Available Mucoadhesion is commonly defined as the adhesion between two materials, at least one of which is a mucosal surface. Over the past few decades, mucosal drug delivery has received a great deal of attention. Mucoadhesive dosage forms may be designed to enable prolonged retention at the site of application, providing a controlled rate of drug release for improved therapeutic outcome. Application of dosage forms to mucosal surfaces may be of benefit to drug molecules not amenable to the oral route, such as those that undergo acid degradation or extensive first-pass metabolism. The mucoadhesive ability of a dosage form is dependent upon a variety of factors, including the nature of the mucosal tissue and the physicochemical properties of the polymeric formulation. This review article aims to provide an overview of the various aspects of mucoadhesion, mucoadhesive materials, factors affecting mucoadhesion, evaluating methods, and finally various mucoadhesive drug delivery systems (buccal, nasal, ocular, gastro, vaginal, and rectal.

  17. 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.

  18. Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

    Directory of Open Access Journals (Sweden)

    Giampiero Francica

    2012-01-01

    Full Text Available AIM: To highlight sonographic and clinical characteristics of scar endometrioma with special emphasis on size-related features. METHODS: Thirty women (mean age 30.6 years, range 20-42 years with 33 scar endometriomas (mean diameter 27.1 mm, range 7-60 mm were consecutively studied by Sonography and Color Doppler examination prior to surgery. Pathological examination was available in all cases. RESULTS: The most frequent (24 of 33 nodules, 74% sonographic B-mode aspect of endometrioma was that of an inhomogenously hypoechoic roundish nodule with fibrotic changes (in the form of hyperechoic spots or strands, a peripheral inflammatory hyperechoic ring, spiculated margins and a single vascular pedicle entering the mass at the periphery. On average, 1.6 cesarean sections were recorded per patient (range 1-3. The median interval between the last cesarean section and admission to hospital was 36 mo (range 12-120 mo and the median duration of symptoms before admission was 25.7 mo (range 0.5-80 mo. 13 patients had 13 large endometriomas (≥ 30 mm with a mean lesion diameter of 41.3 ± 9.02 mm (range 30-60 mm. Seventeen women had 20 small endometriomas with a mean lesion size of 18.2 ± 5.17 mm (range 7-26 mm. The mean interval between the last cesarean section and admission to hospital (66.0 mo vs 39.6 mo, P < 0.01 and the mean duration of symptoms before admission (43.0 mo vs 17.4 mo, P < 0.01 were significantly longer in patients with large endometriomas; in addition, a statistically significant higher percentage of patients with large implants had undergone previous inconclusive diagnostic examinations, including either computed tomography/magnetic resonance imaging/fine needle biopsy/laparoscopy (38.4% vs 0%, P < 0.05. On sonography, large endometriomas showed frequent cystic portions and fistulous tracts (P < 0.02, loss of round/oval shape (P < 0.04 along with increased vascularity (P < 0.04. CONCLUSION: Endometrioma near cesarean section scar is

  19. Emergency cesarean section in an epidemic of the middle east respiratory syndrome: a case report

    Science.gov (United States)

    Kim, Hee Ryun; Sung, Ji Hee; Kim, Jong Hwa

    2016-01-01

    Only a few reports have been published on women with an infectious respiratory viral pathogen, such as Middle East Respiratory Syndrome (MERS) Coronavirus delivering a baby. A laboratory confirmed case of MERS was reported during a MERS outbreak in the Republic of Korea in a woman at gestational week 35 + 4. She recovered, and delivered a healthy baby by emergency cesarean section (C-sec). We present the clinical course and the emergency C-sec in a pregnant woman with MERS. PMID:27274377

  20. 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...

  1. The Related Research of the Pregnant Women’s Prenatal Body Mass Index and the Healing Rate of Cesarean Section Grade%孕妇产前体重指数与剖宫产切口甲级愈合率的相关研究

    Institute of Scientific and Technical Information of China (English)

    简洁

    2013-01-01

    目的:探讨孕妇产前体重指数对剖宫产切口甲级愈合率的影响。方法:选取380名孕妇作为研究对象,220例产前BMI≤30者为产前体重正常组,160名产前BMI>30者为产前肥胖组。分析两组剖宫产切口甲级愈合率有无差异。结果:正常组平均体重指数为(26.35±1.98),肥胖组平均体重指数为(31.26±2.21),两组间差异有统计学意义(P30 as the obesity observation group. Analyze the differences of cesarean Grade healing rate between two group.Results:The average BMI in the normal group was (26.35±1.98), The average BMI in the obesity observation group was(31.26±2.21), the difference was statistically significant (P<0.05);The cesarean incision grade healing rate of the normal group was 93.64%, The cesarean incision grade healing rate of the obesity observation group was 83.75%, the difference was statistically significant (P<0.05). Conclusion:Prenatal BMI affects the cesarean incision grade healing rate, obesity affect the healing of the incision.

  2. Premature delivery

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-09-01

    Full Text Available Preterm delivery is the single most important cause of perinatal morbidity and mortality. In Chile, preterm births have increased in the past decade, although neonatal morbidity and mortality attributable to it shows a downward trend, thanks to improvements in neonatal care of premature babies, rather than the success of obstetric preventive and therapeutic strategies. This article describes clinical entities, disease processes and conditions that constitute predisposing factors of preterm birth, as well as an outline for the prevention and clinical management of women at risk of preterm birth.

  3. Post placental copper-T 380A insertion after normal vaginal delivery and cesarean section and its clinical outcome

    Directory of Open Access Journals (Sweden)

    Jyoti Malik

    2016-07-01

    Conclusions: Although there was high incidence of missing IUCD threads (due to coiling of thread, actual expulsion rate was far lesser. Removal rate due to menorrhagia, pain abdomen and vaginal discharge was low and 6 months continuation rate was considerably good. [Int J Reprod Contracept Obstet Gynecol 2016; 5(7.000: 2254-2256

  4. A randomized comparative trial of combinational methods for preventing post-spinal hypotension at elective cesarean delivery

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2011-01-01

    Conclusions: Among the three studied methods, administration of ephedrine plus bandage of the lower extremities was the most effective one in reducing the incidence of post-spinal hypotension. The groups were not clinically different concerning the effect of treatment on newborn health.

  5. Standard medical application of nursing after cesarean section%人本位医疗对剖宫产术后护理的应用

    Institute of Scientific and Technical Information of China (English)

    李娜

    2014-01-01

    Objective To study the standard medical application effect of nursing after cesarean section. Methods According to the person's physical,psychological,social,to meet the requirements of the people the best care.Results Through the standard medical treatment,systematic holistic nursing,abdominal surgery mouth class-a healing rate>99%,the postoperative complication rates recent99%.Conclusion Standard medical systematic holistic nursing is more effective in helping patients smoothly and safely through cesarean delivery after preoperative,postoperative and recovery process,improve the overall quality of obstetrics,so as to promote the hospital technology beneifts,social beneifts and economic beneifts.%目的:探讨人本位医疗对剖宫产术后护理的应用效果。方法根据人的生理、心理、社会、文化、精神等多方面的需要,提供适合人的最佳护理。结果通过人本位医疗,系统化整体护理,腹部术口甲级愈合率>99%,术后近期并发症发生率<1%,母乳喂养成功率>99%,指导饮食成功率>99%,术后6 h内下床活动率>99%。结论人本位医疗系统化整体护理更有效地帮助患者身心平稳、安全地度过剖宫产术前、术后及之后的康复过程,保障母婴安全,降低产妇死亡率和围产儿死亡率,从而提升了医院的技术效益、社会效益、经济效益。

  6. The safe motherhood referral system to reduce cesarean sections and perinatal mortality - a cross-sectional study [1995-2006

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    Rudge Marilza VC

    2011-11-01

    Full Text Available Abstract Background In 2000, the eight Millennium Development Goals (MDGs set targets for reducing child mortality and improving maternal health by 2015. Objective To evaluate the results of a new education and referral system for antenatal/intrapartum care as a strategy to reduce the rates of Cesarean sections (C-sections and maternal/perinatal mortality. Methods Design: Cross-sectional study. Setting: Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University/UNESP, Brazil. Population: 27,387 delivering women and 27,827 offspring. Data collection: maternal and perinatal data between 1995 and 2006 at the major level III and level II hospitals in Botucatu, Brazil following initiation of a safe motherhood education and referral system. Main outcome measures: Yearly rates of C-sections, maternal (/100,000 LB and perinatal (/1000 births mortality rates at both hospitals. Data analysis: Simple linear regression models were adjusted to estimate the referral system's annual effects on the total number of deliveries, C-section and perinatal mortality ratios in the two hospitals. The linear regression were assessed by residual analysis (Shapiro-Wilk test and the influence of possible conflicting observations was evaluated by a diagnostic test (Leverage, with p Results Over the time period evaluated, the overall C-section rate was 37.3%, there were 30 maternal deaths (maternal mortality ratio = 109.5/100,000 LB and 660 perinatal deaths (perinatal mortality rate = 23.7/1000 births. The C-section rate decreased from 46.5% to 23.4% at the level II hospital while remaining unchanged at the level III hospital. The perinatal mortality rate decreased from 9.71 to 1.66/1000 births and from 60.8 to 39.6/1000 births at the level II and level III hospital, respectively. Maternal mortality ratios were 16.3/100,000 LB and 185.1/100,000 LB at the level II and level III hospitals. There was a shift from direct to indirect causes of

  7. Remifentanil at induction of general anesthesia for cesarean section: Double blind, randomized clinical trial

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    Shokoufeh Behdad

    2013-05-01

    Full Text Available Introduction: Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of remifentanil during cesarean section surgery. Methods: Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Society of Anesthesia (ASA, who were undergoing general anesthesia for semi-elective cesarean section were randomized into two groups (40 in each group that received either and intravenous bolus of 0.5 µg/kg remifentanil or the same dose of saline as a placebo. Maternal hemodynamic variables and neonatal umbilical artery pH and Apgar score at first and fifth min were evaluated in both groups. Results: Systolic and diastolic blood pressure were significantly lower after tracheal intubation and skin incision in the remifentanil group as compared with the control group (p<0.05. There were no significant differences regarding heart rate between groups at any time (p>0.05. Apgar scores at first and fifth min were not significantly different among groups (p>0.05. No neonate required assisted ventilation or naloxan administration. Conclusion: Remifentanil may be a safe and effective drug for the induction of general anesthesia and surgical stimulation without subsequent neonatal depression. 

  8. [The incredible story about the cesarean section from ancient times till nowadays].

    Science.gov (United States)

    Zilberlicht, Ariel; Kedar, Reuven; Riskin-Mashiah, Shlomit; Lavie, Ofer

    2014-08-01

    During its evolution the cesarean section has meant different things to different people. The indications for it have changed throughout the course of history. From the initial purpose to retrieve an infant from a dead or dying mother in order to bury the child separately from his mother, to contemporary indications. This article strives to follow the roots of this common procedure--starting from the descriptions in the ancient Greek mythology, through the imperial Roman law, aspects of Judaism and the evolution of the procedure throughout modern history. Major improvements in the surgical techniques, the introduction of anesthesia and aseptic procedures contributed to the decline in mortality and morbidity rates. We will attempt to find the etymology for the expression "cesarean section" which has commonly been accounted to Julius Caesar's name, although history denies it. This review takes us on a historical journey, from ancient times to nowadays, in which we follow the course and nature of a procedure being performed daily in thousands of hospitals. PMID:25286639

  9. Deliveries among diabetic females; a tertiary care experience

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    Qummry Ali Hindi

    2012-10-01

    Full Text Available Objectives: To determine the cesarean section (CS rate in a consecutive series of pregnant women with Diabetes Mellitus. Material and Methods: This retrospective patients’ files review of deliveries happened to diabetic mothers was carried out from 1st January, 2005 to 31st December, 2006 in the department of Obstetrics and Gynecology of Alnoor Specialist Hospital, Makkah, Saudi Arabia. Results: Among all subjects (118, Saudi national women predominated 101(86%. Majority belonged to the age group of 36-40 years, i.e., 38(32% and 52(44% was diagnosed as gestational diabetes mellitus. However, 89(75% of pregnancies were terminated through CS. Conclusion: Majority were delivered by CS.

  10. Analysis of the risk factors of poor healing of uterus incision after cesarean section%剖宫产术后影响子宫切口愈合不良的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    党淼

    2015-01-01

    Objective To analyze the risk factors of poor healing of uterus incision after cesarean section, to provide basis for clinical prevention of uterus poor healing of incision. Methods A total of 968 cases with cesarean section in The Second Affiliated Hospital of Shanxi College of TCM from Apr 2012 to Aug 2014 were selected, including 31 cases with poor healing of incision were selected as observation group, 50 patients with well healing of incision in the same period were selected as control group, the factors may cause poor healing were contrast analyzed. Results The incidence of uterine fibroids, anemia, diabetes, history of previous cesarean delivery, premature rupture of membranes of observation group were higher than control group, the body mass index, operation time and blood loss of observation group were also higher than control group, while the ratio of postoperative preoperative antibiotic use of observation group was lower than control group, the differences were statistically significant (P<0. 05). Conclusion Obesity, anemia, diabetes, postpartum blood loss, long operation time, gestational hypertension, premature rupture of membranes, uterine fibroids, the history of cesarean section and preoperative lack use of antibiotics are the related risk factors of poor healing of uterus incision after cesarean section, proper measures should be conducted in practical operations, in order to reduce the probability of poor healing of incision.%目的:分析造成剖宫产术后子宫切口愈合不良的相关危险因素,为临床防止切口愈合不良提供参考依据。方法收集2012年4月至2014年8月陕西中医学院第二附属医院收治的968例剖宫产手术患者的临床资料,其中31例切口愈合不良患者作为观察组,选取同期切口愈合良好患者50例作为对照组,对可能造成切口愈合不良的因素进行对照分析。结果观察组患者的妊娠期高血压、子宫肌瘤、贫血、糖尿病、胎膜

  11. Resuscitation of newborn in high risk deliveries

    International Nuclear Information System (INIS)

    High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. Methods: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. Results: A total of 90 high risk deliveries were included in the study. Emergency caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. Conclusion: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery. (author)

  12. The Type of Anesthesia Used during Cesarean Section Is Related to the Transient Tachypnea of the Newborn.

    Science.gov (United States)

    Keleş, Esengül; Yazgan, Hamza; Gebeşçe, Arzu; Pakır, Emine

    2013-01-01

    Aim. To demonstrate whether transient tachypnea of the newborn (TTN) is found more frequently in women undergoing general or combined epidural-spinal (CES) anesthesia during Cesarean section. Methods. This study was done retrospectively. A total of 1447 Cesarean sections (C/S) were performed in our clinic between January 2008 and December 2011. General anesthesia was performed in 1078 (74.5%) of the Cesarean cases. CES anesthesia was performed in 369 cases (25.5%). The International Classification of Diseases,Tenth Revision code of P22.1, was used to identify the infants with TTN. Stratified multivariate analysis was undertaken on subgroups to assess the effect modification by factors known to influence the incidence of TTN: maternal age, maternal systolic-diastolic artery pressure, heart rate, Apgar score at 1 and 5 minutes, sex, time interval from spinal block to skin incision, and time interval from skin incision to umbilical cord clamping. Results. The rate of TTN diagnosis was found to be higher in parturients who had a cesarean section with combined epidural-spinal anesthesia, but no statistical differences were found. (P related to C/S but independent from the type of anesthesia. However, studies with a wider spectrum of patients and a lower quantitative difference between the groups are needed in order to draw firm this conclusions. PMID:23710366

  13. 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。

  14. Comparison of Costs of Surgical Site Infection and Endometritis after Cesarean Section Using Claims and Medical Record Data

    OpenAIRE

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Fraser, Victoria J.

