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Sample records for cesarean section scar

  1. The cosmetic outcome of the scar formation after cesarean section

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Möller-Christensen, T; Steele, R E

    1994-01-01

    to significantly narrower scars compared with percutaneous closure, 4.5 versus 11.1. Thus, even better results can be expected as experience with the technique increases. Observer and patient satisfaction with the cosmetic outcome were measured independently on a 'Lasa-line'. Their opinions coincided; the order......Three methods of skin closure after cesarean section were tested and compared in a prospective trial. Eighty-nine (82.5%) appeared for follow-up investigation 4-5 months after delivery. The mean scar width was significantly narrower after phannenstiel incision compared with percutaneous nylon...... sutures after lower midline incision, 3.1 mm versus 11.3 mm. Intracutaneous continuous PDS-suture after lower midline incision produced scars 40% narrower than with percutaneous sutures, 6.8 versus 11.3 mm. 37.5% of the women sutured intracutaneously complained over persistent secretion after discharge...

  2. 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...

  3. [Parietal-scar endometriosis after cesarean section: a rare entity].

    Science.gov (United States)

    El Fahssi, Mohammed; Lomdo, Massama; Bounaim, Ahmed; Ali, Abdelmounaim Ait; Sair, Khalid

    2016-01-01

    Wall endometriosis is a rare clinical entity whose pathophysiology remains unclear. It occurs most frequently after gynecologic or obstetric surgery. We report the case of a patient with cyclic pain at the caesarean section scar. Clinical examination showed a 5 cm mass in the right iliac fossa. Tomodensitometry revealed a tissue density mass (45mm on the major axis). Hence, the decision to perform a wide excision of the lesion. Anatomo-pathological examination confirmed the diagnosis of parietal endometriosis. Postoperative sequelae were simple with a follow-up period of 20 months with no recurrence of the mass or of the pain. Our study highlights the characteristics of this disease to allow the health practitioner to understand the importance of diagnosis, of early treatment of this disease as well as of the possibility to prevent it during each gynecologic or obstetric surgery. PMID:27642418

  4. Cesarean scar pregnancy

    DEFF Research Database (Denmark)

    Birch Petersen, Kathrine; Hoffmann, Elise; Rifbjerg Larsen, Christian;

    2016-01-01

    OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE...

  5. 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)

  6. 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.

  7. 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

  8. Pitfall in Ultrasound Evaluation of Uterine Scar from Prior Preterm Cesarean Section

    Directory of Open Access Journals (Sweden)

    Sarah-Maude B. Laflamme

    2011-09-01

    Full Text Available We report two cases of women with a previous cesarean performed before active labor at 29 weeks of gestation who underwent sonographic measurement of the lower uterine segment (LUS at 36 weeks' gestation in their subsequent pregnancy. In both cases, uterine scar defect was detected on the upper part of the LUS, at ~9 to 11 cm from the cervical os, and was only visualized by the transabdominal approach. We suggest that early gestational age and the absence of labor at previous cesarean can lead to a higher uterine scar location on the LUS and, therefore, increase the risk of uterine rupture in subsequent pregnancy. The heterogeneity of uterine scar location could explain discrepancies observed in studies using the transabdominal versus the transvaginal approach or both regarding the predictive value of LUS measurements for uterine rupture.

  9. Cesarean Section

    Science.gov (United States)

    A Cesarean section (C-section) is surgery to deliver a baby. The baby is taken out through the mother's abdomen. In the United ... three women has their babies this way. Some C-sections are planned, but many are done when ...

  10. 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.

  11. 阴式子宫下段加固术治疗剖宫产瘢痕妊娠%Vaginal Reinforcement of Cesarean Section Scar for Cesarean Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

    李环; 杨将; 杜辉; 胡艳; 魏蔚霞; 吴瑞芳

    2016-01-01

    目的:探讨阴式子宫下段加固术治疗剖宫产瘢痕妊娠( cesarean scar pregnancy , CSP )的临床效果。方法2014年12月~2015年6月采用阴式子宫下段加固术治疗20例CSP,打开膀胱宫颈间隙,暴露子宫下段薄弱部位,避开膀胱后行B超引导下清宫术,B超引导及扩宫棒、手指引导下,加固缝合子宫下段薄弱部位。结果所有手术均顺利完成,手术时间30~120 min,(53.4±26.0)min;术中出血量中位数50 ml(20~400 ml);术后住院时间2~18 d,平均4.6 d;术后监测血hCG降至正常时间中位数46 d(4~90 d)。结论阴式子宫下段加固术治疗CSP具有操作简便、创伤小、增加子宫肌层厚度等优点。%Objective To investigate the clinical effect of vaginal reinforcement of cesarean section scar in the treatment of cesarean scar pregnancy (CSP). Methods Twenty female patients with CSP from December 2014 to June 2015 were recruited.All the patients were treated with vaginal reinforcement of cesarean section scar .The vesicocervical space was opened to expose the thin part of the scar .Dilation and curettage was carried out under surveillance of sonography after drawing back the bladder .The low thin part of the uterine was reinforced under the guidance of cervical dilator , finger and sonography . Results All the surgical procedures were successfully performed.The duration of surgery was 30-120 min (53.4 ±26.0 min).The median of intraoperative hemorrhage was 50 ml (20-400 ml).The length of hospital stay was 2-18 d (4.6 ±3.3 d).The median time of serum hCG dropped to normal was 46 d (4-90 d). Conclusions Vaginal reinforcement of cesarean section scar has privileges for treating CSP , especially for patients with extensive thin part of scar .The procedure is characterized by easy performance , minimal invasion , and increasing the muscular sickness of scar .

  12. 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.

  13. Relationship Between Myometrium Closure Methods and the Incidence of Cesarean Scar Defect in Cesarean Section%剖宫产子宫切口缝合术式与子宫切口假腔的关系

    Institute of Scientific and Technical Information of China (English)

    游一平; 阳笑; 唐雅兵; 靳晓丹

    2013-01-01

    [目的]探讨剖宫产子宫切口缝合术式与子宫切口假腔(cesarean scar defect)发生的关系.[方法]应用阴道四维B超观察改良新式剖宫产中“连续套锁缝合(continuous lock catch suture)”及“连续单层缝合(Continuous single-layer closure)”在子宫切口缝合后患者子宫切口假腔发生的情况(阴道B超追踪术后4d、42 d、1年、2年子宫切口情况).计算切口假腔的发生率.[结果]行“连续单层缝合”子宫切口的患者,子宫切口假腔发生率显著低于行“连续套锁缝合”子宫切口的患者(2.74% vs 6.76%,P<0.05).[结论]子宫切口假腔的发生与子宫切口缝合术式相关,“连续单层缝合”子宫切口的缝合术式可有效降低子宫切口假腔的发生.%[Objective] To explore the relationship between myometrium closure methods and the incidence of cesarean scar defect. [Methods] Transvaginal B-ultrasound scan was used to observe the incidence of cesarean scar defect after continuous lock catch suture or continuous single-layer closure in modified new cesarean section. Uterine incision condition at 4d, 42d, 1 year and 2 years after the operation was followed up by using transvaginal B-ultrasound scan. The incidence of cesarean scar defect was calculated. [Results] The incidence of cesarean scar defect in patients undergoing continuous single-layer closure of myometrium was significantly lower than that in patients undergoing continuous lock catch closure of myometrium. [Conclusion] The incidence of cesarean scar defect is related with myometrium closure methods. Continuous single-layer closure can effectively decrease the incidence of cesarean scar defect.

  14. 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 ...

  15. Care to prevent scar uterus abdominal distension after cesarean section%预防瘢痕子宫剖宫产术后腹胀的护理

    Institute of Scientific and Technical Information of China (English)

    李萍

    2015-01-01

    Objective Summarize nursing intervention to prevent scar uterine cesarean section abdominal distension. Methods 245 cases of uterine cesarean section scar patients were divided into control group and experimental group to implement the nursing intervention. Results Incidence of abdominal distension, anal exhaust time, discharge time, complication rates is better than that in control group. Conclusions Scar uterine cesarean section to take comprehensive measures to reduce abdominal distention, reduce maternal discomfort, shorten hospitalization time.%目的:总结预防瘢痕子宫剖宫产术腹胀的护理干预。方法:对245例瘢痕子宫剖宫产术后患者分为对照组和实验组实施护理干预。结果:实验组腹胀发生率、肛门排气时间、出院时间、并发症发生率方面优于对照组。结论:瘢痕子宫剖宫产术后采取一些综合措施可减少腹胀发生,减轻产妇不适,缩短住院时间。

  16. 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 ...