    2010-01-01

    We used administrative and clinical data from a case-control study to calculate the costs of surgical site infection and endometritis after cesarean section. Attributable costs determined by generalized least squares with the two data sources were similar, suggesting that administrative data can be used to calculate infection costs.

  15. Perbandingan Keberhasilan Vaginal Birth After a Cesarean (VBAC pada Inersia Uteri Hipotonik dengan dan tanpa Pemberian Oksitosin Drip

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    Dani Setiawan

    2012-06-01

    Full Text Available Trial of labor after cesarean section can be a choice on maternity with cesarean history. The successful trial of labor is then called vaginal birth after a cesarean (VBAC. The failure on VBAC is often caused by hypotonic uterine inertia. Oxytocin infusion augmentation is not a contraindication; it is a solution for increasing success on VBAC with requisite continuing observation. The aim of this research was to determine the successful differences of VBAC on hypotonic uterine inertia with and without oxytocin augmentation. This research was an experimental study on randomized clinical trial, using 40 patients with history of cesarean section at Dr. Hasan Sadikin Hospital and two satellite hospitals (Sumedang and Astana Anyar during March–May 2009 which fulfilled inclusion criteria divided into two groups; the group using oxytocin infusion and the group without oxytocin infusion. The patients’ characteristic, the success on VBAC and the maternal complication also neonatal condition were noted as encode. Chi-square test was used for statistical analysis. There was no statistical significant difference of success between the group used oxytocin infusion (80% and the group without using oxytocin infusion (60% with p>0.05 (p=0.168, but using confidence interval 95% showed the successful on VBAC with oxytocin infusion was greater 1.71 (0.72–4.06. The maternity and neonatal complication on two groups did not indicate a significant difference. In conclusion, using oxytocin infusion on hypotonic uterine inertia can increase the success on VBAC

  16. Maternal and Cord Blood Levels of Serum Amyloid A, C-Reactive Protein, Tumor Necrosis Factor-α, Interleukin -1β, and Interleukin-8 During and After Delivery

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    Luciane Marzzullo Cicarelli

    2005-01-01

    after delivery and try to correlate these proteins with tumor necrosis factor-α, interleukin -1β, and interleukin-8. Acute-phase proteins and cytokines were measured by ELISA in 24 healthy pregnant women undergoing vaginal delivery or Cesarean section. Cord blood samples in addition to maternal blood were collected. SAA and CRP reached the maximum maternal serum levels 24 hours after delivery, while cytokines remained constant over time. SAA and CRP were significantly higher in maternal serum than in newborn's (P<.001 at the moment of delivery. SAA and CRP, regardless of the type of delivery, reproduce the common pattern observed in most inflammatory conditions. Proinflammatory cytokine serum levels do not mirror the increase in SAA and CRP levels.

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

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    Paulo Fontoura Freitas

    2005-10-01

    Brazil in 1996, 1998 and 2000. Data from the Live Birth National Information System were used to estimate annual rates and crude and adjusted odds ratios (OR of cesarean sections according to social conditions (maternal age and education, newborn skin color/ethnicity and macro-regions, duration of pregnancy, and number of prenatal visits. RESULTS: The overall cesarean section rate was 45%, and above 37% in all macro-regions. Increased rates were seen among native and black mothers, aged 30 years or more, living in metropolitan, river valley and mountain macro-regions and having attended to more than six prenatal visits. Crude and adjusted OR show that cesarean rates were negatively associated with all categories of skin color/ethnicity when compared to white newborns, particularly those of native Brazilian (ORadj=0.43; 95% CI: 0.31-0.59, and they were positively associated with higher maternal education (ORadj=3.52; 95% CI: 3.11-3.99, older age (ORadj=6.87; 95% CI: 5.90-8.00 and greater number of prenatal visits (ORadj=2.16; 95% CI: 1.99-2.35. The effects of age and education were partly mediated by the greater number of prenatal visits among higher educated older women. The OR varied among macro-regions but were greater for the wealthier mountain region. CONCLUSIONS: High rates of cesarean section rates in Southern Brazil are a public health concern. They are associated with social, economic and cultural factors which can lead to misuse of medical technology during labor and delivery.

  18. 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

  19. Cesarean birth in the border region: a descriptive analysis based on US Hispanic and Mexican birth certificates.

    Science.gov (United States)

    McDonald, Jill A; Mojarro Davila, Octavio; Sutton, Paul D; Ventura, Stephanie J

    2015-01-01

    Cesarean birth (CB) is more prevalent in the US-Mexico border region than among all US Hispanics. Comparable data from US and Mexican birth certificates can be used to compare prevalence and identify risk factors on either side of the border. Using 2009 US and Mexican birth certificates, we compared the characteristics of US Hispanic and Mexican CBs in six geographic subgroups: US and Mexican border counties/municipios, US and Mexican non-border counties/municipios and the US and Mexico overall. We also explored cesarean prevalence over time. During 2000-2009, CB rates increased from 22.1 to 31.6 % among US Hispanics and from 25.9 to 37.9 % among Hispanics in the US border region. 2009 rates were 44.5 % in Mexico and 43.1 % in the Mexican border region. In both countries, CB rates were similar for primiparas and multiparas. Higher education, being married and parity >4 were associated with CB in Mexico; being married was associated in the US. Hispanic rates were higher in the US border than non-border region for all age groups. Along the border, cesarean rates for Hispanics were highest in Texas (43.5 %) and neighboring Tamaulipas (49.8 %). Higher cesarean prevalence in Mexico than in US Hispanics, while unexplained, is consistent with high prevalence in some Latin American countries. Higher cesarean prevalence among Hispanics in the US border region than among Hispanics nationwide cannot be explained by maternal age or parity. Medical indications are also unlikely to explain such high rates, which are undesirable for mothers and infants. PMID:24791973

  20. The application of uterine artery embolization for the treatment of uterine scar pregnancy after cesarean section

    International Nuclear Information System (INIS)

    Objective: To assess the clinical value of uterine arterial embolization (UAE) in treating uterine scar pregnancy after cesarean section. Methods: A total of' 35 cases with cesarean scar pregnancy, admitted to authors' hospital during the period from Jan. 2007 to June 2011, were divided into two groups: embolization group (n=21) and non-embolization group (n=14). By using Seldinger technique, UAE was performed via the right femoral access and gelatin sponge particle was used as embolization agent to occlude the uterine artery. In embolization group, sixteen patients received uterine cavity curettage one or two days after UAE, while five patients received laparotomy or perineotomy surgery to remove the lesions after UAE. In non-embolization group, uterine cavity curettage was performed directly in 8 patients, local injection of' methotrexate followed by uterine cavity curettage was carried out in 3 patients, and direct laparotomy to remove the lesions was adopted in the remaining 3 patients. The blood loss during the procedure, the hospitalization days and the time for β-HCG levels falling to normal were documented. The results were compared between the two groups. Results: UAE was successfully accomplished in all the 21 patients of embolization group and the uterus was preserved in all patients. For the embolization group, the mean hospitalization time was (11.5±3.6) days, and the time for β-HCG levels falling to normal was (18.6±4.9) days. For the non-embolization group, the mean hospitalization time was(20.4±5.2)days, and the time for β-HCG levels falling to normal was (28.7±5.6)days. Hysterectomy had to be carried out in two patients of non-embolization group due to the massive bleeding occurred in therapeutic procedures. Conclusion: For the treatment of cesarean scar pregnancy, UAE is very effective and mini-invasive with high success rate. UAE can preserve the patient's reproductive function, and it also plays a significant role in preventing hemorrhage

  1. Clinical Observation of Tramadol and Metoclopramide in Treatment of Shivering During Cesarean Section%曲马多联合甲氧氯普胺治疗剖宫产术中寒颤的临床观察

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

     Objective To observe treatment effect and adverse reactions of using tramadol and metoclopramide to treat shivering in cesarean section. Methods One hundred ASA I~II parturient patients, who were undergoing elective cesarean section, were included in the study. They were randomly assigned to one of two groups – Group T and Group MT. Group T receives 1mg/kg tramadol iv after delivery. Group MT receives 10mg metoclopramide iv followed by 1mg/kg tramadol iv. Monitor scale of shivering, incidence of nausea and vomiting, dizziness, respiratory depression and incidence of extrapyramidal reactions. Results 97% remission rate and 82% cure rate of shivering was observed after tramadol was given. Group T showed 70% incidence of nausea and vomiting. Group MT showed 86% less incidence of nausea and vomiting compared to Group T. Conclusion 1mg/kg tramadol is effective in preventing and treating shivering in cesarean section. Metoclopramide is effective in reducing nausea and vomiting caused by tramadol.%  目的观察曲马多联合甲氧氯普胺对剖宫产术中寒颤的治疗效果及不良反应。方法拟择期行剖宫产术产妇100例,ASA1-2级,随机分为二组:曲马多组(T组),曲马多联合甲氧氯普胺组(MT组)。胎儿取出后T组给予曲马多1mg/kg静注,MT组给予甲氧氯普胺10mg静注之后再给予曲马多1mg/kg静注。观察寒颤评分、恶心呕吐、头晕、呼吸抑制及锥体外系反应发生情况。结果曲马多组寒颤缓解率为97%,治愈率为82%,恶心呕吐发生率为70%,曲马多联合甲氧氯普胺组恶心呕吐发生率降低86%。结论曲马多1mg/kg能有效预防和治疗剖宫产术中的寒颤,甲氧氯普胺能有效减少曲马多引起的恶心呕吐。

  2. Respiratory distress syndrome in late preterm neonates delivered by elective cesarean section%选择性剖宫产与晚期早产儿呼吸窘迫综合征的研究进展

    Institute of Scientific and Technical Information of China (English)

    吴倩倩

    2013-01-01

    Late preterm neonates have immature respiratory systems and higher incidence of respiratory distress syndrome compared with term neonates.With the increase rate of elective cesarean section world-wild,the association between elective cesarean section and late preterm neonates respiratory distress syndrome has attracted a huge attention.Clinical data have showed that the incidence of respiratory distress syndrome was significantly increased in late preterm neonates delivered by elective cesarean section.The delay of lung fluid movement dilutes the concentration of pulmonary surfactant and causes the alveolar collapse.Compared with early preterm neonates,the respiratory distress syndrome of late preterm neonates appears later with a worse reaction of pulmonary surfactant and higher incidence of complications.Thus,vaginal delivery of late preterm neonates is the optimal choice and early diagnosis and therapy of respiratory distress syndrome is very important.%晚期早产儿的呼吸系统发育尚未完全成熟,因此和足月儿相比有更高的呼吸窘迫综合征发病率.随着选择性剖宫产率在世界范围内的迅速增加,选择性剖宫产和晚期早产儿呼吸窘迫综合征的关系越来越引起重视.临床资料显示,选择性剖宫产会导致晚期早产儿呼吸窘迫综合征发病率显著增加.其主要因为肺液排除延迟,吸收不良,导致肺泡表面活性物质浓度稀释,达不到生物学效应,肺泡萎陷.与早期早产儿相比,晚期早产儿发生呼吸窘迫综合征往往症状出现迟,肺泡表面活性物质效果不理想,如治疗不及时,易发生其他并发症.因此,对于晚期早产儿呼吸窘迫综合征的防治应尽可能经阴道分娩,一旦出现呼吸窘迫综合征症状,应早期诊断、及时救治.

  3. Factors Associated with Preference for Repeat Cesarean in Neyshabur Pregnant Women

    Directory of Open Access Journals (Sweden)

    Ali Gholami

    2014-01-01

    Conclusions: As observed in this study, most pregnant women with previous caesarean delivery prefer repeated caesarean delivery rather than VD in their subsequent pregnancy and educational level of pregnant women and doctor′s advice were important factors that influenced this preference. This subject suggests the need to counsel pregnant women with an obstetrician before select delivery type.