  17. 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)

  18. Incision cesarean section scar pregnancy version of the intervention of nursing%剖宫产切口瘢痕妊娠介入治疗的护理

    Institute of Scientific and Technical Information of China (English)

    葛忠玲

    2012-01-01

      Objective:To expcore incision cesarean section scar pregnancy intervention treatment nuring key points. Methods:Summarize 10 cases of cesarean section scar pregnancy nursing intervention treatment,before the number of tiems must then,patient decubitus choice|. disease observation,the postoperative complications prevention.Results:10 cases in cision cesaren section scar pregnancy after uterine artery embocism after treatment,aii one-time success,after the qing dynasty palace without a massive haemorrhage.Conclusion:After uterive qrtery interventional therapy in cision scar pregnancy,carry of comprehensive care,than traditional conservative treatment offect is good,the risk small,can effectively control hemorrhage,shorten hospitalization time,to qvoid the relevant risk factors%  目的:探讨剖宫产切口瘢痕妊娠介入治疗的护理要点。方法:总结10例剖宫产瘢痕妊娠的护理,术前物品准备,术中患者卧位选择、病情观察。术后并发症预防结果:10例剖宫产切口瘢痕妊娠经子宫动脉栓塞治疗后,均一次性成功,术后清宫无一例大出血。结论:经子宫动脉介入治疗瘢痕妊娠,进行护理干预比传统保守治疗效果好,风险小,能有效控制出血,缩短了住院时间,避免了相关危险因素。

  19. Management of Cesarean Deliveries and Cesarean Scars With Osteopathic Manipulative Treatment: A Brief Report.

    Science.gov (United States)

    Martingano, Daniel

    2016-07-01

    Cesarean scars pose a unique set of risks for women who have had previous cesarean deliveries. Between 1996 and 2007, the rate of trial of labor after previous cesarean delivery increased, along with reported rates of uterine rupture and other complications. Consequently, trial of labor after previous cesarean delivery and resultant vaginal birth after cesarean delivery have decreased and cesarean delivery has increased. With nearly one-third of women having cesarean delivery, the rate of rare complications such as cesarean scar ectopic pregnancy has also increased. An integration of osteopathic manipulative treatment techniques into the management of cesarean deliveries and cesarean scars has yet to be defined. The author presents 4 cases of cesarean delivery in which osteopathic manipulative treatment was integrated with successful outcomes.

  20. 剖宫产瘢痕处妊娠32例分析%Analysis of 32 cases of cesarean section scar in pregnancy

    Institute of Scientific and Technical Information of China (English)

    成健; 黄森

    2014-01-01

    目的:探讨剖宫产切口瘢痕妊娠(CSP)的诊断和治疗。方法回顾性分析我院收治32例CSP患者的临床资料。结果18例选择子宫动脉栓塞术+刮宫术,12例行药物治疗,2例由外院急诊转入。结论彩色多普勒阴道超声检查是诊断剖宫产术后瘢痕妊娠的首选影像学手段,治疗应个体化,切忌盲目刮宫。%Objective To explore the diagnosis and treatment of cesarean section incision scar pregnancy. Method The clinical data of 32 cases of patients with CSP were analyzed retrospectively. Results 18 patients choose uterine artery embolization and curettage,12 routine drug therapy, 2 cases by emergency into the outer court. Conclusion Color doppler transvaginal ultrasonic inspection is the first choice for diagnosis of scar pregnancy after cesarean section imaging diagnosis and treatment should be individualized, avoid by all means is blind and curettage.

  1. 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...

  2. 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

  3. Cesarean Section Birth

    Medline Plus

    Full Text Available ... c-section delivery without labor, there's an increased risk for the baby to need some extra help. ... with each successive c-section, there's an increased risk of there being scar tissue, which may increase ...

  4. 剖宫产术后疤痕处妊娠的治疗%Treatment of scar pregnancy after cesarean section

    Institute of Scientific and Technical Information of China (English)

    仲秀梅

    2015-01-01

    Objective:To explore the method and effect of treatment of scar pregnancy after cesarean section.Methods:In recent years treated40 cases after cesarean section scar pregnancy patients, all patients were taken bilateral uterine artery methotrexate infusion chemotherapy and embolization with gelfoam particles and, and curettage in 3 to 7 days after operation, intraoperative bleeding volume and scrapings send disease physical examination, uterine curettage after 1 week of transvaginal color Doppler ultrasound examination, review of serum beta hCG.Results:All40 patients were successfully treated by interventional therapy, and the vaginal bleeding after operation, the pregnancy capsule was significantly decreased, and the serum -HCG was significantly decreased. Postoperative curettage with reduced bleeding, scrapings for pathological examination showed villus tissue, have different degrees of degeneration and necrosis;color Doppler ultrasound in the diagnosis of uterine scar, no abnormal echo and blood fiow signal. Conclusion:For bilateral uterine artery methotrexate combined with embolization therapy given to patients with scar pregnancy after cesarean section, and curettage can receive good treatment effect, obviously reduces the gestational sac, effectively reduce the level of serum beta hCG; maximum control uterine bleeding, for patients to preserve the uterus, an effective method for treatment of cesarean section after caesarean scar pregnancy, it is worth in clinical application.%目的:探究剖宫产术后疤痕处妊娠治疗的方法及效果。方法选取近五年收治的40例剖宫产术后疤痕处妊娠患者,所有患者均采取双侧子宫动脉甲氨蝶呤灌注化疗及明胶海绵颗粒栓塞,并在术后3~7天进行清宫术,记录术中的出血量,并将刮出物送病理进行检查,清宫术结束后1周进行阴道彩超检查,复查血β-HCG。结果40例患者均顺利完成介入治疗,术后阴道

  5. 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, ...

  6. 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- ...

  7. Cesarean Section Birth

    Medline Plus

    Full Text Available ... may increase the patient's risk for complications or injury to surrounding organs such as bowel or bladder. ... sections, there's a risk of scar tissue and injury to surrounding organs. So I think it's oftentimes ...

  8. 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。

  9. Cesarean scar pregnancy: diagnosis, management, and follow-up.

    Science.gov (United States)

    Uysal, Fatma; Uysal, Ahmet; Adam, Gürhan

    2013-07-01

    Cesarean scar pregnancy is a very rare form of pregnancy and a life-threatening situation. It has become an important and serious problem over the last 10 years, as a result of the worldwide increase in cesarean births. In this retrospective series, the diagnosis of cesarean scar pregnancy, management, treatment methods, risk factors, and possibility of subsequent normal pregnancy are discussed, and case descriptions are presented.

  10. 瘢痕子宫与非瘢痕子宫二次剖宫产并发症分析%Analysis of the complications of two times cesarean section in scar uterus and non scar uterus

    Institute of Scientific and Technical Information of China (English)

    罗力冰; 吴婷

    2014-01-01

    目的 对瘢痕子宫孕妇二次剖宫产并发症发生情况进行分析,为临床医师合理掌握剖宫产指征提供依据.方法 选取160例瘢痕子宫孕妇二次剖宫产作为研究对象(研究组),另选取同期进行剖宫产手术分娩的80例非瘢痕子宫孕妇作为对照组,对两组孕妇的临床资料进行回顾性分析.结果 研究组术中出血量、手术时间、手术费用、术后出血量、子宫切除率、新生儿窒息发生分别为(432±331)mL、(64±21) min、(0.91±0.11)万元、(262±187) mL、4.4%、11.9%,对照组分别为(361±209) mL、(44±16)min、(0.63±0.0)万元、(184±132) mL、1.3%、6.3%,两组差异均有统计学意义(=2.52、8.19、26.10、4.00,x2=3.98、4.76,均P<0.05),两组周围脏器损伤情况差异无统计学意义(P>0.05).结论 瘢痕子宫孕妇二次剖宫产手术容易导致手术出血量及术后出血量增加、手术时间延长、子宫切除率增加、新生儿窒息发生率增加等并发症.对于瘢痕子宫二次妊娠孕产妇应严格掌握手术指征.%Objective To analyze the complications of pregnant secondary cesarean in scar uterus,to provide theoretical guidance for cesarean section.Methods 160 pregnant women of secondary cesarean uterine scar were chosen as the study group.80 pregnant women of non-scar uterine were chosen as the control group.Results The bleeding volume during operation,operation time,operation fee,postoperative bleeding,uterine resection rate,neonatal asphyxia in study group were (432 ± 331) mL,(64 ± 21) min,(0.91 ± 0.11) million,(262 ± 187) mL,4.4%,11.9%,which in the control group were (361 ± 209) mL,(44 ± 16) min,(0.63 ± 0) million,(184 ± 132) mL,1.3%,6.3% respectively,the differences were significant (t =2.52,8.19,26.10,4,4.76,x2 =3.98,all P < 0.05).The two groups had no statistically significant difference in organ damage situation (P > 0.05).Conclusion Secondary cesarean uterine scar easily lead to maternal

  11. Feasibility of abdominoplasty with Cesarean section

    Directory of Open Access Journals (Sweden)

    Thabet WN

    2012-03-01

    Full Text Available Wael Naeem Thabet1, Ahmad Samir Hossny1, Nadine Alaa Sherif21Department of General Surgery, 2Department of Obstetrics and Gynecology, Cairo University, Cairo, EgyptAbstract: Abdominoplasty is an esthetic surgical procedure that restores abdominal contouring. Repeated pregnancies combined with advancing maternal age usually lead to lower abdominal skin redundancy and excess fat accumulation. Delivery via Cesarean section adds weakness to the lower abdominal wall muscles and yields a lower transverse Cesarean scar. Some patients request whether abdominoplasty can be performed with Cesarean section in the same setting, to avoid a future surgery. This study was designed to evaluate the outcome of combined abdominoplasty with Cesarean section. The study included 50 pregnant women from September 2009 to June 2010 with an average follow-up period of 9 months. Nine patients (18% developed wound infection; three of them (6% developed wound dehiscence. Six patients (12% developed lower abdominal skin necrosis; three of them (6% were treated conservatively and healed by secondary intention, while surgical debridement and secondary sutures were needed in the other three patients (6%. Residual abdominal skin redundancy in nine patients (18%, outward bulging of the abdomen and lack of waist definition in 16 patients (32%, and outward bulging of the umbilicus in twelve patients (24% were the reported unesthetic results. The results were compared with results of 80 abdominoplasties in nonpregnant women.Keywords: abdominoplasty, Cesarean section, pregnancy

  12. 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 ...

  13. Hysteroscopy and suction evacuation of cesarean scar pregnancies: a case report and review.

    Science.gov (United States)

    Fylstra, Donald L

    2014-03-01

    Implantation of a pregnancy into the scar of a prior cesarean is an uncommon type of ectopic pregnancy. The incidence of cesarean scar pregnancy is thought to be one in 1800-2216 pregnancies. The increase in the incidence of cesarean scar pregnancy is thought to be a consequence of the increasing rates of cesarean delivery. The natural history of cesarean scar pregnancy is unknown. However, if such a pregnancy is allowed to continue, uterine scar rupture with hemorrhage and possible hysterectomy seem likely. Two early diagnosed cesarean scar pregnancies were treated with hysteroscopy and suction curettage removal. One required intramuscular methotrexate to resolve a persistent cesarean scar ectopic pregnancy. It would seem reasonable that simple suction evacuation would frequently leave chorionic villi imbedded within the cesarean scar, as the pregnancy is not within the endometrial cavity.

  14. 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.

  15. 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.

  16. Clinical analysis on 15 cases with scar pregnancy after cesarean section%剖宫产子宫瘢痕部位妊娠52例临床分析

    Institute of Scientific and Technical Information of China (English)

    侯玉兰; 郭端英; 范毅

    2011-01-01

    目的:探讨剖宫产子宫瘢痕部位妊娠(CSP)的早期诊断方法及评估子宫动脉灌注栓塞术用于治疗CSP的临床疗效.方法:回顾性分析2004年1月~2009年12月收治的52例CSP病例的临床表现、超声检查及治疗效果.结果:45例经彩超检查提示瘢痕妊娠,33例行子宫动脉灌注栓寒术,6例因β-hCG水平较低采用MTX治疗,5例因瘢痕部位破裂行病灶切除及子宫修补术,5例因瘢痕部位包块较大行开腹手术治疗,3例经腹腔镜探查明确诊断及手术治疗.术后监测血β-hCG于2~5周均降至正常水平.结论:彩色多普勒超声检查可用丁早期诊断CSP,子宫动脉灌注栓塞术具有微创、止血迅速、病灶萎缩快等优点,对于CSP是一种安全有效的治疗方法.%Objective: To explore the method of early diagnosis of scar pregnancy after cesarean section, evaluate the clinical efficacy of uterine arterial perfusion and embolization in treatment of scar pregnancy after cesarean section. Methods: The clinical manifestations, ultrasonic examination and clinical efficacy of 52 cases with scar pregnancy after cesarean section who were treated in the hospital from January 2004 to December 2009 were analyzed retrospectively. Results: 45 cases were diagnosed as scar pregnancy after cesarean section by color Doppler ultrasonography, 33 cases received uterine arterial perfusion and enbolization, 6 cases were treated with MTX because of low level of β - hCG, 5 cases received focal lesion excision and uterine repair because of rupture, 5 cases received laparotomy because of scar large mass, 3 cases were diagnosed definitely by laparoscopy, and operation was performed; 'after operation, serum β - hCG decreased to normal level. Conclusion: Color Doppler ultrasonography can be used for early diagnosis of scar pregnancy after cesarean section, uterine arterial perfusion and embolization has the advantages of minimal invasion, quickly to stop bleeding, fast atrophy of

  17. 剖宫产术后子宫疤痕处妊娠29例超声诊断%Ultrasound Diagnosis of 29 Patients with Cesarean Section Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

    成宇璐; 韦德湛; 陈勇霞

    2012-01-01

      Objective: To explore the value of ultrsound in the diagnosis and follow-up of cesarean section scar pregnancy. Method: The clinical data of 29 patients with cesarean section scar pregnancy were retrospectively analyzed from Jul 2006 to Jul 2011. Results: Among the 29 cases, ultrasound detected gestational sac type in 18 cases and 1 was misdiagnosed as normal intrauterine gestational sac, mass type in 10 cases and 2 were cases misdiagnosed as incomplete abortion, rupture type in 1 case. Conclusion: Ultrasound diagnosis of cesarean section scar pregnancy is a simple and safe method, and reliable findings are obtained.%  目的:探讨超声在剖宫产术后子宫瘢痕处妊娠的诊断与随访中的临床应用价值。方法:回顾性分析2006年7月至2011年7月诊断的剖宫产术后子宫瘢痕妊娠患者29例的临床资料。结果:29例中,超声检出妊娠囊型18例(1例误诊为正常宫内孕囊),包块型10例(2例误诊为不全流产),破裂型l例。结论:超声对剖宫产术后子宫瘢痕妊娠的诊断简便安全,结果可靠。

  18. Treatment and prevention of poor wound healing of scar incision cesarean section again%瘢痕切口再次剖宫产术切口愈合不良的处理及防范

    Institute of Scientific and Technical Information of China (English)

    陶芳; 骆骏

    2014-01-01

    目的:探讨瘢痕切口再次剖宫产术,术后发生切口愈合不良的处理及防范措施。方法:收治瘢痕切口再次剖宫产术发生切口愈合不良患者12例。切口愈合不良分为切口感染和切口脂肪液化两种,根据渗液的多少采取不同的处理方法。结果:仅3例经换药后,渗液减少后进行了Ⅱ期缝合,其他9例均经换药后,达到Ⅰ期愈合,收效良好。结论:加强防范,积极处理,尽量减少瘢痕切口再次手术后切口愈合不良的发生,以促进切口的早期愈合。%Objective:To investigate the treatment and prevention of poor wound healing of scar incision cesarean section again. Methods:12 patients with poor wound healing of scar incision cesarean section again were selected.The poor wound healing was divided into two kinds of incision infection and incision fat liquefaction,we took a different approach according to how much fluid. Results:Only 3 cases were given Ⅱ period suture when the drainage decrease after dressing change,the other 9 cases achieve Ⅰperiod healing after dressing change,with good results.Conclusion:If we want to promote the early healing of incision,we must strengthen the prevention,active treatment,and minimize to occur poor wound healing of scar incision cesarean section again.

  19. DIAGNOSIS AND TREATMENT OF CESAREAN SCAR PREGNANCY

    Institute of Scientific and Technical Information of China (English)

    Lan-zhou Jiao; Jun Zhao; Xi-run Wan; Xin-yan Liu; Feng-zhi Feng; Tong Ren; Yang Xiang

    2008-01-01

    Objective To investigate the early diagnosis and treatment of cesarean sear pregnancy (CSP).Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the le-sion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed.Results CSP constituted 1.05% of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1:1 221. Themean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 weremisdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging (MRI). The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hyster-ectomy. The conservative treatment was successful in 24 eases. All of the 28 women were cured through individual ther-apies.Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP,and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.

  20. Evolution & the Cesarean Section Rate

    Science.gov (United States)

    Walsh, Joseph A.