  4. Jordanian obstetricians' personal preference regarding mode of delivery.

    Science.gov (United States)

    Lataifeh, Isam; Zayed, Faheem; Al-Kuran, Oqba; Al-Mehaisen, Lama; Khriesat, Wadah; Khader, Yousef

    2009-01-01

    The personal preference of Jordanian obstetricians regarding mode of delivery in uncomplicated pregnancy with singleton cephalic presentation at term was surveyed by an anonymous structured questionnaire distributed at five conferences/scientific meetings on obstetrics and gynecology held in Jordan in 2007. The response rate was 70% (n=315), and 22 (7%) of the respondents chose elective cesarean section (CS). Respondents or=55 years (14.1% vs. 3.7%). In multivariate analysis, increased age was inversely associated with the odds of choosing elective CS (OR = 0.93, 95% CI: 0.88-0.99, p=0.024) after adjusting for gender, sector, and duration of practice. The main reasons for preferring abdominal delivery were the fear of long-term sequel (stress incontinence and anal sphincter damage) and the wish to preserve sexual function (86.4 and 50.0%, respectively). The majority of Jordanian obstetricians and gynecologists preferred vaginal delivery in uncomplicated pregnancy for themselves or their wives. PMID:19306134

  5. Enzymatic wound debridement; role of papaya in the management of post cesarean gaped wounds

    International Nuclear Information System (INIS)

    Background: Enzymatic wound debridement is an emerging concept in facilitating the wound healing process. Papaya has de-sloughing, antibacterial and wound healing properties. It has been used in African countries since centuries for different medicinal pur-poses. Apart from anecdotal reports and few studies on chronic ulcers and burns, no planned studies are available to support its action in postoperative wound infection.Objectives: To compare efficacy and safety of papaya dressing with conventional wound dressing with povidone iodine in post cesarean section gaped wounds. Setting: Gynecology Unit 3, Sir Ganga Ram Hospital Lahore - Pakistan, over a period of six months(June 2012 to Nov 2012). Study Design: Randomized, quasi experimental stu-dy. Materials and Methods: The study sample included 60 patients with post cesarean section gaped wounds. The sample was divided into two groups; thirty patients as Group A or the study group received Papaya dressing and rest of thirty patients as Group B or the control group received Povidone iodine dressing. Wounds were thoroughly washed with saline and then mashed unripe papaya was spread over the whole area of wound in the study group and povidone iodine in the control group. Wounds were covered with sterile bandage for at least 48 hours in study group and 24 hours in the control group. The process was repeated till a clean base of wound with healthy granulation tis-sue was achieved suitable for secondary suture. The efficacy parameters studied were the duration of time needed to develop healthy granulation tissue and total duration of hospital stay which were compared bet-ween the two groups. Safety factors studied were the adverse effects of medications used in the study. Results: Out of 1200 cesarean sections done during study period, sixty (5%) were gaped in the post-operative period. Out of 60, 55 (90%) were emergency and only 5 (10%) were elective cesarean sections. All the sixty patients with postoperative gaped

  6. Evaluation of the Use and Effectiveness of Antibiotics for Prophylactic in Patients with Cesarean Section at Hospitals in Surakarta in 2010

    OpenAIRE

    Nurul Mutmainah; Puri Setyati; Niken Handasari

    2014-01-01

    The use of antibiotics for prophylactic in sectio cesarean can reduce the risk of infection-related complications and postoperative infections. This study aims to describe and evaluate the usage and the effectiveness of prophylactic antibiotics in cesarean section patients in two hospitals in Surakarta in year 2010. The study used retrospective data from medical records. The analysis was then conducted on the use of antibiotic including the appropriateness of antibiotic (compare...

  7. Twin pregnancy with HELLP syndrome complicated with acute renal failure for emergency cesarean section: An unusual case and its anesthetic management

    OpenAIRE

    Poonam S Ghodki; Singh, Noopur D.; Patil, Kalyani N.

    2013-01-01

    Acute renal failure is not common in pregnancy. However, the incidence rises when pregnancy is complicated with Hemolysis, Elevated Liver enzymes, Low Platelets (HELLP) syndrome, which itself is a rare occurrence. We had an unusual case of HELLP syndrome in twin pregnancy with deranged renal profile for emergency cesarean section. We report the case, its anesthetic management for emergency cesarean section, and perioperative supportive treatment for acute renal failure.

  8. Variation in Vaginal Birth After Cesarean by Maternal Race and Detailed Ethnicity.

    Science.gov (United States)

    Edmonds, Joyce K; Hawkins, Summer Sherburne; Cohen, Bruce B

    2016-06-01

    Objective Our objective was to examine the likelihood of vaginal birth after cesarean (VBAC) for women in Massachusetts. Methods We used birth certificate data among term, singleton, vertex presentation births by repeat cesarean or VBAC to conduct logistic regression models to examine the likelihood of VBAC for women categorized into standard classifications of race and ethnicity and into 31 detailed ethnicities. Data were analyzed for the entire study period (1996-2010, N = 119,752) and for the last 5 years (2006-2010, N = 46,081). Results The adjusted odds of VBAC were lowest for non-Hispanic Black mothers (0.91, CI [0.85, 0.98]) and highest for Asian/Pacific Islander mothers (1.41, CI [1.31, 1.53]) relative to non-Hispanic White women. VBAC rates ranged from 5.8 % among Brazilians to 29.3 % among Cambodians. The adjusted odds of VBAC were lower for 7 of the 30 ethnic groups (range of AORs 0.40-0.89) and higher for 8 of the 30 ethnic groups (range of AORs 1.18-2.11) relative to self-identified American mothers. For the last 5 years, Asian/Pacific Islander mothers had a higher adjusted VBAC rate (1.39, CI [1.21, 1.60]), as did 9 of the 30 ethnic groups (range of 1.25-1.84). Only Brazilian mothers had lower rates (0.37, CI [0.27, 0.50]), relative to self-identified American mothers. Conclusions Detailed maternal ethnicity explains the variation in VBAC rates more precisely than broad race/ethnicity categories. Improvements in our public health data infrastructure to capture detailed ethnicity are recommended to identify and address disparities and improve the quality of maternity care. PMID:26699791

  9. Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section

    Directory of Open Access Journals (Sweden)

    Nikhil Kothari

    2011-01-01

    Full Text Available Aims and Context: The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia. Settings and Design : Randomized single blind trial. Methods: 210 ASA I-II pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I (n=70 patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group II (n=70 patients received intrathecal mixture of 0.5% hyperbaric bupivacaine (8 mg and clonidine 50 μg. In group III (n=70 , patients received 0.5% hyperbaric bupivacaine (10 mg intrathecally along with 50 μg of clonidine. Statistical Analysis Used: Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test (χ2 =57.2410. Results: On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21±5.15 min. (group II vs 146.0±4.55 min (group I, P=0.021; 95% confidence interval: 238.01-257.40, group II and 134.99-157.0 group I]. Conclusions: Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief.

  10. Cesarean Birth

    Science.gov (United States)

    ... with your health care provider. As with any surgery, there are risks and complications to consider. Your hospital stay may be longer ... in the space at the base of the spine. Fetal Monitoring: A procedure in ... surgery. Placenta: Tissue that provides nourishment to and takes ...

  11. 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 ...

  12. Responsive foams for nanoparticle delivery.

    Science.gov (United States)

    Tang, Christina; Xiao, Edward; Sinko, Patrick J; Szekely, Zoltan; Prud'homme, Robert K

    2015-09-01

    We have developed responsive foam systems for nanoparticle delivery. The foams are easy to make, stable at room temperature, and can be engineered to break in response to temperature or moisture. Temperature-responsive foams are based on the phase transition of long chain alcohols and could be produced using medical grade nitrous oxide as a propellant. These temperature-sensitive foams could be used for polyacrylic acid (PAA)-based nanoparticle delivery. We also discuss moisture-responsive foams made with soap pump dispensers. Polyethylene glycol (PEG)-based nanoparticles or PMMA latex nanoparticles were loaded into Tween 20 foams and the particle size was not affected by the foam formulation or foam break. Using biocompatible detergents, we anticipate this will be a versatile and simple approach to producing foams for nanoparticle delivery with many potential pharmaceutical and personal care applications. PMID:26091943

  13. Ocular delivery of macromolecules

    OpenAIRE

    Kim, Yoo-Chun; Chiang, Bryce; Wu, Xianggen; Prausnitz, Mark R.

    2014-01-01

    Biopharmaceuticals are making increasing impact on medicine, including treatment of indications in the eye. Macromolecular drugs are typically given by physician-administered invasive delivery methods, because non--invasive ocular delivery methods, such as eye drops, and systemic delivery, have low bioavailability and/or poor ocular targeting. There is a need to improve delivery of biopharmaceuticals to enable less-invasive delivery routes, less-frequent dosing through controlled-release drug...

  14. Video Delivery Performance of a Large-Scale VoD System and the Implications on Content Delivery

    OpenAIRE

    Li, Zhenyu; Wu, Qinghua; Salamatian, Kavé; Xie, Gaogang

    2015-01-01

    Video delivery performance is the main factor that affects Internet video quality. Characterizing the video delivery performance, especially the delivery throughput, can help content providers as well as Internet service providers (ISPs) in system optimization and network planning. Based on a unique dataset consisting of 20 million video download speed measurements , this paper comprehensively studies the video delivery throughput of a large-scale commercial video-on- demand (VoD) system. We ...

  15. Comparative study of bupivacaine 0.25% vs 0.375% Levobupivacaine spinal anesthesia for cesarean Section

    Directory of Open Access Journals (Sweden)

    Pérez-Guzmán Carlos Andrés

    2011-06-01

    Full Text Available During recent decades, it has been seen development of regional anesthesia as thebest method for cesarean section, thereby, there is constant research interestforoptimal dose that can abolish inherent complications of spinal technique. In pregnantwomen undergoing cesarean delivery under spinal anesthesia with conventionaldoses, hemodynamic changes occur abruptly, leading to clinical manifestations andcomplications related to maternal and fetal hypotension and hypoxemia, fetal acidosisand poor neonatal adaptation; considering this implications, they acquire a specialmedical interest in early diagnosis and prompttreatment.Objectives: To compare effectiveness of a dilution technique of heavy bupivacaine0.25% with a heavy dilution to 0.375% levobupivacaine in terms of quality of anesthesiaand clinical conditions of patient within 15 minutes after application.Methods: Intervention, non-blinded study in which two anesthetic techniques wereapplied, bupivacaine 0.25% and heavy heavy levobupivacaine to 0.375%, in patientsrequiring elective or emergency caesarean section in a health institution in Cartagena,Colombia, between June 2009 and June 2010. The technique was randomly assigned toeach patient; prior to its implementation, demographic and clinical variables of patientswere identified and blood pressure and heart rate baseline were obtained, the latter hadthree additional measurements at 5, 10 and15 minutes. Level of motor block also had three assessments; at 15 minutes of theprocedure, we verify the existence or absence of complications. Differences betweenvalues of both techniques for quantitative variables was performed with the U testof Mann-Whitney, for qualitative variables, we used the Pearson Chi-square or Fisherexact test when there were expected frequencies under 5.Results: In this research, decreased local anesthetic doses were used, which reboundin cost-benefit balance and length of stay of patients in post-anesthesia care unit

  16. A Comparison of the Effects of Fentanyl and Remifentanil on Nausea, Vomiting, and Pain after Cesarean Section

    OpenAIRE

    Fatemeh Gourtanian; Safoura Rouholami; Mitra Jabalameli

    2011-01-01

    Background: The effects of different opioids on postoperative nausea and vomiting (PONV) and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial recruiting 96 parturients with American Society of Anesthesiologists (ASA) physical status I and II. They sch...

  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. Limb-girdle muscular dystrophy with obesity for elective cesarean section: Anesthetic management and brief review of the literature

    OpenAIRE

    R V Ranjan; Ramachandran, T. R.; S Manikandan; John, Roshan

    2015-01-01

    Limb-girdle muscular dystrophy (LGMD) is an autosomal recessive disorder in which the pelvic or shoulder girdle musculature is predominantly or primarily involved. We report the management of a 27-year-old primigravida with LGMD associated with obesity posted for elective cesarean section. She was successfully managed with epidural anesthesia assisted with noninvasive positive pressure ventilation. She had an uncomplicated intra- and post-operative course.

  19. Clinical application of bilateral uterine arterial chemoembolization in the treatment of massive hemorrhage due to cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical application of bilateral uterine arterial chemoembolization in treating massive hemorrhage due to uterine scar pregnancy after cesarean section. Methods: Sixteen patients with massive hemorrhage due to cesarean scar pregnancy were enrolled in the study, the mean blood loss was (2 200 ± 1 400) ml. With Seldinger technique, abdominal angiography by using a pig-tail catheter was carried out. When bilateral uterine arterial bleeding was confirmed, selective or super-selective catheterization was employed and bilateral uterine arterial chemoembolization with infusion of 5-Fu or methotrexate (MTX) together with gelatin sponge via the catheters was conducted. The clinical results were observed. Results: The technical success was achieved in all 16 patients. No recurrent bleeding occurred during a follow-up of 3-6 months. Conclusion: The emergency bilateral uterine arterial chemoembolization is a safe and effective treatment for massive hemorrhage due to cesarean scar pregnancy with no serious complications, therefore, this technique is worth being used in clinical practice. (authors)

  20. Controlling hemorrhage by carprost suppsitioria administration with holding uterine out of abdomen cavity in cesarean section%子宫托出法加卡孕栓对减少剖宫产出血量的临床观察

    Institute of Scientific and Technical Information of China (English)

    林柏青; 曾永忠; 蔡志敏

    2010-01-01

    technique of holding uterine out of abdomen cavity.Conclusion Administration of carprost suppsitioria 0.5 mg sublingually with surgical technique of holding uterine out of abdomen after delivery of placenta have good effects in reducing hemorrhage during cesarean section.