    2008-01-01

    "Nothing in biology makes sense except in the light of evolution." This was the title of an essay by geneticist Theodosius Dobzhansky writing in 1973. Many causes have been given for the increased Cesarean section rate in developed countries, but biologic evolution has not been one of them. The C-section rate will continue to rise, because the…

  1. 剖宫产术后瘢痕处妊娠的高危因素探讨%Study on high risk factors of pregnancy at the scar after cesarean section

    Institute of Scientific and Technical Information of China (English)

    刘小媚; 袁秀英; 刘燕燕

    2014-01-01

    目的:探讨剖宫产术后瘢痕处妊娠的高危因素,提高诊断水平。方法剖宫产手术史且合并瘢痕处妊娠的患者34例纳入瘢痕妊娠组,同期在我院接受剖宫产手术但未合并瘢痕处妊娠的产妇34例,纳入对照组。比较两组的手术指征、人工流产次数、手术医院级别等。结果两组的产程延长例次、胎儿宫内窘迫例次、产科合并症例次、剖宫产次数及反复宫腔操作例次比较,差异均有统计学意义。两组接受最近一次剖宫产手术的医院级别、人工流产平均次数比较,差异有统计学意义。 Logistic回归分析结果显示,产程延长、胎儿窘迫、产科合并症、反复宫腔操作、剖宫产2次以上均是影响瘢痕处妊娠的高危因素。结论产程延长、胎儿窘迫、产科合并症、剖宫产次数、反复宫腔操作均是影响瘢痕处妊娠的高危因素。%Objective To explore the high risk factors of pregnancy at the scar after cesarean section ,and improve the diagnostic level. Methods A total of 34 patients of cesarean section operation with scar pregnancy were arranged in scar pregnancy group,in the same period,34 patients who received cesarean operation but not with scar pregnancy were arranged in the control group. Results The production process extension number,fetal distress number,obstetric com-plications number,fetal breech number,repeated uterine cavity operation number ,comparison difference had statistics significance. Recent cesarean operation of hospital level , the average number of artificial abortion of two groups had statistical significance differences. The results of logistic regression analysis display, prolonged labor, fetal distress, obstetric complications, recurrentuterine cavity operation, cesarean section 2 above are all risk factors influencing the scar pregnancy. Conclusion Prolonged labor, fetal distress, obstetric complications, breech presentation,recurrent u

  2. 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

  3. Cesarean section changes neonatal gut colonization

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Thorsen, Jonathan; Chawes, Bo L;

    2016-01-01

    delivery, 12% by means of emergency cesarean section, and 9% by means of elective cesarean section. Birth by means of cesarean section was significantly associated with colonization of the intestinal tract by Citrobacter freundii, Clostridium species, Enterobacter cloacae, Enterococcus faecalis, Klebsiella...

  4. 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 ...

  5. Clinical analysis of 30 cases on cesarean section of placenta previa with scarred uterine%前置胎盘合并瘢痕子宫剖宫产30例临床分析

    Institute of Scientific and Technical Information of China (English)

    丁卫

    2011-01-01

    Objective To analyze the harm of placenta previa with scarred uterine on mother and neonate,and improve the understanding of it. Methods 108 cases with placent previa from January 2008 to May 2010 in our hospital were analyzed retrospectively, among which there were 30 cases of scarred uterine, 78 cases of non-scarred uterine. Results 108 patients were terminated pregnancy through cesarean section. The Postpartum hemorrhage in scarred uterine's group was significantly higher than the group of non-scarred uterine (P<0.05). The incidences of placenta accreta, placenta adhesion, hysterectomy were significantly higher than non-scarred uterine group(P<0.05). However the birth weight was significantly lower than non-scarred uterus group (P<0.05).Preterm, fetal distress, neonatal asphyxia, perinatal mortality were significantly higher than non-scarred uterus group (P<0.05). Conclusion Placenta previa with the scarred uterine increased significantly the maternal and perinatal complications and risk.%目的 分析前置胎盘合并瘢痕子宫对孕产妇及围生儿的危害,提高对前置胎盘合并瘢痕子宫的认识.方法回顾性分析终止妊娠的前置胎盘108例,其中既往有剖宫产史30例(瘢痕子宫组),无剖宫产史78例(非瘢痕子宫组).结果:108例均行剖官产术终止妊娠.瘢痕子宫组产后出血量大于非瘢痕子宫组,其胎盘植入、胎盘粘连、子宫切除的发生率均高于非瘢痕子宫组,差异有统计学意义(P<0.05).瘢痕子宫组新生儿体质量低于非瘢痕子宫组,其早产、胎儿窘迫、新生儿窒息、围生儿死亡均高于非瘢痕子宫组,差异有统计学意义(P<0.05).结论 前置胎盘合并瘢痕子宫明显增加孕产妇及围生儿的并发症和危险性.

  6. Cesarean Section Birth

    Medline Plus

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

  7. 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.

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

    Institute of Scientific and Technical Information of China (English)

    王秀清

    2014-01-01

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

  9. Clinical analysis of hysteroscopic examination and laparoscopic repair of uterine scar diverticulum after cesarean section%剖宫产后子宫瘢痕憩室宫腹腔镜治疗临床分析

    Institute of Scientific and Technical Information of China (English)

    孙启建; 尹笋

    2014-01-01

    探讨剖宫产后子宫瘢痕憩室的病因及宫腹腔镜联合手术治疗效果。方法:对2010年10月至2013年12月在我院行宫腹腔镜联合修复剖宫产后子宫瘢痕憩室的11例患者进行回顾性分析和随访。结果:7例患者剖宫产术后经期延长、淋漓不净;3例月经量增多、经间期出血;1例继发不孕。术后随访3~16月。9例症状得到改善,经期缩短为(7.3±2.2)天,有效率81.8%(9/11)。结论:宫腹腔镜联合修复子宫瘢痕憩室安全,有效,可以明显改善患者的症状。%objective to investigate the cause of uterine cesarean section scar diverticulum and palace laparoscopy combined therapeutic effect. Methods in October 2010 to December 2013 in our hospital xanadu joint laparoscopic repair of uterine cesarean section scar diverticulum in 11 patients were retrospectively analyzed and follow-up. Results 7 cases of patients with cesarean section menstrual extension, dripping wet is not clear; 3 cases of menstrual quantity increased, the interphase bleeding; 1 case of secondary infertility. Followed up for 3 ~ 16 months after surgery. 9 cases symptoms improved and period shorten is (7.3 + 2.2) days, the effective rate was 81.8% (9/11). Conclusion palace joint laparoscopic repair of uterine scar diverticulum safe, effective, can obviously improve the symptoms of patients.

  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. 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 

  12. Placenta Increta Complicating Persistent Cesarean Scar Ectopic Pregnancy following Failed Excision with Subsequent Preterm Cesarean Hysterectomy.

    Science.gov (United States)

    Malik, M F; Hoyos, L R; Rodriguez-Kovacs, J; Gillum, J; Johnson, S C

    2016-01-01

    Introduction. Cesarean scar pregnancies (CSPs) are one of the rarest forms of ectopic pregnancy. Given their rarity, there is lack of consensus regarding the management and natural course of CSPs. Case. A 37-year-old G10 P3063 female with a history of two prior cesarean deliveries was diagnosed with her second CSP at 6 weeks and 5 days in her tenth pregnancy. The patient underwent vertical hysterotomy, excision of a gestational sac implanted in the cesarean sac, and bilateral salpingectomy via a laparotomy incision. The histopathology report confirmed immature chorionic villi. The patient returned 10 weeks later and was found to be still pregnant. Obstetric ultrasound confirmed a viable fetus of 19 weeks and 4 days of gestational age with a thin endometrium and an anteroposterior and right lateral placenta with multiple placental lakes. The patient ruptured her membranes at 31 weeks of gestation and pelvic MRI revealed an anterior placenta invading the myometrium and extending to the external serosal surface consistent with placenta increta. Following obstetric interventions, a live female infant was delivered by cesarean hysterectomy (because of placenta increta) at 32 weeks of gestation. Conclusion. Development of standardized guidelines for management of CSPs, as well as heightened vigilance for possible complications, is required for proper care and avoidance of potential morbidity and mortality. PMID:27375911

  13. Placenta Increta Complicating Persistent Cesarean Scar Ectopic Pregnancy following Failed Excision with Subsequent Preterm Cesarean Hysterectomy

    Directory of Open Access Journals (Sweden)

    M. F. Malik

    2016-01-01

    Full Text Available Introduction. Cesarean scar pregnancies (CSPs are one of the rarest forms of ectopic pregnancy. Given their rarity, there is lack of consensus regarding the management and natural course of CSPs. Case. A 37-year-old G10 P3063 female with a history of two prior cesarean deliveries was diagnosed with her second CSP at 6 weeks and 5 days in her tenth pregnancy. The patient underwent vertical hysterotomy, excision of a gestational sac implanted in the cesarean sac, and bilateral salpingectomy via a laparotomy incision. The histopathology report confirmed immature chorionic villi. The patient returned 10 weeks later and was found to be still pregnant. Obstetric ultrasound confirmed a viable fetus of 19 weeks and 4 days of gestational age with a thin endometrium and an anteroposterior and right lateral placenta with multiple placental lakes. The patient ruptured her membranes at 31 weeks of gestation and pelvic MRI revealed an anterior placenta invading the myometrium and extending to the external serosal surface consistent with placenta increta. Following obstetric interventions, a live female infant was delivered by cesarean hysterectomy (because of placenta increta at 32 weeks of gestation. Conclusion. Development of standardized guidelines for management of CSPs, as well as heightened vigilance for possible complications, is required for proper care and avoidance of potential morbidity and mortality.

  14. Per operative findings in repeat cesarean section

    Directory of Open Access Journals (Sweden)

    Parul Sinha

    2016-04-01

    Conclusions: Chances of developing adhesions increases with each cesarean section, which leads to increase in morbidity of women. Thus cases of previous cesarean section should be educated about routine antenatal care. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1093-1096

  15. Educational strategies in performing cesarean section

    DEFF Research Database (Denmark)

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

    2012-01-01

    Cesarean section is a common operation and one of the first surgeries performed independently by trainees/residents in obstetrics and gynecology. Determination of trainees' technical skills level is dependent upon subjective faculty assessment. Based on three studies on learning curves in cesarean...

  16. 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.

  17. Pregnancy, Delivery, and Neonatal Outcomes of In Vitro Fertilization-Embryo Transfer in Patient with Previous Cesarean Scar.

    Science.gov (United States)

    Zhang, Ningyuan; Chen, Hua; Xu, Zhipeng; Wang, Bin; Sun, Haixiang; Hu, Yali

    2016-01-01

    BACKGROUND What role should previous cesarean section play in affecting clinical pregnancy outcomes and avoiding the complications of in vitro fertilization? In this article, we focus on elective single-embryo transfer (eSET) versus double-embryo transfer (DET) and assess the clinical efficacy and safety of eSET in patients who have a previous cesarean scar. MATERIAL AND METHODS The pregnancy, delivery, and neonatal outcomes of 130 patients who had a previous cesarean scar and received in vitro fertilization-embryo transfer (IVF-ET) were retrospectively analyzed. The number of transferred embryos was chosen depending on patients' desire after acknowledging all benefits and risks, including eSET (eSET group, n=56) and DET (DET group, n=74). A total of 101 patients with previous vaginal delivery receiving IVF-ET in the same period were included as a control group. RESULTS The pregnancy rates, multiple birth rates, abortion rates, ectopic pregnancy rates, gestational age at delivery, preterm birth rates, neonatal birth weight, and take-home baby rates were similar between the previous cesarean section group and the previous vaginal delivery group. A previous cesarean section scar did not affect embryo implantation and pregnancy outcomes in IVF. In the eSET and DET groups of previous cesarean section patients, the embryo implantation rates, pregnancy rates, abortion rates, and take-home baby rates were similar. However, the rate of multiple pregnancies reached 50% in the DET group, which led to more preterm births and lower birth weight. CONCLUSIONS Elective single-embryo transfer is a well-accepted strategy to avoid multiple pregnancies and improve the obstetric and neonatal outcomes of singleton pregnancy in IVF patients with a previous cesarean section. PMID:27636504

  18. 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.

  19. Diagnosis and Treatment of Cesarean Scar Pregnancy%剖宫产术后子宫瘢痕妊娠的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    赵立武

    2011-01-01

    Cesarean scar pregnancy is one of the long-term complications of cesarean section, which mainly refers to implantation of gestational sac in the scar of a previous cesarean delivery, a rare form of ectopic pregnancy. The gestational sac is completely surrounded by myometrium and the fibrous tissue of the scar. But recently,the incidence of cesarean scar pregnancy has increased in paralled with the increasing incidence of cesarean delivery. Cesarean scar pregnancy may cause uterine rupture and uncontrollable vaginal bleeding, which may lead to loss of subsequent fertility, or even maternal death. Therefore the early diagnosis and treatment of cesarean scar pregnancy is very important. The article is a review of the diagnosis and treatment of cesarean scar pregnancy.%剖宫产术后子宫瘢痕妊娠是剖宫产术的一种远期并发症,主要是指妊娠囊种植在子宫瘢痕部位,其外周被子宫肌层和纤维组织包围,是一种罕见的异位妊娠.但是,由于近年来剖宫产率的不断提高,其发生率也有所增加.剖宫产术后子宫瘢痕处的妊娠可引起阴道大出血及子宫破裂,可以导致孕产妇生育能力丧失甚至孕产妇死亡.故早期诊断与治疗剖宫产术后子宫瘢痕妊娠是非常重要的,现就剖宫产术后子宫瘢痕妊娠的诊断与治疗予以综述.

  20. 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.

  1. 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

  2. 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)

  3. 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;

    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 Departm...... myometrial thickness and decreases defect width. Results do not prove but imply increased scar strength after two-layer closure.......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...

  4. 产前高频超声检查在剖宫产瘢痕子宫胎盘植入的临床应用%Clinical application of high frequency prenatal ultrasound in the diagnosis of placenta increta in cesarean section scar uterine

    Institute of Scientific and Technical Information of China (English)

    樊树华

    2013-01-01

    Objective To investigate the prenatal ultrasonographic features of placenta increta in cesarean section scar uterus using high frequency color ultrasound, so as to increase the diagnostic accuracy of placenta increta. Methods Color ultrasonographic data of 32 cases of placenta increta in cesarean section scar uterus confirmed by pathology or clinical information were analyzed retrospectively. The data in our hospital were collected from October 2009 to May 2013.Results Of the 32 cases, 3 cases were false negative, so the diagnosis accuracy rate was 90.6%. Conclusion To grasp the ultrasonographic characteristics of placenta increta in cesarean section scar uterus can increase the detection rate.%目的:探讨剖宫产瘢痕子宫胎盘植入的产前高频彩超声像图特征,以提高产前超声检查瘢痕子宫胎盘植入的准确率。方法回顾性分析2009年10月~2013年5月在我院经产后病理或临床证实为瘢痕子宫胎盘植入的32例患者彩超资料。结果32例胎盘植入患者中,产前高频彩超诊断29例,漏诊3例,诊断准确率90.6%。结论准确掌握瘢痕子宫胎盘植入的产前高频超声声像图特点,能提高胎盘植入的检出率。

  5. B-test in late pregnancy on the thickness of the lower uterine segment cesarean section scar significance%B超检测妊娠晚期子宫下段瘢痕厚度对再次剖宫产的意义

    Institute of Scientific and Technical Information of China (English)

    张春风

    2014-01-01

    Objective To investigate the B-test trimester uterine segment cesarean section scar vicious value again. Methods In accordance with scar thickness is<3mm, 94 cases of cesarean section will be divided into maternal<3mm group and ≥ 3mm each group 47 cases. Comparison of two blood loss, the number of cases of postpartum hemorrhage and oxytocin usage to re-evaluation of the value of B-test cesarean scar thickness. Results <3mm group blood loss was 336.9 ± 118.4mL, the number of cases of postpartum hemorrhage in 9 cases (19.15%), oxytocin usage was 90.1±18.7 U, significantly higher than the index≥3mm group(P<0.05). Conclusion B-test scar thickness can effectively guide cesarean section has important clinical significance.%目的:探讨B超检测妊娠晚期子宫下段瘢痕厚度对再次剖宫产的价值。方法将94例再次剖宫产孕产妇按照子宫下段瘢痕厚度分为<3 mm组和≥3 mm组各47例,比较2组术中出血量、产后出血例数和缩宫素使用量,以评价B超检测瘢痕厚度对再次剖宫产的价值。结果<3 mm组术中出血量为(336.9±118.4)mL,产后出血例数有9例(19.15%),缩宫素使用量为(90.1±18.7)U,均明显高于≥3 mm组(P<0.01)。结论通过B超检测子宫瘢痕厚度可以有效地指导再次剖宫产,具有重要的临床意义。

  6. Cesarean section in sub-Saharan Africa.

    Science.gov (United States)

    Harrison, Margo S; Goldenberg, Robert L

    2016-01-01

    Cesarean section is an essential maternal healthcare service. Its role in labor and delivery care in low- and middle-income countries is complex; in many low-resource settings it is underutilized in the most needy of populations and overused by the less needy, without clear methods to ensure that universal access is available. Additionally, even if universal access were available, it is not evident that these countries would have the capacity or the finances to appropriate meet demand for the procedure, or that patients would want to utilize the care. This review summarizes the literature and illustrates the complicated relationship that cesarean section, which is rapidly on the rise around the world, has with individuals, communities, and nations in sub-Saharan Africa. PMID:27398224

  7. 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.