  1. Comparative efficacy and safety of local and systemic methotrexate injection in cesarean scar pregnancy

    Directory of Open Access Journals (Sweden)

    Peng P

    2015-01-01

    Full Text Available Ping Peng,1 Ting Gui,1 Xinyan Liu,1 Weilin Chen,1 Zhenzhen Liu2 1Department of Obstetrics and Gynecology, 2Department of Ultrasonography, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Objective: To investigate the efficacy of methotrexate (MTX injection in treatment of cesarean scar pregnancy (CSP. Method: A randomized controlled study was performed in 104 CSP patients receiving either local or systemic MTX injection at the Peking Union Medical College Hospital from the year 2008 to 2013. Results: Complete cure was defined as regression of ultrasonographic findings and normalization of serum β-hCG within 60 days. It was regarded as delayed cure if additional dilation and curettage (D&C was needed. The overall cure rate (complete cure plus delayed cure was 69.2% versus 67.3% for local injection versus systemic administration (P>0.05. The median time for serum β-hCG remission and uterine mass disappearance after systemic administration (42 [21–69] days and 40 [20–67] days were significantly lower than those receiving local injection (56 [24–92] days and 53 [23–88] days, with P=0.029 and 0.046, respectively. The mean pretreatment serum β-hCG (human chorionic gonadotropin level and lesion size in cured group (21,941±18,351 mIU/mL and 2.9±1.3 cm, respectively were significantly lower than those in the failed group (37,047±30,864 mIU/mL and 3.6±1.3 with P=0.038 and 0.044, respectively. Conclusion: MTX injection is effective in CSP treatment. Systemic administration shows similar overall cure rate compared to local injection, but requires shorter time for serum β-hCG remission and uterine mass disappearance. Keywords: cesarean scar pregnancy, methotrexate injection, local, systemic

  2. Randomized comparison of effectiveness of unimodal opioid analgesia with multimodal analgesia in post–cesarean section pain management

    Directory of Open Access Journals (Sweden)

    Adeniji AO

    2013-05-01

    Full Text Available Adetunji Oladeni Adeniji,1 Oluseyi Olaboyede A Atanda21Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria; 2Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, NigeriaBackground: Postoperative pain leads to patient discomfort, decreased level of satisfaction, prolonged recovery, and higher health costs. Acute pain control therefore improves the overall quality of life in patients undergoing cesarean section. Pain relief is a fundamental human right, but there is no gold standard for post–cesarean section pain management.Objective: To compare the efficacy of pentazocine and tramadol used in unimodal and multimodal (in combination with piroxicam approach, in the management of post–cesarean section pain.Materials and methods: This study employed a random allocation design to compare the effectiveness of intramuscular pentazocine (60 mg or tramadol (100 mg as single analgesic agent and in combination with daily intramuscular piroxicam 20 mg, for the management of post–cesarean section pain during the immediate 12 hours after surgery. The primary outcome measure was control of postoperative pain, while the secondary outcome measures were the analgesic agent onset of action, duration of action, patient satisfaction, and maternal and neonatal adverse outcomes. Data obtained were entered into a predesigned sheet and analyzed with the Statistical Package for Social Sciences version 17. Means ± standard deviation (SD were calculated for the quantitative variables, and the difference between two independent groups was compared using unpaired Student's t-test. The level of significance was set at 0.05.Results: A total of 120 patients were equally and randomly allocated to four study groups – two that received unimodal analgesia (the pentazocine group and the tramadol group and two that received multimodal analgesia (the pentazocine

  3. eDelivery

    Data.gov (United States)

    US Agency for International Development — eDelivery provides the electronic packaging and delivery of closed and complete OPM investigation files to government agencies, including USAID, in a secure manner....

  4. NEW DRUG DELIVERY SYSTEM

    OpenAIRE

    Sarkar Biresh K; Jain Devananda; Banerjee Angshu

    2011-01-01

    Incorporating an existing medicine into a new drug delivery system can significantly improve its performance in terms of efficacy, safety, and improved patient compliance. The need for delivering drugs to patients efficiently and with fewer side effects has prompted pharmaceutical companies to engage in the development of new drug delivery systems. Today, drug delivery companies are engaged in the development of multiple platform technologies for controlled release, delivery of large molecule...

  5. Center Variation in the Delivery of Indicated Late Preterm Births.

    Science.gov (United States)

    Aliaga, Sofia; Zhang, Jun; Long, D Leann; Herring, Amy H; Laughon, Matthew; Boggess, Kim; Reddy, Uma M; Grantz, Katherine Laughon

    2016-08-01

    Objective Evidence for optimal timing of delivery for some pregnancy complications at late preterm gestation is limited. The purpose of this study was to identify center variation of indicated late preterm births. Study design We performed an analysis of singleton late preterm and term births from a large U.S. retrospective obstetrical cohort. Births associated with spontaneous preterm labor, major congenital anomalies, chorioamnionitis, and emergency cesarean were excluded. We used modified Poisson fixed effects logistic regression with interaction terms to assess center variation of indicated late preterm births associated with four medical/obstetric comorbidities after adjusting for socio-demographics, comorbidities, and hospital/provider characteristics. Results We identified 150,055 births from 16 hospitals; 9,218 were indicated late preterm births. We found wide variation of indicated late preterm births across hospitals. The extent of center variation was greater for births associated with preterm premature rupture of membranes (risk ratio [RR] across sites: 0.45-3.05), hypertensive disorders of pregnancy (RR across sites: 0.36-1.27), and placenta previa/abruption (RR across sites: 0.48-1.82). We found less center variation for births associated with diabetes (RR across sites: 0.65-1.39). Conclusion Practice variation in the management of indicated late preterm deliveries might be a source of preventable late preterm birth. PMID:27120474

  6. 剖宫产术后盆腔粘连的临床治疗及因素分析%The clinical treatment of pelvic adhesions after cesarean section and factor analysis

    Institute of Scientific and Technical Information of China (English)

    陈丽

    2015-01-01

    目的:探讨影响剖宫产术后盆腹腔粘连的危险因素,并提出治疗和预防措施。方法:选取我院48例既往剖宫产手术后并发盆腔粘连患者,给予腹腔镜微创手术治疗。结果:48例患者中,轻度粘连者27例,占56.3%,中度粘连11例,占22.9%,重度粘连10例,占20.8%;治疗后痊愈37例,占77.1%,11例出现腰酸、腹痛等症状,行保守治疗后好转,无中转开腹手术患者,未见肠管、输尿管损伤等并发症。结果:腹腔镜微创手术治疗盆腔粘连效果良好,但剖宫产术中、术后预防才是减少盆腔粘连发生的主要措施。%Objective To explore risk factors affecting basin celiac adhesion after cesarean section, and the treatment and prevention measures are put forward.Methods Choose from 48 patients with previous cesarean section surgery complicated with pelvic stick, give the laparoscopic minimally invasive surgery.Results 48 cases patients, 27 cases with mild adhesion, accounted for 56.3%, moderate adhesion in 11 cases, accounted for 22.9%, 10 cases of severe adhesion, accounted for 20.8%;37 cases recovered after treatment, 77.1%, 11 cases appear the symptom such as waist sour, abdominal pain, improve after conservative treatment.Conclusions Laparoscopic minimally invasive surgical treatment of pelvic adhesion effect is good, but in cesarean section, postoperative prevention is the main measures for decreasing the occurrence of pelvic adhesions.

  7. Cesárea prévia como fator de risco para o descolamento prematuro da placenta Previous cesarean section as a risk factor for abruptio placentae

    Directory of Open Access Journals (Sweden)

    Fábio Roberto Cabar

    2004-10-01

    relationship between previous cesarean section and abruptio placentae. METHODS: a retrospective study reviewed 6495 deliveries between April 2001 and January 2004. The adopted inclusion criteria were: clinical diagnosis of abruptio placentae confirmed by placental examination after delivery, single pregnancy, birth weight >500 g, gestational age >22 weeks and no history of abdominal trauma. Five controls were selected for each abruptio placentae case and were matched for the following parameters: parity, gestational age ( 30 weeks, maternal arterial hypertension during pregnancy, presence of nonobstetrical uterine scar, premature rupture of membranes and polyhydramnios. Statistical analysis of continuous variables was perfomed by Student's t test. Statistical significance of the comparisons of categorical variables was evaluated by the chi2 test or by the Fisher exact test. p values <0.05 were considered to be significant. RESULTS: thirty-four cases of abruptio placentae were included (incidence 0.52%. The control group included 170 cases that fulfilled the matching criteria. The incidence of previous cesarean section in the abruptio placentae group was 26.5% (9 cases and in the control group it was 21.2% (36 cases. No significant difference was found between the groups (p=0.65, OR=1.34, CI 95%=0.53-3.34. CONCLUSION: the present study was not able to demonstrate association between abruptio placentae and previous cesarean section.

  8. Epidural anesthesia: A safe option for cesarean section in parturient with severe pulmonary hypertension.

    Science.gov (United States)

    Sen, Sreyashi; Chatterjee, Sourav; Mazumder, Pinaki; Mukherji, Sudakshina

    2016-01-01

    Rheumatic heart disease is the most common cardiac disease complicating pregnancy in developing countries. Heart disease accounts for 15% pregnancy-related mortality. In the presence of maternal heart disease, the circulatory changes of pregnancy may result in exacerbation of the hemodynamic perturbations due to complex cardiac valvular lesions leading to decompensation or death of mother or fetus. Determining the ideal anesthetic technique for cesarean section in the presence of complex cardiac conditions remains a much debated topic. General anesthesia is associated with a further increase in pulmonary pressure in response to laryngoscopy and intubation along with myocardial depression by anesthetic agents. Neuraxial blockade may lead to decrease in systemic vascular resistance and cardiac output. We report the successful anesthetic management of a parturient suffering from rheumatic heart disease with multivalvular lesions resulting in severe pulmonary hypertension under epidural anesthesia with good maternal and neonatal outcome. Successful management requires vigilant perioperative monitoring and thorough knowledge of the hemodynamics of complex cardiac valvular disease. PMID:27433072

  9. The Effect of Acupressure on Nausea and Vomiting after Cesarean Section Under Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    Heydar Noroozinia

    2013-03-01

    Full Text Available Postoperative nausea and vomiting (PONV is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S under spinal anesthesia. In a prospective randomized clinical trial, 152 patients who were candidate for elective C/S under spinal anesthesia were evaluated in two groups (acupressure vs control groups. Subjects in the acupressure group received constant pressure by a specific wrist elastic band (without puncture of the skin on the Nei-Guan acupuncture point, 30 min prior to spinal anesthesia. The incidence of PONV was assessed during the surgery, at recovery room and at 1st, 2nd and 3rd two hours after the surgery. Significant differences in the incidence of the post-operative nausea and vomiting were found between the acupressure and control groups, with a reduction in the incidence rate of nausea from 35.5% to 13.2%. The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery

  10. Anesthetic Management of a Parturient Undergoing Cesarean Section with a Tracheal Tumor and Hemoptysis

    Directory of Open Access Journals (Sweden)

    Yuet-Tong Ng

    2003-01-01

    Full Text Available Anesthetic management of a parturient with respiratory failure associated with hemoptysis,dyspnea, and orthopnea is difficult. An anesthesiologist should realize that the patient'smajor problem is not solved during the surgery. This circumstance is similar to a patientwith associated cardiac disease scheduled for non-cardiac surgery. General anesthesia withendotracheal intubation can provide safe oxygenation for both the parturient and the fetus,but with possible unexpected massive hemoptysis and tumor seeding. Prolonged intubationmay delay the patient's pulmonary treatment course. Laryngeal mask anesthesia can providean airway, but must not be secured due to the risk of aspiration. The need of high doses ofinhalation drugs may hinder uterine contractions. The addition of a muscle relaxant willchange the patient's respiratory patterns and physiology. Regional anesthesia alone mightnot be tolerated. A decrease in cough strength, as well as dyspnea, orthopnea, and hyperventilationmay be harmful to both the parturient and the fetus. However, we successfullymanaged this case using epidural anesthesia combined with assisted mask ventilation insteadof spontaneous breathing usually provided by a simple mask in almost all American Societyof Anesthesiology (ASA class I-II parturients during cesarean section. The anesthetic levelwas maintained at T8 with 18 ml of 2% Xylocaine mixed with 2 ml of 7% sodium bicarbonatewith 1:200,000 epinephrine epidurally and with the patient in a supine position with thehead up at 30o to prevent cephalic spreading and to ensure better pulmonary ventilation.

  11. Post Dural Puncture Headache after Cesarean Section, a Teaching Hospital Experience

    Directory of Open Access Journals (Sweden)

    Farhad Etezadi

    2012-03-01

    Full Text Available Objective: This prospective study examined the frequency of Post-Dural Puncture Headache (PDPH in361 parturient women undergoing spinal anesthesia for cesarean section in a teaching hospital ofTehran University of Medical Sciences.Materials and methods: Spinal anesthesia was performed using 25 gauge Quincke needles in allwomen. Patients were followed up to determine incidence of PDPH and then tried to compare those withor without PDPH using statistical methods to determine risk factors of PDPH.Results: The overall incidence of PDPH was 10.8 percent in this study. In terms of probable risk factorswhich were compared between the two groups of patients, no statistically significant differences werefound.Conclusion: The incidence of PDPH in our study was higher than studies which used pencil - tippedneedles and we determined that the occurrence of PDPH is not associated to some factors like theprevious history of nonspecific headache, Body Mass Index, age, type of local anesthetic, previoushistory of PDPH, experience of operator, history of habitual tea and coffee drinking.

  12. NEW DRUG DELIVERY SYSTEM

    Directory of Open Access Journals (Sweden)

    Sarkar Biresh K

    2011-05-01

    Full Text Available Incorporating an existing medicine into a new drug delivery system can significantly improve its performance in terms of efficacy, safety, and improved patient compliance. The need for delivering drugs to patients efficiently and with fewer side effects has prompted pharmaceutical companies to engage in the development of new drug delivery systems. Today, drug delivery companies are engaged in the development of multiple platform technologies for controlled release, delivery of large molecules, liposome, taste-masking, oral fast- dispersing dosage forms, technology for in- soluble drugs, and delivery of drugs through intranasal, pulmonary, transdermal, vaginal, colon, and transmucosal routes.

  13. HIV Mother-to-Child Transmission, Mode of Delivery, and Duration of Rupture of Membranes: Experience in the Current Era

    Directory of Open Access Journals (Sweden)

    Siobhan Mark

    2012-01-01

    Full Text Available Objective. To evaluate whether the length of time of rupture of membranes (ROM in optimally managed HIV-positive women on highly active antiretroviral therapy (HAART with low viral loads (VL is predictive of the risk of mother to child transmission (MTCT of the human immunodeficiency virus (HIV. Study Methods. A retrospective case series of all HIV-positive women who delivered at two academic tertiary centers in Toronto, Canada from January 2000 to November 2010 was completed. Results. Two hundred and ten HIV-positive women with viral loads <1,000 copies/ml delivered during the study period. VL was undetectable (<50 copies/mL for the majority of the women (167, 80%, and <1,000 copies/mL for all women. Mode of delivery was vaginal in 107 (51% and cesarean in 103 (49%. The median length of time of ROM was 0.63 hours (range 0 to 77.87 hours for the entire group and 2.56 hours (range 0 to 53.90 hours for those who had a vaginal birth. Among women with undetectable VL, 90 (54% had a vaginal birth and 77 (46% had a cesarean birth. Among the women in this cohort there were no cases of MTCT of HIV. Conclusions. There was no association between duration of ROM or mode of delivery and MTCT in this cohort of 210 virally suppressed HIV-positive pregnant women.

  14. Preliminary Study on Diagnosis and Treatment Method of Cesarean Scar Pregnancy after Cesarean Section%剖宫产术后子宫瘢痕妊娠的诊治方法初步研究

    Institute of Scientific and Technical Information of China (English)

    李荣丽

    2016-01-01

    Objective To study the diagnosis and treatment method and curative effect of cesarean scar pregnancy after ce-sarean section. Methods 20 cases of patients with cesarean scar pregnancy after cesarean section included from January 2013 to January 2016 were randomly divided into two groups, the group A were treated with injection of methotrexate and complete curettage of uterine cavity, the group B were treated with injection of methotrexate and hysteroscope operation. Results The total effective rate in the group A was obviously higher than that in the group B, (70.00%vs 90.00%), the sta-tistical treatment showed that the treatment effects were different by χ2-test, P<0.05, the menstruation recovery time and serumβ-HCG recovery time in the group B were obviously shorter than those in the group A, [(62.51±6.380)d, (33.52±4.38) d vs (39.56±6.34)d, (15.52±1.36)d], and the statistical treatment showed that the differences in the menstruation recovery time and serumβ-HCG recovery time between the groups were obvious by χ2-test, P<0.05. Conclusion The effect of injec-tion of methotrexate and hysteroscope operation in treatment of cesarean scar pregnancy after cesarean section is definite, which is worth promotion.%目的:探讨剖宫产术后子宫瘢痕妊娠的诊治方法和疗效。方法随机选取2013年1月—2016年1月该院剖宫产术后子宫瘢痕妊娠患者20例,随机分组,A组注射甲氨蝶呤+清宫术治疗,B组注射甲氨蝶呤+宫腔镜手术治疗。结果跟A组总有效率70.00%比较,B组总有效率明显较高,达到90.00%,经χ2检验行统计学处理显示治疗效果差异有统计学意义(P<0.05)。跟A组(62.51±6.38)d、(33.52±4.38)d比较,B组月经恢复时间(39.56±6.34)d、血β-HCG恢复时间(15.52±1.36)d明显较短,经t检验行统计学处理显示月经恢复时间、血β-HCG恢复时间差异有统计学意义(P<0.05)。结论剖宫产术后子宫瘢痕妊娠注射甲氨蝶呤+宫腔镜手术治疗效果确切,值得推广。

  15. Clinical analysis of 13 cases of cesarean scar pregnancy after cesarean section%剖宫产术后瘢痕妊娠13例临床分析

    Institute of Scientific and Technical Information of China (English)

    王娟

    2014-01-01

    Objective To clinically analyze 13 cases of cesarean scar pregnancy after cesarean section. Methods Type-B ultrasound, tests of biochemical indices and other technologies were applied to analyze the clinical characteristics, early diagnosis, treatment method and prognosis of 13 patients of Cesarean scar pregnancy. Results All 13 patients had a history of Cesarean section and post-menopausal vaginal bleeding; the diagnosis, based on vaginal color Doppler ultrasound, showed the possibility of Cesarean scar pregnancy; 8 patients received a conservative treatment of methotrexate plus mifepristone plus uterus cleaning. 4 patients received resection of scar lesions in lower uterine segment plus uterus repair (2 trans-vaginal, 2 trans-abdominal). 1 patient had hemorrhea after uterus cleaning in another hospital and received subtotal hysterectomy in the emergency clinic. Conclusion Early application of B-type ultrasound helps confirm the diagnosis of cesarean scar pregnancy, determine the treatment method and effectively reduce the risk of hemorrhea, which has a positive clinical significance;trans-vaginal resection of scar lesions in lower uterine segment plus uterus repair has advantages of smaller amount of bleeding, minor injuries, shorter hospitalization and faster decrease of bloodβ-HCG, which is a preferred method for the disease.%目的:探讨13例剖宫术后瘢痕妊娠临床分析。方法采用B超检查及各项生化指标检查的方法或技术手段来分析13例剖宫术后瘢痕妊娠患者的临床特点,早期诊断,治疗方法及预后。结果13例患者均有剖宫术史及停经后阴道流血史;诊断依据经阴道彩超提示剖宫产瘢痕部位妊娠可能;8例行甲氨蝶呤+米非司酮+清宫保守治疗,4例子宫下段瘢痕病灶切除子宫修补术(2例行经阴道,2例经腹部),1例外院清宫术后大出血,急诊行次全子宫切除术。结论剖宫术后瘢痕妊娠早期运用B超检查能明确诊断

  16. 剖宫产术中寒战护理研究进展%The progress of nursing research on shivering during cesarean section

    Institute of Scientific and Technical Information of China (English)

    梁丽珠

    2015-01-01

    剖宫产产妇术中发生寒战严重影响产妇的呼吸、心脏、血液系统,影响产妇术后的康复。本研究探讨产妇发生术后寒战的影响因素,对目前剖宫产术中寒战护理的研究现状进行综述。%Shivering during cesarean section will seriously influnce the respiratory,heart and blood system of maternal,and also influence their postoperative rehabilitation.In this study we explored the factors of shivering during cesarean section,and summarized the progress of nursing research on shivering during cesarean section.

  17. 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.

  18. 剖宫产产妇的产后护理体会%Nursing experience on postpartum of cesarean section

    Institute of Scientific and Technical Information of China (English)

    羊静

    2015-01-01

    目的:总结剖宫产产妇的产后护理体会。方法:收治行剖宫产手术产妇58例,按照随机数表法分为针对性护理组30例和常规护理组28例,比较两组护理效果。结果:与常规护理组比较,针对性护理组产妇SAS和SDS评分更低、护理结果更优,P<0.05。结论:对剖宫产产妇给予产后针对性护理,产妇抑郁、焦虑情绪得到缓解,产后身体状况恢复快。%Objective:To summarize the experience of nursing after cesarean section.Methods:58 maternal after cesarean section were selected.They were randomly divided into the nursing group with 30 cases and the routine nursing group with 28 cases,then we compared the nursing effects between the two groups.Results:Compared with the conventional nursing group,the SAS and SDS score of the targeted nursing group were lower,and the nursing results was better,P<0.05.Conclusion:Targeted nursing on maternal after cesarean section can help them reliefed from depression and anxiety,and it also can recover postpartum health.

  19. Treatment Progress of Shivering after Cesarean Section%剖宫产手术寒战的治疗进展

    Institute of Scientific and Technical Information of China (English)

    秦玫(综述); 薛兴(审校)

    2015-01-01

    Shivering after cesarean section is one of the most serious postoperative complications causing hyoxemia,myocardial ischemia,increased intracranial pressure and even influences uterine contraction and increases postoperative infection.Shivering after cesarean section is generally reported to be related to anes-thesia approach,intraoperative medication,temperature and state of the pregnant women.Here makes a brief summary on the prevention and treatment of shivering after cesarean section,including dispelling tension of the pregnant,physical therapy and medication,and the advantages and disadvantages of each medicine are summarized in detail.%寒战是剖宫产术后常见的并发症之一。其发生可能与麻醉方式、术中用药、温度及孕妇自身因素等有关。寒战可以使机体的耗氧量成倍增加,导致低氧血症、心肌缺血的发生,严重者可使颅内压增高,甚至影响子宫收缩及使术后切口感染率增加。该文就目前剖宫产手术寒战的预防和治疗进展予以综述,探讨了预防和治疗寒战时所使用的心理安慰、物理保温及药物治疗等手段,并重点阐述了药物治疗中各类药物的优缺点。

  20. Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Fábio Farias de Aragão

    2014-09-01

    Full Text Available Maternal hypotension is a common complication after spinal anesthesia for cesarean section, with deleterious effects on the fetus and mother. Among the strategies aimed at minimizing the effects of hypotension, vasopressor administration is the most efficient. The aim of this study was to compare the efficacy of phenylephrine, metaraminol, and ephedrine in the prevention and treatment of hypotension after spinal anesthesia for cesarean section. Ninety pregnant women, not in labor, undergoing cesarean section were randomized into three groups to receive a bolus followed by continuous infusion of vasopressor as follows: phenylephrine group (50 μg + 50 μg/min; metaraminol group (0.25 mg + 0.25 mg/min; ephedrine group (4 mg + 4 mg/min. Infusion dose was doubled when systolic blood pressure decreased to 80% of baseline and a bolus was given when systolic blood pressure decreased below 80%. The infusion dose was divided in half when systolic blood pressure increased to 120% and was stopped when it became higher. The incidence of hypotension, nausea and vomiting, reactive hypertension, bradycardia, tachycardia, Apgar scores, and arterial cord blood gases were assessed at the 1st and 5th minutes. There was no difference in the incidence of hypotension, bradycardia, reactive hypertension, infusion discontinuation, atropine administration or Apgar scores. Rescue boluses were higher only in the ephedrine group compared to metaraminol group. The incidence of nausea and vomiting and fetal acidosis were greater in the ephedrine group. The three drugs were effective in preventing hypotension; however, fetal effects were more frequent in the ephedrine group, although transient.

  1. Service delivery process design and efficiency in financial services: Case study on Š

    OpenAIRE

    Penttinen, Tommi

    2013-01-01

    ABSTRACT Objectives of the Study The purpose of this thesis is to examine design and performance of the service delivery systems. How should service delivery systems be build, how service delivery processes should operate and how design affects to the service outcome? This thesis will also examine does process lead time affect to the outcome and performance of the delivery process, especially in banking sector. Academic background and methodology The Literature part of the thesis ...

  2. Anesthesic treatment for an urgent cesarean in a pregnant patient suffering from morbid obesity. A case report.

    Directory of Open Access Journals (Sweden)

    Bárbara Cabezas Poblet

    2008-04-01

    Full Text Available Morbid obesity is not a condition frequently found in patients under surgical treatment. However, its prevalence in the last decades tends to rise which may have a profound impact in the anesthetic morbid-mortality. These risks are increased in the case of pregnant patients. For these reasons a case of a pregnant woman is presented. She is suffering from morbid obesity when was announced to be surgically treated in emergency due to a cesarean at the University Hospital Dr. Gustavo Aldereguía Lima in Cienfuegos.

  3. 高渗氯化钠羟乙基淀粉40注射液预扩容对母婴血浆胶体渗透压的影响%Effects of hypertonic sodium chloride hydroxyethyl starch 40 injection on plasma colloid osmotic pressure during cesarean section

    Institute of Scientific and Technical Information of China (English)

    朱慧琛; 忻纪华; 范逸辰; 何征宇; 何振洲; 王祥瑞

    2012-01-01

    目的 观察高渗氯化钠羟乙基淀粉40注射液(HSH40)预扩容对母婴血浆胶体渗透压(COP)的影响.方法 选择择期行剖宫产术的产妇80例,随机分为两组,每组40例.HSH40组预先静脉滴注HSH40 4 mL/kg,平衡液组预先静脉滴注乳酸钠林格注射液4 mL/kg.监测并记录入手术室时(T0)、预充量静脉滴注完即刻(T1)、预充量静脉滴注后30 min(T2)、胎儿娩出时(T3)、术毕(T4)的心率和血压,并采集各时间点产妇的静脉血及胎儿娩出尚未建立呼吸时的脐动、静脉血检测血浆COP.结果 两组产妇的年龄、体重、麻醉诱导至胎儿娩出时间、子宫切开至胎儿娩出时间和手术时间的差异均无统计学意义(P值均>0.05).与平衡液组同时间点比较,HSH40组在T1、T2、T3时间点的血浆COP水平均显著升高(P值均<0.05);与同组T0时间点比较,两组在T2、T3、T4时间点的血浆COP水平均显著降低(P值均<0.05);两组间脐动、静脉血血浆COP水平的差异均无统计学意义(P值均>0.05).HSH40组产妇的低血压发生率为12.5%显著低于平衡液组的27.5% (P<0.05).两组间新生儿出生后1和5min Apgar评分的差异均无统计学意义(P值均>0.05).结论 HSH40预扩容有利于维持产妇术中血浆COP和血流动力学的稳定,且对胎儿血浆COP无影响.%Objective To observe the preloading effects of hypertonic sodium chloride hydroxyethyl starch 40 injection (HSH40) on plasma colloid osmotic pressure (COP) during cesarean section. Methods Eighty patients scheduled for cesarean section under spinal-epidural anesthesia were randomly divided into two groups (n = 40). HSH40 (4 mL/kg, group H) or Ringer solution (4 mL/kg, group L) was injected for preloading. Blood samples were taken to measure the levels of COP and hemodynamic parameters (heart rate and blood pressure) before infusion (T0), at the end of infusion (T1) and 30 mins after infusion (T2), at delivery of baby (T3) and the

  4. Bilateral megalocystic ovaries following in vitro fertilization detected during cesarean section: a case presentation.