  8. 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.

  9. 剖宫产瘢痕妊娠的临床研究进展%Clinical research of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    梁婵玉(综述); 谭毅(审校)

    2016-01-01

    剖宫产瘢痕妊娠( cesarean scar pregnancy,CSP)是一种比较少见的异位妊娠,随着剖宫产率的增加,其发生率呈现了增长的趋势,并引起了产科医师的关注。该文对其临床研究的进展情况作一简要的介绍。%Cesarean scar pregnancy ( CSP) is a relatively rare ectopic pregnancy.With the increase of cesar-ean section rate, the incidence of CSP shows a growing trend, which causes the attention of the obstetricians.In this paper, the progress of its clinical research is reviewed.

  10. 剖宫产后瘢痕子宫再次分娩方式的比较%Compare of the Next Delivery Mode in Scar Uterus after one Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    赖晓岚; 陈茜; 林碧君

    2014-01-01

    Objective To evaluate the safety and complications between two kinds of delivery mode in patients with prior cesarean section. Methods 122 cases of a second time pregnant women with one previous cesarean section ,69 gravidas chose repeat caesarean and 53 gravidas chose vaginal birth after previous caesarean section ,the outcome of two kinds of mode of delivery was compared. Results There is no signiifcant difference with uterine atony, postpartum hemorrhage, neonatal asphyxia, wound infection between vaginal birth and repeat caesarean , but the incidence of anemia with repeat caesarean is higher than that in vaginal birth . Conclusions Woman with one previous cesarean section should be offered a trial of labor with a full assessment.Choosing correct labor techniques,infusing oxytocin carefully, avoiding uterine rupture are very important in delivery course.%目的:比较剖宫产术后再次妊娠不同分娩方式的相关并发症及安全性。方法选取有一次剖宫产史的瘢痕子宫孕妇122例,再次妊娠分娩,其中剖宫产者69例,经阴道顺产者53例,比较两种分娩方式对分娩结局的影响。结果瘢痕子宫经阴道顺产或再次剖宫产的宫缩乏力、产后出血、伤口感染及新生儿窒息发生率无统计学差异,但再次剖宫产组者产后贫血发生率较阴道顺产组升高(P<0.05)。结论一次剖宫产术后,经充分评估后确定符合阴道试产条件者,在严密监护下应予阴道试产,引产时注意引产方式的选择、缩宫素的合理应用及先兆子宫破裂、子宫破裂的密切观察。

  11. 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...

  12. 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.

  13. Analysis of diagnosis and treatment of 11 cases of scar pregnancy after cesarean section%剖宫产术后瘢痕妊娠11例诊治分析

    Institute of Scientific and Technical Information of China (English)

    赵金娜

    2014-01-01

    目的:探讨剖宫产切口瘢痕妊娠(CSP)的病因、诊断及治疗方法。方法回顾分析2010年1月~2013年12月我院妇科收治的11例CSP患者临床资料。结果11例患者停经40~75d,入院前无痛性阴道流血7例,大出血4例(3例为外院B超检查诊断为宫内孕,1例为我院诊断为难免流产)。11例患者均用甲氨蝶呤+米非司酮联合治疗,其中4例患者经药物保守治疗查血β-HCG降至正常后出院,7例药物治疗无效转入手术治疗(2例接受了病灶局部切除+子宫下段修补术,2例患者行双侧髂内动脉结扎术,3例年龄>35岁、无生育要求者行全子宫次切除术)。7例手术患者术后1个月血β-HCG降至正常,恢复良好,病理证实子宫瘢痕妊娠。结论CSP临床较少见,易误诊,对有剖宫产术史的患者应尽早行阴道彩色多普勒超声检查,结合妇科检查及实验室检查早期明确诊断。%Objective To investigate the pathogen, diagnosis and treatment methods of cesarean scar pregnancy(CSP). Methods Clinical data of 11 CSP patients admitted to the gynecology department of our hospital from January 2010 to December 2013 were analyzed retrospectively. Results All 11 patients underwent 40 to 75 days of menolipsis, of which 7 patients had painless vaginal bleeding prior to admission and 4 patients had massive haemorrhage(3 patients were diagnosed with intrauterine pregnancy by B-ultrasound in other hospitals and 1 patient was diagnosed with inevitable abortion in our hospital). All 11 patients received methotrexate+mifepristone combined treatment, of which 4 patients' β-HCG reduced to normal after conservative medication and they were discharged from hospital, and 7 patients' conservative medication was ineffective and they changed to operative treatment(2 patients received lesion local resection + lower uterine segment repair, 2 patients received bilateral internal iliac artery ligation, and 3 patients

  14. Major risk factors of maternal adverse outcome in women with two or more previous cesarean sections

    Directory of Open Access Journals (Sweden)

    Egić Amira

    2016-01-01

    Full Text Available Background/Aim. Maternal morbidity is defined as any condition that is attributed to or aggravated by pregnancy and childbirth that has a negative impact on the woman's wellbeing. In recent years, a growing trend of cesarean section rates can be seen throughout the world. The aim of this study was to assess factors that might have major impact on maternal adverse outcome in women with two or more previous cesarean sections. Methods. This retrospective study included women with single term pregnancy after two or more cesarean deliveries in a 10-year period (2004−2013 in the University Clinic “Narodni front” in Belgrade, Serbia. Medical records were reviewed for clinical data for maternal intraoperative and early postoperative complications regarding gestational age at delivery, the number of previous cesarean sections and mode of surgery (elective or emergency. Results. A total of 551 patients were included in the study. At 37 completed weeks delivered 14.1%, at 38 delivered 45.2% and at 39 completed weeks 40.7% patients. Women younger than 35 years more often delivered after 39 completed weeks compared with those over 35 years (69.2% vs 30.8%, p < 0.05. The overall rate of maternal complications in the study group was 16.5% with no statistical difference by gestational age at delivery. The overall rate of maternal adverse outcome was significantly less in the patients with three as compared with those with four or more cesareans (10.4% vs 66.7%, p < 0.05. There was a statistically significant difference between these groups of women regarding complications: scar dehiscence, the presence of adhesions, blood transfusion and admission in intensive care unit. Elective cesarean delivery was with less maternal complications compared with emergency cesarean deliveries (12.9% vs 27.3%, p < 0.05. Conclusion. Termination of pregnancy before completed 39 weeks does not decrease maternal morbidity. The major impact on maternal complications has the

  15. Fetomaternal hemorrhage in women undergoing elective cesarean section

    DEFF Research Database (Denmark)

    Perslev, Anette; Jørgensen, Finn Stener; Nielsen, Leif Kofoed;

    2010-01-01

    , at the Department of Gynecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Denmark. Methods. Two maternal blood samples were taken, the first before cesarean section and the second immediately after. Both samples were analyzed at the Blood Bank, Rigshospitalet, Copenhagen, for the 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...

  16. Cesarean Section and Chronic Immune Disorders

    DEFF Research Database (Denmark)

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

    2015-01-01

    analyses. RESULTS: Children delivered by cesarean delivery had significantly increased risk of asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies, and leukemia. No associations were found between cesarean delivery and type 1 diabetes, psoriasis......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...

  17. Two Cases of Tuberculous Meningitis after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    This article revealed two valuable case reports about two young females suffered tuberculous meningitis after cesarean section. After antituberculous therapy, the condition of one patient improved and the other one became deteriorated.

  18. 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

  19. 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: *...