    Science.gov (United States)

    Alptekin, Hüsnü; Gezginç, Kazım; Yılmaz, Fatma Yazıcı

    2012-01-01

    We present a patient with persistent bilateral megalocystic ovaries following in vitro fertilization which was detected during cesarean section. A 24 year-old primigravida presented to our clinic at the 36(th) week of a twin pregnancy with labour pain and cervical dilatation. On ultrasound examination, 2 masses of 90×60 and 60×70 mm were seen in the right and left adnexal regions respectively. Her history showed that she had unexplained infertility for 4 years and had undergone IVF with gonadotropin releasing hormone (GnRH)-agonist stimulation. Two embryos were transferred. Twin pregnancy was detected on ultrasound examination. The patient was delivered by emergency caesarean section due to transverse presentations at 36(th) weeks of gestation. During the operation, both adnexae were markedly enlarged, the right ovary measuring about 15×18 cm and the left about 16×18 cm. There was minimal ascites in the abdominal cavity. Ovarian biopsy was performed and the final pathology report showed bilateral follicle cysts. The patient was discharged on the postoperative 4(th) day. The patient was seen 4 weeks later. She had no complaints and ultrasound follow-up revealed a normal size uterus and ovaries. We should keep in mind that hyperstimulated, enlarged ovaries and its complication may be seen in the late weeks of pregnancy, even at term, in cases of in vitro fertilization cases. Therefore, close follow-up of pregnant IVF patints is recommended whether they had OHSS or not, because ovarian torsion caused by hyperstimulated ovaries may be difficult to diagnose during pregnancy. PMID:24592025

  5. Intrathecal Administration of Morphine Decreases Persistent Pain after Cesarean Section: A Prospective Observational Study

    Science.gov (United States)

    Moriyama, Kumi; Ohashi, Yuki; Motoyasu, Akira; Ando, Tadao; Moriyama, Kiyoshi; Yorozu, Tomoko

    2016-01-01

    Purpose Chronic pain after cesarean section (CS) is a serious concern, as it can result in functional disability. We evaluated the prevalence of chronic pain after CS prospectively at a single institution in Japan. We also analyzed perioperative risk factors associated with chronic pain using logistic regression analyses with a backward-stepwise procedure. Materials and Methods Patients who underwent elective or emergency CS between May 2012 and May 2014 were recruited. Maternal demographics as well as details of surgery and anesthesia were recorded. An anesthesiologist visited the patients on postoperative day (POD) 1 and 2, and assessed their pain with the Prince Henry Pain Scale. To evaluate the prevalence of chronic pain, we contacted patients by sending a questionnaire 3 months post-CS. Results Among 225 patients who questionnaires, 69 (30.7%) of patients complained of persistent pain, although no patient required pain medication. Multivariate analyses identified lighter weight (p = 0.011) and non-intrathecal administration of morphine (p = 0.023) as determinant factors associated with persistent pain at 3 months. The adjusted odds ratio of intrathecal administration of morphine to reduce persistent pain was 0.424, suggesting that intrathecal administration of morphine could decrease chronic pain by 50%. In addition, 51.6% of patients had abnormal wound sensation, suggesting the development of neuropathic pain. Also, 6% of patients with abnormal wound sensation required medication, yet no patients with persistent pain required medication. Conclusion Although no effect on acute pain was observed, intrathecal administration of morphine significantly decreased chronic pain after CS. PMID:27163790

  6. Evaluation of the Adequacy of General Anesthesia in Cesarean Section by Bispectral Index

    Directory of Open Access Journals (Sweden)

    Sayed Mohammad Reza Hadavi

    2013-09-01

    Full Text Available Background: Awareness and recall, though not common, are the major hazards of general anesthesia, especially in Cesarean section (C/S because of the absence of benzodiazepine and opioids for a significant time during anesthesia. In this study, the Bispectral Index (BIS, end-tidal isoflurane, and hemodynamic parameters were examined to evaluate the depth of the routine general anesthetic technique in C/S. Methods: This study was carried out on 60 parturient patients undergoing elective C/S. A standardized anesthetic technique was applied: induction with Thiopental (4-5 mg/kg and Succinylcholine (1.5-2 mg/kg as well as maintenance with O2, N2O, and isoflurane. Electrocardiogram, heart rate, blood pressure, Spo2, end-tidal isoflurane concentration, BIS, and any clinical signs of inadequate depth of anesthesia such as movement, sweating, lacrimation, coughing, and jerking were continuously monitored and recorded at 16 fixed time points during anesthesia. Results: A median BIS of less than 70 (range: 42-68 was obtained on all occasions during surgery; however, at each milestone, at least 20% of the patients had BIS values above 60. Hemodynamic parameters increased significantly in some patients, especially during laryngoscopy and intubation. No patient experienced recall or awareness. Conclusion: The currently used general anesthetic technique in our center appears inadequate in some milestones to reliably produce BIS values less than 60, which are associated with lower risk of awareness. Therefore, with respect to such desirable outcomes as good Apgar and clinical status in neonates, we would recommend the application of this method (if confirmed by further studies through larger dosages of anesthetic agents.

  7. 上海市闸北区高剖宫产率供方因素定性研究%Qualitative study of the effect of health service providers and health care system on high cesarean section rate in Zhabei District of Shanghai

    Institute of Scientific and Technical Information of China (English)

    杨莉敏; 纪红蕾; 杨岭岭; 叶茜

    2013-01-01

    Objective To explore the effect of knowledge , belief and behavior of health service providers and health care system on high cesarean section rate by in-depth individual interview among medical and nursing staff .Methods Semi-structured interview in qualitative study was applied to conduct in-depth interview among 12 doctors and nurses with different professional titles and positions in two comprehensive hospitals in Zhabei District of Shanghai .The interview was recorded on spot .NVIVO 8.0 was used for analysis .Results Altogether 12 doctors and nurses (6 in hospital A and 6 in hospital B) were interviewed.The longest working age was 30 years (midwife and head nurse ) and the shortest was 2 years ( resident physician ) .All interviewees were fully aware of the impact of different delivery modes on health of mothers and their babies .In case of cesarean section asked for by pregnant women , all interviewees could try to persuade them to have natural delivery .Eleven of 12 subjects believed that they could follow the provision of Shanghai Health Bureau and master cesarean section indications strictly .All interviewees denied that doctors would widen indications of cesarean section because of profit.Most interviewees believed that doctors would not apply cesarean section because of manpower deficiency , but insufficiency of human resources was the main reason for “continuous support during labor” and“pain relief services during labor” not available in both hospitals . All interviewees believed that avoiding medical risks due to strained doctor-patient relationship led to loosening indications of cesarean section were loosened .Conclusion Insufficiency of human resources and intense doctor-patient relationship are two impact factors of cesarean section rate .Human resource should be strengthened in obstetrical department to promote the development of “continuous support during labor” and“pain relief services during labor”.Doctor-patient relationship

  8. Risk Management of the Delivery Room in Obstetrics%产房风险管理探讨

    Institute of Scientific and Technical Information of China (English)

    杨艳贞; 郑剑兰; 付景丽; 孙小花; 洪阿双

    2011-01-01

    Objective To study on the importance and efficiency of the risk management in the delivery room.Methods The risk factors were analyzed, and the specific measures were summarized of the risk management of delivery room during the past three years in the hospital.Results After the implementation of risk management,the high - risk pregnancies, the cesarean section rate, the episiotomy rate, the postpartum hemorrhage rate, the rate of neonatal asphyxia, the prenatal mortality rate, the perineal wound infection rate were reduced,while the delivery room job satisfaction was increased.And these differences were statistically significant.Conclusions The risk management of delivery room can enhance the awareness of risk prevention and service level, reduce the cesarean section rate, improve the obstetric quality, ensure the safe of motherhood and neonate, and reduce the medical disputes.%目的研究风险管理在产房工作中的重要性及有效性.方法分析产房的各种风险因素,归纳总结近3年来医院产房工作中风险管理的具体措施.结果 实施风险管理后,医院高危妊娠、剖宫产率、会阴侧切率、产后出血率、新生儿窒息率、围产儿死亡率、会阴切口感染率、产房工作满意度均有明显改善.结论 产房的风险管理可以提高医护人员的风险防范意识及医疗护理水平,降低剖宫产率,提高产科质量,确保母婴安全,减少医疗纠纷.

  9. Project delivery system (PDS)

    CERN Document Server

    2001-01-01

    As business environments become increasingly competitive, companies seek more comprehensive solutions to the delivery of their projects. "Project Delivery System: Fourth Edition" describes the process-driven project delivery systems which incorporates the best practices from Total Quality and is aligned with the Project Management Institute and ISO Quality Standards is the means by which projects are consistently and efficiently planned, executed and completed to the satisfaction of clients and customers.

  10. Health care delivery systems.

    OpenAIRE

    Stevens, F; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective, meaningful, and socially accepted. From a sociological point of view, the analysis of health care delivery systems implies recognition of their distinct history over time, their specific values an...

  11. 改良新式剖宫产术与腹膜外剖宫产术手术方式的探讨%Comparison of new method of cesarean section with the extra peritoneum cesarean section

    Institute of Scientific and Technical Information of China (English)

    田家娟; 赵树旺

    2006-01-01

    目的:比较改良新式剖宫产术(modified cesarean section)与腹膜外剖宫产术(extra peritoneum cesarean section).方法:观察40例改良新式剖宫产与30例腹膜外剖宫产孕妇.新方法包括:使用Joel Cohen方法开腹,不缝合膀胱腹膜反折与腹膜,一层缝合子宫下段切口,腹壁脂肪层自然对合.结果:观察组胎儿娩出的平均时间为(5±3)min,对照组为(10±4)min,P0.05.结论:改良新式剖宫产术具有缩短胎儿娩出时间、出血少、创伤小、术后疼痛轻、恢复快、减少住院时间等优点,值得推广.

  12. Delivery Process Management in the Role of Promoting Natural Delivery%助产流程管理在促进自然分娩中的作用

    Institute of Scientific and Technical Information of China (English)

    吴仕元; 袁劲进; 肖锦艳

    2015-01-01

    ObjectiveTo discuss the effect of implementing the delivery process management to improve the quality of Midwifery and to promote natural labor.Method 1261 cases of vaginal delivery in our hospital From July 1, 2014 to December 31, 2014 were selected as the research group. And 1011 cases of vaginal delivery in our hospital from January 1, 2014 to June 30, 2014 were selected as the control group. The control group did not implement the delivery process management while the research group did. We compare the natural labor rate, the cesarean section rate, the postpartum hemorrhage rate, the rate of perineum side cut, the rate of perineum injury, and the rate of neonatal asphyxia in the two groups.Result The natural labor rate in the study group was significantly higher than that in the control group(P<0.05). The cesarean section rate, the postpartum hemorrhage rate, the rate of perineum side cut, the rate of perineum injury, and the rate of neonatal asphyxia in the study group was significantly lower than that in the control group(P<0.05).Conclusion Since the delivery process management can not only effectively improve the quality of midwifery, but also reduce the cesarean section rate and promote natural delivery, it is worthy of promotion.%目的:探讨助产流程管理对提高助产质量、促进自然分娩中的效果。方法选择本院2014年7月1日至2014年12月31日实行助产流程管理后住院阴道分娩的产妇1261例(研究组),同时选取2014年1月1日至2014年6月30日在本院未实行助产流程管理住院阴道分娩的产妇1011例(对照组),比较两组的自然分娩率、剖宫产率、产后出血率、会阴侧切率、会阴损伤率、新生儿窒息发生率等。结果研究组自然分娩率明显高于对照组(P<0.05),剖宫产率、会阴侧切率、会阴损伤率、产后出血及新生儿窒息发生率等明显低于对照组(P<0.05)。结论助产流程管理能有效地提

  13. FLOATING DRUG DELIVERY SYSTEM - CHRONOTHERAPEUTIC APPROACH

    Directory of Open Access Journals (Sweden)

    Vishal Kalal

    2011-04-01

    Full Text Available The purpose of writing this review on the floating drug delivery systems (FDDS was to compile the recent literature with special focus on the principal mechanism of floatation to achieve gastric retention. FDDS is one of the approaches in chronotherapeutic drug delivery. In the past reviews of FDDS the physiological and formulation variables affecting gastric retention, approaches to design single-unit and multiple-unit floating systems, their classification and formulation aspects have been covered. This review summarizes the special focus on chronotherapeutics, diseases affected by biological rhythm, its importance, advantages, various approaches in Chronotherapeutic drug delivery and applications of FDDS. These systems are useful for several problems encountered during the development of a pharmaceutical dosage forms.

  14. The effect of targeted nursing intervention on reducing shivering for patients after cesarean section%针对性护理降低剖宫产患者术后寒颤的临床观察

    Institute of Scientific and Technical Information of China (English)

    刘丽英

    2015-01-01

    Objective To explore the effect of targeted nursing intervention on reducing shivering for patients after cesarean section.Methods Fifty patients receiving cesarean section between December 2012 and December 2014 were selected as a control group and given conventional nursing.Another fifty patients undergoing the operation in the following year were chosen as the observation group and provided with targeted nursing on basis of conventional nursing.The axillary temperatures were measured while entering the operation room,at the end of anesthesia,at the skin incision,after the delivery of fetus,when the operation was over,and compared between the two groups.Patients'satisfaction degree of nursing care and occurrence rate of postoperative shivering were also compared.Results In the control group,the axillary temperatures were (36.5±0.16)℃,(36.5 ±0.27)℃,(36.4±0.07)℃,(35.8±0.54)℃ and (35.6±0.47 )℃ at five different time points,while in the observation group the values were(36.6± 0.24)℃,(36.4 ±0.25)℃,(36.3 ±0.19)℃,(36.4±0.27)℃ and(36.2±0.37)℃ accordingly.There were significant differences at the same time points between the two groups(F =11.53,P 0.05),but the temperatures were decreased in the control group(t =6.12,P 0.05),而对照组腋温降低(t =6.12,P <0.05)。对照组寒颤发生率为64%,观察组寒颤发生率为14%,观察组低于对照组(χ2=26.27,P <0.01)。对照组总满意度为78%,观察组总满意度为98%,观察组高于对照组(Z =-4.581,P <0.01)。结论针对性护理能有效减小围手术期患者体温波动,降低剖宫产患者术后寒颤发生率,提高护理质量,增加剖宫产患者对剖宫产围手术期护理的满意度。

  15. Aspectos relacionados à escolha do tipo de parto: um estudo comparativo entre uma maternidade pública e outra privada, em São Luís, Maranhão, Brasil Aspects related to choice of type of delivery: a comparative study of two maternity hospitals in São Luís, State of Maranhão, Brazil

    Directory of Open Access Journals (Sweden)

    Natália Ribeiro Mandarino

    2009-07-01

    Full Text Available Esta pesquisa objetivou analisar aspectos relacionados à escolha do tipo de parto em uma maternidade do serviço público e outra do serviço privado, em São Luís, Maranhão, Brasil. Trata-se de um estudo transversal abordando comparativamente 163 primíparas de uma maternidade pública e 89 de maternidade privada, com médias de idade de 21,63 ± 5,24 e 28,8 ± 5,41 anos, respectivamente. Preferiam o parto vaginal 79,1% das gestantes da maternidade pública, e a cesariana 67,4% das da maternidade privada (p This study aimed to analyze aspects related to choice of type of delivery in two maternity hospitals, one public and the other private, in São Luís, Maranhão State, Brazil. This cross-sectional study compared 163 primiparous women in a public maternity hospital and 89 in a private hospital, with mean ages of 21.63 ± 5.24 and 28.8 ± 5.41 years, respectively. In the public hospital, 79.1% of the women reported preferring vaginal deliveries, while in the private hospital 67.4% of the women preferred cesareans (p < 0.0001. Cesareans were performed in 46% of the women in the public maternity hospital and 97.8% of those in the private hospital (p < 0.0001. Patient satisfaction was high for both modes of delivery, but the desire to repeat the same mode was reported more frequently by women with vaginal deliveries (71.6% vs. 41.3% in the public maternity hospital and 100% vs. 65.5% in the private. In the public maternity hospital, the cesarean subgroup included more white and higher-income women. The cesarean rate was thus high in both maternity hospitals and was significantly higher in the private hospital; the study also showed a preference for vaginal delivery in the public hospital and cesareans in the private.

  16. Drug Delivery Approaches for the Treatment of Cervical Cancer

    OpenAIRE

    Farideh Ordikhani; Mustafa Erdem Arslan; Raymundo Marcelo; Ilyas Sahin; Perry Grigsby; Schwarz, Julie K.; Abdel Kareem Azab

    2016-01-01

    Cervical cancer is a highly prevalent cancer that affects women around the world. With the availability of new technologies, researchers have increased their efforts to develop new drug delivery systems in cervical cancer chemotherapy. In this review, we summarized some of the recent research in systematic and localized drug delivery systems and compared the advantages and disadvantages of these methods.

  17. Intra-arterial infusion of MTX for the treatment of cesarean scar pregnancy: a comparative study between different doses

    International Nuclear Information System (INIS)

    Objective: To investigate the effective dose of methotrexate (MTX) via intra-arterial infusion for the treatment of cesarean scar pregnancy. Methods: Thirty-six cases of incisional scar pregnancy at the gestational age of 5-9 weeks received bilateral uterine arterial infusion of MTX. According to the dose of MTX used, the patients were randomly and equally divided into four groups with MTX dose of 60, 100, 150 and 200 mg respectively. After the perfusion was completed the embolization of both uterine arteries with Gelfoam was carried out until the uterine arteries were no longer visualized on DSA. Uterine curettage was conducted within 1-7 days after the treatment. Results: In one week after the procedure, the difference in the decreasing rate of serum β-HCG and progesterone between group 60 mg and group 200 mg was of statistical significance (P 0.05). The hospitalization days of group 60 mg was the longest, while that of group 200 mg was the shortest. Conclusion: The recommended dose of MTX used via intra-arterial infusion in treating cesarean scar pregnancy is 200 mg. The interventional procedure can kill the embryo tissue and quickly lower the serum β-HCG and progesterone levels,it can also shorten the patient's hospitalization time. (authors)

  18. Health care delivery systems.

    NARCIS (Netherlands)

    Stevens, F.; Zee, J. van der

    2007-01-01

    A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,

  19. 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

    previous CS was the most common cause (32.4%. On the basis of this study, we believe that EFM has no effect in itself on cesarean section rates considering overall deliveries at HUSM. With proper education of the clinician and correct interpretation of the findings, EFM would not increase cesarean section rates, but rather should allow for a more accurate description of intrapartum fetal well-being.

  20. 自控镇痛对剖宫产产后抑郁症发病率影响的研究%Research in influence of patient-controlled analgesia on incidence of postpartum depression after cesarean section

    Institute of Scientific and Technical Information of China (English)

    廖少玲; 曾三梅; 李小林

    2012-01-01

    目的 探讨硬膜外自控镇痛(PCEA)对剖宫产产后抑郁症发病率的影响.方法 将256例单胎足月初次剖宫产妇随机分为研究组]30例和对照组126例,研究组产妇术后保留硬膜外导管与镇痛泵连接,注入镇痛液镇痛,对照组产妇术后拔管,术后4~6 h肌肉注射盐酸哌替啶100 mg,6h后重复1次,总量200 mg.术后观察48h,用放射免疫分析法测定产前、产后24,48h血浆催乳素(PRL)的浓度.产后6周采用爱丁堡产后抑郁量表(EPDS)对2组产妇进行评定,比较2组产妇产后抑郁症的发病率,并进行比较.结果 研究组产妇产后24,48 h血浆PRL水平均明显高于对照组,研究组产妇抑郁症发病率为6.15%,而对照组产妇抑郁症发病率为16.67%,2组比较差异显著.结论 剖宫产术后应用自控镇痛可明显地降低产妇产后抑郁症的发病率,对预防产后抑郁症的发生具有非常重要的现实意义.%Objective To explore the influence of patient-controlled epidural analgesia(PCEA) on incidence of postpartum depression after cesarean section. Methods 256 cases of singleton term primary cesarean delivery were randomly divided into the study group( 130 cases)and the control group( 126 cases).The study group retained analgesia pump connected with epidural catheter,analgesic liquid was injected.In the control group,epidural catheter was removed,and was given intramuscular injection of pethidine hydrochloride 100 mg 4~6 h after operation,repeated 6 h later,total dosage was 200 mg.Postoperative observation time was 48h.Plasma prolactin(PRL) concentration was determined by radioimmunoassay in prenatal,postnatal 24 h and 48 h.Edinburgh postnatal depression scale (EPDS) was used to assess depression state 6 weeks postpartum in the two groups.The incidence of postpartum depression was compared between two groups. Results The plasma PRL level in the study group was significantly higher than the control group 24 h,48 h postpartum.The incidence

  1. 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.

  2. Prevention of Postoperative Nausea and Vomiting by Administration of Sub Hypnotic Doses of Propofol and Midazolam during Spinal Anesthesia for Cesarean Section

    Directory of Open Access Journals (Sweden)

    Saghar Samimi Sade

    2010-12-01

    Conclusion: Sub hypnotic dose of midazolam was as effective as the sub hypnotic dose of propofol for preventing of nausea and vomiting in parturients undergoing cesarean section under spinal anesthesia. We undertook this study in regard to examine a simple, safe and non-expensive antiemetic method.

  3. TRANSDERMAL DRUG DELIVERY SYSTEM: REVIEW

    OpenAIRE

    Vishvakarama Prabhakar; Agarwal Shivendra; Sharma Ritika; Saurabh Sharma

    2012-01-01

    Various new technologies have been developed for the transdermal delivery of some important drugs. Today about 74% of drugs are taken orally and are found not to be as effective as desired. To improve such characters transdermal drug delivery system was emerged. Drug delivery through the skin to achieve a systemic effect of a drug is commonly known as transdermal drug delivery and differs from traditional topical drug delivery. Transdermal drug delivery systems (TDDS) are dosage forms involve...

  4. 无创分娩经验%Noninvasive delivery experience

    Institute of Scientific and Technical Information of China (English)

    罗艳琼

    2015-01-01

    Objective:To study the effect of noninvasive delivery for reducing episiotomy rate.Methods:126 cases of vaginal delivery women from July to September 2013 were divided into the observation group and the control group, with 63 cases in each. The observation group were given noninvasive delivery technology,while the control group were given traditional delivery technology.The curative effect of two groups were compared.Results:The difference of perineum complete and episiotomy of two groups was statistically significant(P0.05).The bleeding was similar between the two groups,with no statistical significance(P>0.05).The difference of postpartum perineum wound healing and perineal pain after 3 days was statistically significant(P<0.05).Conclusion:Noninvasive childbirth can reduce episiotomy rate and reduce the perineal pain postpartum.It is favorable for perineum wound healing and improving the quality of life.It makes maternal women no longer fear episiotomy,so that it reduces the rate of cesarean delivery.%目的:探讨无创分娩对于减少会阴侧切率的效果。方法:2013年7-9月收治经阴道分娩产妇126例,分成观察组和对照组,各63例。观察组采用无创分娩技术,对照组采用传统分娩技术。比较两组效果。结果:两组会阴完整、会阴侧切比较差异有统计学意义(P<0.05),会阴裂伤程度差异无统计学意义(P>0.05),两组出血比较差异无统计学意义(P>0.05),产后3 d 会阴伤口愈合及会阴疼痛差异有统计学意义(P<0.05)。结论:无创分娩降低会阴侧切率,减轻会阴产后疼痛,有利会阴伤口愈合,改善产妇生活质量,使产妇不再惧怕侧切而行剖宫产,降低了剖宫产率。

  5. VARIATION IN THE SYSTOLIC ARTERIAL PRESSURE WITH THE CHANGES OF POSITION, AS PREDICTOR OF POSTANESTHETIC HYPOTENSION IN ELECTIVE CESAREAN (IN SPANISH

    Directory of Open Access Journals (Sweden)

    De la Peña-Martínez Michael

    2014-01-01

    Full Text Available Introduction: It is important to identify to those pregnant women with risk to present postanesthetic arterial hypotension, when they are submitted to cesarean under spinal anesthesia. Objective: to identify if the variability in the systolic arterial pressure (SAP with the preoperative changes of position is predictor of postanesthetic arterial hypotension in elective cesarean. Methods: 244 women with pregnancy at term, programmed for elective cesarean were studied. Preanesthetic measures of the SAP in supine decubitus and in left lateral decubitus position were carried out, estimating the difference between the two measures. Postanesthetic arterial hypotension was defined as SAP lower than 90 mmHg or reduction higher to 30% of the SAP in supine decubitus position. Results: postanesthetic arterial hypotension was presented in 107 (43.8% of the pregnant women. The variation of the SAP in the group that presented postanesthetic arterial hypotension was 10.5 [2.0 to 16.5] Vs 2.5 [-6.5 to 6.0] between those who did not present it (P<0,0001. It was estimated that variability higher to 11 mmHg of the SAP predicted postanesthetic arterial hypotension with sensibility: 47.6%, specificity: 93.4%, LR (+: 7.26, LR (-: 0.58 and area under the curve of 0.737 (CI 95%: 0.677-0.791, (p=0.0001. In turn such a variation was significant risk factor for the decrease of the arterial pressure. RR: 2.79 (CI95%: 2.19-3.56. Conclusion: the preanesthetic variation of the SAP with the change of position from supine decubitus to lateral decubitus position was predictor of arterial hypotension subsequent to the use of spinal anesthesia in pregnant women submitted to elective cesareans. Rev.Cienc.Biomed. 2014;5(1:29-34 KEYWORDS Arterial Pressure; Blood Pressure; Cesarean Section; Anesthesia, Obstetric.

  6. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush

    We investigate antecedents and contingencies of location configurations supporting global delivery models (GDMs) in global outsourcing. GDMs are a new form of IT-enabled client-specific investment promoting services provision integration with clients by exploiting client proximity and time......-zone spread allowing for 24/7 service delivery and access to resources. Based on comprehensive data we show that providers are likely to establish GDM configurations when clients value access to globally distributed talent pools and speed of service delivery, and in particular when services are highly...

  7. Analgesia perioperatoria en cesárea: eficacia y seguridad del fentanilo intratecal Perioperative analgesia in cesareans: effectiveness and safeness of intrathecal fentanyl

    Directory of Open Access Journals (Sweden)

    M. C. Aragón

    2004-03-01

    women was high in both groups, but greater scores were obtained in Group F. Conclusion: The addition of fentanyl 50 µg to the local anesthetic, hyperbaric bupivacaine for subarachnoid anesthesia in cesareans is an effective technique that increases intensity and length of the sensitive blockade, extending the post-operative analgesia for more than 6 hours without affecting the recovery of the motor blockade, without any fetal effect and with a low incidence of side effects, except for mild itching.