  20. Correlation of the expressions of MMPs-9, TIMP-1 and TIMP-2 with cesarean section scar%基质金属蛋白酶9和基质金属蛋白酶组织抑制剂1,2在子宫剖宫产疤痕中的表达和相关性

    Institute of Scientific and Technical Information of China (English)

    李琼; 郭遂群; 柳大烈; 冯淑英; 魏清柱

    2012-01-01

    目的 研究基质金属蛋白酶9(MMPs-9)和基质金属蛋白酶组织抑制剂1,2(TIMP-1,2)在子宫剖宫产疤痕愈合中的影响.方法 收集2009年8月~2011年11月在我院收治的有严重并发症的疤痕子宫妊娠病人22例(子宫剖宫产疤痕早期8例妊娠(CSP)、因胎盘粘连或植入而行子宫切除术的疤痕子宫足月妊娠病例14例);选择同期孕期检查正常无并发症疤痕子宫足月妊娠病人38例作为对照1组;同期孕期检查正常、无任何并发症因社会因素要求剖宫产的足月妊娠病人32例作为对照2组.采用免疫组织化学EnVision二步法检测3组中MMPs-9和TIMP-1,2的表达,并对其表达进行相关性分析.结果 MMPs-9、TIMP-1在3组间的表达差异有统计学意义(P<0.05).TIMP-2在3组间的表达差异无统计学意义(P>0.05).Spearman等级相关分析显示,在疤痕组织中MMPs-9的表达随疤痕愈合不良呈正相关,相关系数分别是0.309、0.643.随着疤痕愈合不良程度加重,MMPs-9的表达逐渐增强,差异有统计学意义(P<0.05).结论 子宫疤痕愈合不良、CSP可能和损伤修复中MMPs-9、TIMP-1的表达失衡有关.%Objective To investigate the roles of MMPs-9, TIMP-1 and TIMP-2 in cesarean section scar healing. Methods The expressions of the MMPs-9, TIMP-1 and TIMP-2 were detected by EnVision immunohistochemistry in 22 pregnant women with serious complications of the uterine scar, including 8 with early caesarean scar pregnancy (CSP) and 14 with full-term pregnancy undergoing hysterectomy for placenta previa or implanted placenta. Thirty-eight full-term pregnant women without serious complications of the uterine scar and 32 normal full-term pregnant women served as the control I and control II groups, respectively. Results The expressions of MMPs-9 and TIMP-1 differed significantly between the 3 groups (P0.05). Spearman rank correlation analysis showed that the expression of MMPs-9 in the uterine scar tissues was

  1. 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.

  2. Cesarean section in twin pregnancies in two Danish counties with different cesarean section rates

    DEFF Research Database (Denmark)

    Henriksen, T B; Sperling, Lene; Hedegaard, M;

    1994-01-01

    on antecedent data. SETTING: Two Danish counties, with a CS rate in twin pregnancies of 57% and 28%, respectively. SUBJECTS: All women with twin pregnancies who delivered in 1989 in the two counties. MAIN OUTCOME MEASURES: Comparison of the CS rates in the two counties according to indications and fetal...... presentation. SECONDARY MEASURES: Perinatal and maternal outcome. RESULTS: The difference in CS rates between the two counties could not be explained by different distributions of background characteristics. Different attitudes were found towards CS in cases with previous CS, with twin A in breech presentation......OBJECTIVE: Based on a comparison of the clinical indications for cesarean section (CS) in two Danish counties and a review of the literature regarding this issue the aim of this study was to discuss possible explanations for variations in CS rates in twin pregnancies. The comparison of indications...

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Feasibility of abdominoplasty with Cesarean section [Retraction

    OpenAIRE

    Thabet WN; Hossny AS; Sherif NA

    2013-01-01

    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 Jo...

  5. [Non-indicated cesarean section--does the "Golem" counteract?].

    Science.gov (United States)

    Herman, Arie

    2011-11-01

    Cesarean section rate is steadily increasing and in Israel it has risen to 20%. MultipLe and different reasons have led to this phenomenon, among them are non-indicated cesarean sections. Although health care providers disagree whether this development is medically, ethically and publically justified, national associations allow it, while respecting those obstetricians who decline to do so. In Israel there are some hospitals which allow non-indicated cesarean sections, whereas others reject them. When discussing this issue with the patients, documentation is advised concerning the reasons for approval or rejection of the patients' request in order to avoid future complaints in the case of adverse outcome. Low risk vaginal delivery should be regarded as a natural process and not as a medical treatment and keeping balanced and reasonable decisions may help to contain the phenomenon and avoid a situation in which the "Golem" created by the medical system, counteracts.

  6. 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.

  7. Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Cuilan Li

    2016-01-01

    Full Text Available Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum. Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS, and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery. Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05, respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40. Three patients (3/40 = 7.5% developed partial improvement, and 1/40 (2.5% was lost to follow-up. Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.

  8. 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...

  9. 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...

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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

  12. 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.)

  13. 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)

  14. 剖宫产瘢痕妊娠的 MRI 诊断%The MRI diagnosis of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    柳健; 丁耀军; 查婧; 陶国民

    2015-01-01

    目的:探讨剖宫产瘢痕妊娠的 MRI 诊断价值。方法回顾性分析18例经临床随访证实的剖宫产瘢痕妊娠MRI 影像资料。结果 MRI 清晰显示18例子宫瘢痕妊娠孕囊,孕囊均位于子宫下段峡部瘢痕周围。18例中7例孕囊位于子宫肌层,11例孕囊向子宫肌层浸润同时向宫腔内生长,局部子宫峡部前壁明显变薄。孕囊的形态主要有两种表现形式,其中单纯妊娠囊型10例,混杂团块型8例。结论 MRI 对剖宫产瘢痕妊娠的早期诊断和治疗方案的选择具有重要意义。%Objective To investigate the MRI feature of cesarean scar pregnancy .Methods MRI of 18 cases of cesarean scar pregnancy was retrospectively analyzed and was confirmed by clinical diagnosis .Results All of the 18 gestational sacs located at or adjacent to the previous cesarean scar were clearly displayed by MRI .In 7 of the 18 cases ,gestational sac was found within the myometrium .Whereas ,in the remaining 11 cases ,gestational sac was found partially within the myome‐trium with extension into the uterine cavity .The anterior wall of isthmus uteri became thinner .The gestational sac mainly had two forms ,simple cystic structure (10 cases) and mixed signal mass (8 cases) .Conclusion MRI is of great value in the early diagnosis and the management of cesarean scar pregnancy .

  15. Resection of Cesarean Scar Pregnancy at Six Weeks of Gestation with Laminaria Cervical Dilatation under Sonographic and Hysteroscopic Guidance

    Directory of Open Access Journals (Sweden)

    Tatsuji Hoshino

    2015-01-01

    Full Text Available In cases of fetal heartbeat- (FHB- positive cesarean scar pregnancy (CSP, the embryo and placenta grow rapidly week by week. We experienced an FHB-positive CSP case at 6 weeks of gestation and assessed the CSP in detail with transvaginal ultrasound and transabdominal ultrasound (TAUS, preoperatively. We performed Laminaria cervical dilatation under TAUS guidance and performed hysteroscopic resection of the pregnancy conceptus and curettage under hysteroscopic and TAUS guidance. We identified the gestational sac attached to the cesarean scar pouch with small plane, decidua basalis, and chorionic villi and present the clinical history and other findings. We also reviewed the related literature and found 76 previous studies, with six cases of FHB-positive CSP that contained hysteroscopic color images of the CSP. We present a review of selected cases. The implantation site was the anterior wall in almost all cases. Cervical dilatation was mainly performed using a Hegar dilator; ours was the only case using Laminaria dilatation. Transcervical resections were performed mainly under ultrasound guidance, with only one case undergoing laparoscopy. Electrocoagulation was performed in three of the six cases.

  16. Uterine Healing after Therapeutic Intrauterine Administration of TachoSil (Hemostatic Fleece in Cesarean Section with Postpartum Hemorrhage Caused by Placenta Previa

    Directory of Open Access Journals (Sweden)

    Katrine Fuglsang

    2012-01-01

    Full Text Available Background. Application of hemostatic fleece (TachoSil directly onto the bleeding surfaces of the lower uterine segment has been used to obtain hemostasis during cesarean section caused by placenta previa. Methods. Eleven of 15 patients treated with TachoSil for excessive postpartum haemorrhage due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of TachoSil application, visible remnants of TachoSil, and scar healing. Results. Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects. Conclusion. TachoSil did not seem to impair healing of the endometrium or scar formation in the uterus after intrauterine application. Resorption of TachoSil seems to progress individually. Intrauterine treatment with TachoSil is a valuable supplement to the traditional treatment of post partum haemorrhage and may help retain reproductive capability. This is a small study, and it will require more studies to confirm the reproducibility.

  17. Maternal deaths after elective cesarean section for breech presentation in the Netherlands

    NARCIS (Netherlands)

    Schutte, Joke M.; Steegers, Eric A. P.; Santema, Job G.; Schuitemaker, Nico W. E.; Van Roosmalen, Jos

    2007-01-01

    Background and methods. The cesarean section rate for term singleton breech babies in the Netherlands rose from 57 to 81% after the Term Breech Trial in 2000. The Dutch Maternal Mortality Committee registered and evaluated maternal mortality due to elective cesarean section for breech. Results. Four

  18. 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....