  8. 自然分娩与剖宫产分娩对产妇产后生理及心理影响的比较%Comparative analysis of natural childbirth and cesarean section on the physiological and psychological effects of

    Institute of Scientific and Technical Information of China (English)

    曾艳; 杨梅

    2015-01-01

    Objective To investigate physiological and psychological effects of natural childbirth and cesarean section on puerpera.Methods A total of 324 cases who were delivered at Second People′s Hospital of Liangshan Yi Autonomous Prefecture from February 2013 to February 2014 were included into this study.According to different delivery approaches,they were divided into natural childbirth group (n=126) and cesarean section group (n=1 98).The following items were observed:postpartum pain scores,recovery of postpartum function (anal exhaust time,incidence rate of abdominal distension,anorexia,> 1 week vaginal bleeding time,temperature),maternal mood and lactation.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Second People′s Hospital of Liangshan Yi Autonomous Prefecture.Informed consent was obtained from the parents of each patient.There were no significant differences between two groups in the aspects of age, gestational age, weight etc.. Results ①There were significant differences between two groups in pain scores at different time points (P 1 week vaginal bleeding time in natural childbirth group were lower than those in cesarean section group with significant differences (P 0.05)。结果①自然分娩组产妇产后在同一时间点的疼痛评分显著低于剖宫产组,并且差异均有统计学意义(P 1周发生率低于剖宫产组,差异均有统计学意义(P <0.05)。自然分娩组产后第1,2天体温均低于剖宫产组,并且差异均有统计学意义(P <0.05)。③自然分娩组产妇产后情绪良好者所占比例高于剖宫产组,并且差异均有统计学意义(P <0.05)。④自然分娩组产妇产后开始泌乳时间早于剖宫产组,并且差异有统计学意义(P <0.05)。结论自然分娩能减轻创伤,促进乳汁分泌和产后恢复。

  9. The management of pregnancy and delivery in 3-hydroxy-3-methylglutaryl-CoA lyase deficiency.

    Science.gov (United States)

    Pipitone, Angela; Raval, Donna B; Duis, Jessica; Vernon, Hilary; Martin, Regina; Hamosh, Ada; Valle, David; Gunay-Aygun, Meral

    2016-06-01

    3-hydroxy-3-methylglutaric (HMG)-CoA lyase is required for ketogenesis and leucine degradation. Patients with HMG-CoA lyase deficiency typically present with hypoketotic hypoglycemia and metabolic acidosis, which can be fatal if untreated. The patient is a 28-year-old female with HMG-CoA lyase deficiency who presented at 4 weeks gestation for prenatal care. Protein intake as well as carnitine supplementation were gradually increased to support maternal and fetal demands up to 65 g per day for protein and 80 mg/kg/day for carnitine. Fetal growth was appropriate. At 36 5/7 weeks, she presented with spontaneous rupture of membranes. Twice maintenance 10% glucose-containing intravenous fluids were initiated. During labor, vomiting and metabolic acidosis developed. Delivery was by cesarean. Preeclampsia developed postpartum. The patient recovered well and was discharged home on postpartum day 5. Stress of pregnancy and labor and delivery can lead to metabolic decompensation in HMG-CoA lyase deficiency. Patients should be monitored closely by a biochemical geneticist, dietitian, and high-risk obstetrician at a tertiary care center during their pregnancy. Fasting should be avoided. Intravenous 10% glucose-containing fluids should be provided to prevent catabolism and metabolic decompensation during labor and delivery. © 2016 Wiley Periodicals, Inc. PMID:26997609

  10. Dilemma in Timing of Delivery in a Patient with an Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Laura M. Héman

    2015-01-01

    Full Text Available Introduction. Acute myocardial infarction (AMI in a pregnant woman is rare. When occurring, AMI is a major cause of maternal and neonatal death. By presenting the following case we describe the dilemma concerning the timing of delivery. Case. A 36-year-old, multiparous women, at 35 6/7 weeks of gestation, suffered from an AMI due to an acute blockage of the left anterior descending artery (LAD. This was treated by angiographic thrombosuction and biodegradable stent placement. Within 5 hours after this procedure, a cesarean section (CS was performed because of a nonreassuring fetal condition. A healthy son with an Apgar score of 9/10 was born. The patient’s postoperative course was complicated by a big wound hematoma, a hemoglobin drop, and heart failure. Discussion. In case of AMI during pregnancy, the cardiological management has absolute priority. The obstetrical management is not outlined. In a nonreassuring fetal condition, delivery is indicated after stabilization of the mother. However, delivery after recent AMI and angiography will bring new risks of cardiologic stress and bleeding complications. The limited literature available tends to an expectant obstetrical management, but this case emphasizes the difficulty of waiting in suspected fetal distress.

  11. Association Between Obstetric Conjugate Diameter Measured by Transabdominal Ultrasonography During Pregnancy and the Type of Delivery

    International Nuclear Information System (INIS)

    Normal morphological features of the maternal pelvis are an important prerequisite to vaginal delivery. We aimed to evaluate the association between obstetric conjugate diameter (OCD) measured by ultrasonography and the type of delivery, vaginally (V) or by cesarean (C) section. Pelvimetry was performed in 200 primigravid women for fetal cephalic presentation. The OCD was measured twice by transabdominal ultrasonography during 25-30 weeks and 30-35 weeks of pregnancy. The mean OCD of both sonographies in groups V and C was 125.51± 8.35 mm (105-144.5) and 112.99 ± 8.53 mm (96-134.5), respectively, which was significantly lower in group C (P<0.001). The values of OCD between the first and second measurements were not different significantly (P=0.065). C-section was indicated in 65 (32.5%) mothers. The optimal cut-off point for the OCD in the prediction of vaginal delivery was ≥ 119.75 mm, with a sensitivity and specificity of 80% and 78.5%, respectively. The US measurement of OCD might be an accurate method that almost always remains constant during late pregnancy; it is easy to measure and might be confidentially employed for predicting C-section, but needs more precise studies to be used widely

  12. Assisted Vaginal Delivery

    Science.gov (United States)

    ... having a repeat assisted vaginal delivery in a future pregnancy? If you have had one assisted vaginal ... Education Green Journal Practice Management Coding Health Info Technology Professional Liability Managing Your Practice Patient Safety & Quality ...

  13. Project Delivery Methods.

    Science.gov (United States)

    Dolan, Thomas G.

    2003-01-01

    Describes project delivery methods that are replacing the traditional Design/Bid/Build linear approach to the management, design, and construction of new facilities. These variations can enhance construction management and teamwork. (SLD)

  14. 孕妇要求不合理剖宫产影响因素分析%The Analysis of Factors Influencing Pregnant Women Requesting Unreasonable Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    文艳玲; 李玲; 陈红花; 任燕华

    2012-01-01

    目的 探讨影响孕妇要求不合理剖宫产的相关因素,为孕产期妇女保健工作提供指导.方法 采用病例对照研究的方法,对某三级甲等医院2010年6月~2011年6月的产科分娩病案记录进行回顾调查.结果 产妇年龄大于35岁、居住在城市、文化程度在本科以上、职业为管理人员或者个体私营业主时,其要求不合理剖宫产的危险性会增加,OR值分别为1.26(1.09,2.01),2.14(1.47,2.98),1.55(1.19,2.70),1.63(1.36,2.89),1.85(1.47,2.86).产妇享有医疗保险、剖宫产分娩史以及肥胖(BMI>29)也是产妇要求不合理剖宫产的危险因素,阴道分娩史是产妇要求不合理剖宫产的保护因素,其OR值分别为2.01(1.26,3.15),3.89(2.17,6.32),1.19(1.02,2.01),0.46(0.21,0.76).结论 应有针对性地加强孕产期妇女保健知识的宣传教育工作,从而控制剖宫产过度使用.%To explore the factors which influence pregnant women requesting unreasonable cesarean section (CS) , and to provide guidance for maternal care. Methods We constructed a case-control study to analyze the medical records of pregnant women who delivered between June, 2010 and June 2011. Results Pregnant women with the following characteristics were more likely to request unreasonable CS: older than 35, living in the city, education level above the bachelor degree, administrative staff or private owners, the OR were 1. 26(1. 09,2. 01) ,2. 14 (1. 47,2. 98) ,1. 55(1. 19,2. 70) ,1. 63(1. 36,2. 89) ,1. 85(1. 47,2. 86) .respectively. Having health insurance, CS delivery history and obesity were risk factors for women to request unreasonable CS, while the vaginal delivery history was protective factors, the OR were 2. 01 (1. 26 , 3. 15) , 3. 89 (2. 17 , 6. 32) , 1. 19 (1. 02 , 2. 01) , 0. 46 (0. 21, 0. 76) , respectively. Conclusions In order to control the excessive use of CS, it is necessary to strengthen health education for pregnant women.

  15. [Transdermal Delivery of NSAIDs].

    Science.gov (United States)

    Nakajima, Takehisa; Makino, Kimiko

    2015-11-01

    Skin has been studied as administration site of drug for its systemic effects, since systemic therapeutic agents can be delivered for long time with a controlled ratio, escaping from the first pass effect by liver by the transdermal delivery, which can decrease the dosage form. The low permeability of drug molecules through stratum corneum has been the limiting factor for developing transdermal delivery system of therapeutic agents. To enhance the permeability of drug molecules, many studies have been reported. PMID:26689064

  16. Continuous software delivery

    OpenAIRE

    KRMAVNAR, NINA

    2015-01-01

    The main purpose of the thesis is the demonstration of one of the best possible approaches to an automated continuous delivery process as it relates to certain application types. In the introductory part, the main reason for choosing the subject is presented, along with a few examples of why nowadays - in order to keep pace with the competition - such an approach seems necessary. Following chapters discuss the basics of software delivery, starting with configuration and version control manage...

  17. Polymers for DNA Delivery

    Directory of Open Access Journals (Sweden)

    A. J. Domb

    2005-01-01

    Full Text Available Nucleic acid delivery has many applications in basic science, biotechnology, agriculture, and medicine. One of the main applications is DNA or RNA delivery for gene therapy purposes. Gene therapy, an approach for treatment or prevention of diseases associated with defective gene expression, involves the insertion of a therapeutic gene into cells, followed by expression and production of the required proteins. This approach enables replacement of damaged genes or expression inhibition of undesired genes. Following two decades of research, there are two major methods for delivery of genes. The first method, considered the dominant approach, utilizes viral vectors and is generally an efficient tool of transfection. Attempts, however, to resolve drawbacks related with viral vectors (e.g., high risk of mutagenicity, immunogenicity, low production yield, limited gene size, etc., led to the development of an alternative method, which makes use of non-viral vectors. This review describes non-viral gene delivery vectors, termed "self-assembled" systems, and are based on cationic molecules, which form spontaneous complexes with negatively charged nucleic acids. It introduces the most important cationic polymers used for gene delivery. A transition from in vitro to in vivo gene delivery is also presented, with an emphasis on the obstacles to achieve successful transfection in vivo.

  18. Cesarean section under epidural anesthesia in a documented case of ruptured aneurysm of the sinus of valsalva.

    Science.gov (United States)

    Divakar, S R; Singh, Chandrashekhar; Verma, Chandra Mohan; Kulkarni, Chaitanya D

    2015-01-01

    Ruptured aneurysm of sinus of Valsalva (RSOV) occurring in pregnancy is a rare cardiac anomaly and it may be either congenital or acquired. Congenital sinus of Valsalva aneurysms are commonly associated with other structural defects such as ventricular septal defect (50-55%), aortic regurgitation (AR) (25-35%), bicuspid aortic valve (10-15%) and Marfan's syndrome (10%). RSOV in pregnancy accentuates the hemodynamic stress on maternal cardiovascular system and pose a significant challenge from obstetric anesthesia point of view. We report a case of 35-year-old documented patient of RSOV with mild AR presenting completely asymptomatic at 37 weeks 4 days of gestation. A successful elective lower segment cesarean section was conducted under epidural anesthesia. PMID:25788785

  19. Therapeutic analysis of bilateral uterine artery chemoembolization performed before uterine dilation and curettage for cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical outcomes of bilateral uterine artery chemoembolization (UACE) followed by uterine dilation and curettage in treating cesarean scar pregnancy. Methods: A total of 104 patients with cesarean scar pregnancy, admitted to hospital during the period from Jan. 2005 to Jan. 2009, were enrolled in the study. The patients were divided into group A (control group, n=49) and group B (study group, n=55). Patients in group A received uterine dilation and curettage only, and patients in group B received additional UACE, which was performed 24-72 hours before uterine dilation and curettage was carried out. The blood loss during the operation, the time for β-human chorionic gonadotrophin (β-hCG) level going down to normal, the success rate of operation, the hospitalization days, the occurrence of complications and the menstrual situation after operation were documented. The results were analyzed and compared between the two groups. Results: In group A, 4 patients had to receive hysterectomy due to massive hemorrhage or inadequate curettage. None of the patients in group B needed to have a hysterectomy. the technical success rates of curettage for group A and group B were 91.84% and 100%, respectively. The mean blood loss in group B was (54.36±38.09) ml, which was significantly lower than that of (54.36±38.09) ml in group A (P0.05], while between those patients who had pregnancy time > 10 weeks, the blood loss in group B was much less than that of group A [(101.33±39.43) ml vs. (457.14±97.59) ml, P0.05]. The difference in hospitalization days between the patients with pregnancy time ≤ 10 weeks in two groups [(11.21±3.24) days vs. (12.68±34.56) days] was not significant (P>0.05). But for patients with pregnancy time > 10 weeks, the hospitalization days of group B was significantly shorter than that of group A (13.46±4.87 days vs. 19.34±5.72 days, P<0.01), Except for 4 patients who had received hysterectomy, all patients regained normal

  20. A Comparison of the Effects of Fentanyl and Remifentanil on Nausea, Vomiting, and Pain after Cesarean Section

    Directory of Open Access Journals (Sweden)

    Fatemeh Gourtanian

    2011-09-01

    Full Text Available Background: The effects of different opioids on postoperative nausea and vomiting (PONV and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial recruiting 96 parturients with American Society of Anesthesiologists (ASA physical status I and II. They scheduled for cesarean section under general anesthesia using sodium thiopental, succynylcholine, and isoflurane O2/N2O 50/50 mixture. After clamping the umbilical cord, the patients were given fentanyl (2 µg/kg/h, remifentanil (0.05 µg/kg/h, or fentanyl (2 µg/kg pulse morphine (0.1 mg/kg intravenously. Visual analog scale for pain and nausea, frequency of PONV, meperidine and metoclopramide consumption were evaluated at recovery, and 4, 8, 12 and 24 hours after the surgery. Results: There was no significant difference between the three groups in terms of frequency of nausea, vomiting, and mean nausea and pain scores at any time points. None of the patients required the administration of metoclopramide. However, the mean VAS for pain in remifentanil-treated group was insignificantly more than that in fentanyl- or fentanyl plus morphine-treated group at recovery or 4 hours after the surgery. The mean mepridine consumption in remifentanil-treated group was significantly (P=0.001 more than that in fentanyl- or fentanyl plus morphine-treated group in 24 hours after the surgery respectively. There was no significant difference in hemodynamic parameters of the three groups in all measurements after the surgery. Conclusion: The findings of this study showed that early postoperative analgesia was better with fentanyl, and postoperative meperidine consumption was significantly less with fentanyl than with remifentanil or combined fentayl and morphine. Trial