  19. 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

  20. Local Methotrexate Injection as the First-line Treatment for Cesarean Scar Pregnancy: Review of the Literature.

    Science.gov (United States)

    Cheung, Vincent Y T

    2015-01-01

    The objective of this study was to determine the outcome of using ultrasound-guided local methotrexate injection as the first-line treatment of cesarean scar pregnancy (CSP). A literature review was performed on all eligible reports using this modality as the first-line treatment of CSP. Relevant publications were obtained from the PubMed electronic database from inception to December 2014. Ninety-six cases from 95 women reported in 17 articles were reviewed. The success rate was 73.9% after a single local methotrexate injection. An accumulated success rate of 88.5% could be achieved after additional local or intramuscular methotrexate administration. Eleven cases (11.5%) failed methotrexate treatment and required surgical interventions. Except for women with serum human chorionic gonadotropin levels higher than 100 000 IU/L, ultrasound-guided local methotrexate injection could be considered as a first-line treatment modality for CSP.

  1. The Dose-response of Intrathecal Ropivacaine Co-administered with Sufentanil for Cesarean Delivery under Combined Spinal-epidural Anesthesia in Patients with Scarred Uterus

    Institute of Scientific and Technical Information of China (English)

    Fei Xiao; Wen-Ping Xu; Yin-Fa Zhang; Lin Liu; Xia Liu; Li-Zhong Wang

    2015-01-01

    Background:Spinal anesthesia is considered as a reasonable anesthetic option in lower abdominal and lower limb surgery.This study was to determine the dose-response of intrathecal ropivacaine in patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia.Methods:Seventy-five patients with scarred uterus undergoing elective cesarean delivery under combined spinal-epidural anesthesia were enrolled in this randomized,double-blinded,dose-ranging study.Patients received 6,8,10,12,or 14 mg intrathecal hyperbaric ropivacaine with 5 μg sufentanil.Successful spinal anesthesia was defined as a T4 sensory level achieved with no need for epidural supplementation.The 50% effective dose (ED50) and 95% effective dose (ED95) were calculated with a logistic regression model.Results:ED50 and ED95 ofintrathecal hyperbaric ropivacaine for patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia (CSEA) were 8.28 mg (95% confidence interval [CI]:2.28-9.83 mg) and 12.24 mg (95% CI:10.53-21.88 mg),respectively.Conclusion:When a CSEA technique is to use in patients with scarred uterus for an elective cesarean delivery,the ED50 and ED95 of intrathecal hyperbaric ropivacaine along with 5 μg sufentanil were 8.28 mg and 12.24 mg,respectively.In addition,this local anesthetic is unsuitable for emergent cesarean delivery,but it has advantages for ambulatory patients.

  2. 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

  3. The Analysis of Efficacy and Failure Factors of Uterine Artery Methotrexate Infusion and Embolization in Treatment of Cesarean Scar Pregnancy

    Directory of Open Access Journals (Sweden)

    Xiao An

    2013-01-01

    Full Text Available Objectives. This study observes therapeutic efficacy of uterine artery embolization combined with MTX infusion which terminates cesarean scar pregnancy (CSP and induces three factors which probably relate to failure. Methods. Twenty-three CSP patients were treated with combined uterine artery MTX infusion and embolization. Among them six patients with severe hemorrhage were immediately treated with interventional operation. Clinical effects were estimated by symptoms, serum -hCG, ultrasound, and MR. Results. Interventional treatments were technologically successful in 22 patients except one. Immediate hemostasis was achieved in all 6 patients with massive colporrhagia. No occurrence of infection and uterine necrosis was observed, but 12 women suffered abdominal pains. Nineteen patients’ uteri were preserved, whereas four underwent hysterectomy eventually. Conclusions. Transcatheter arterial chemoembolization is effective to treat high-risk CSP in preference to hysterectomy. To achieve more successful outcomes, three factors should be highlighted: adequate MTX dosage, appropriate embolic material, and complete embolization of target arteries that supply blood to embryo in the scar.

  4. A Case of Idiopathic Severe Acute Pancreatitis following Cesarean Section Delivery.

    Science.gov (United States)

    Kim, Jung; Choi, Jin Ho; Shin, Bang Sup; Nam, Joon Yeul; Kang, Eun Ae; Kim, Joo Seong; Hwang, Jin Hyeok; Kim, Jaihwan

    2016-09-25

    Acute pancreatitis rarely occurs in the postpartum period. Furthermore, there are very few reports of it after cesarean section delivery. A 35-year-old woman presented with dyspnea and abdominal distension on the third day after cesarean section delivery. Under a suspicion of acute pancreatitis, she was initially managed with conservative treatment. However, she developed intra-abdominal fluid collections and gastric bleeding, which were managed with percutaneous drainage, endoscopic hemostasis, and angiographic embolization. She was discharged with good clinical recovery. Postpartum pancreatitis, especially after cesarean section, is rare; however, its management is not different from that for usual pancreatitis. PMID:27646587

  5. Cesarean uterine scar pregnancy clinical study of early diagnosis%剖宫产子宫瘢痕妊娠早期诊断的临床研究

    Institute of Scientific and Technical Information of China (English)

    梁春燕; 范开蓉; 黄艳萍; 刘志玲; 冯芳; 艾国华; 姚小丽; 陈晓营

    2012-01-01

    Objective To explore uterine incision of cesarean section scar pregnancy in the early diagnosis method. Methods 20 cases with CPS of our hospital and MCH hospital in recent 2 years were collected as observation group, 25 cases which were normal position of pregnancy after cesarean section were as control group, the abdominal combined transvaginal color ultrasound, beta-HCG rise rate and progesterone were compared between the observation group and the control group, to determine the CSP early diagnosis method. Results The observation group compared with the control group, the color ultrasound of observation group was that the cervical canal without gestational sac, cesarean section incision was significantly expanded, the uterus wall under the internal orifice of uterus muscle layer above the discontinuity of wedge-shaped depressions or thinning, here to see the gestational sac or clutter echo area; the serum beta-HCG 48 h titre rise of control group was (65.6±3.2)%, the progesterone was (25.6±2.7) nmol/L, the serum beta-HCG 48 h titre rise of observation group was (42.2±1.2)%, the progesterone was (14.3±2.7) nmol/L, there were significiant differences between the observation group and the control group of the two indexes (P < 0.05). Conclusion Abdominal and vaginal color Doppler ultrasound, serum beta-HCG and progesterone detection in early diagnosis of CSP reliable clinical methods of examination, early diagnosis, prompt treatment to prevent the CSP serious complications, have important social and economic value.%目的 探讨剖宫产子宫切口瘢痕部位妊娠(cesarean scars pregnancy,CSP)的早期诊断方法.方法 收集我院及市妇幼保健院两家医院近2年来CPS 20例作为观察组,剖宫产后正常位置妊娠25例作为对照组,比较观察组与对照组腹部联合阴道彩色超声、β-HCG升高率和孕酮来确定CSP早期诊断的方法.结果 观察组与对照组相比,观察组B超示宫颈管无孕囊,剖宫产切口处明显

  6. 急诊介入栓塞对剖宫产后瘢痕妊娠大出血的应用价值%Emergency uterine arterial choemembolization in the treatment of massive hemorrhage due to cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    孙晓龙; 石红春

    2011-01-01

    Objective: To investigatecthe clinical application of bilateral uterine arterial chemoembolization in treating massive hemorrhage due to cesarean section scar pregnancy (CSP). Methods:Twenty-three patients with massive hemorrhage due to cesarean were enrolled in the study,The mean blood loss was 2 000 ml.Selective catheterization was employed and bilateral uterine arterial chemoembolization with infusion methotrexate (MTX) together with gelatin sponge via the catheters was conducted. Results:The technical success was achieved in all the 23 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 using in clinical practice.%目的:探讨剖宫产后子宫瘢痕妊娠(Cesarean section pregnancy,CSP)大出血时急诊双侧子宫动脉化疗栓塞术的应用价值.方法:23例CSP患者出血量1500~3500 ml,平均2000 ml,行双侧子宫动脉超选择性插管后灌注甲氨蝶呤(Methotrex-ate,MTX)和明胶海绵颗粒行栓塞治疗.结果:23例CSP患者全部栓塞成功,随访3~6个月无再次大出血.结论:急诊双侧子宫动脉化疗栓塞术治疗CSP患者安全、有效、无严重并发症,值得临床推广使用.

  7. 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.

  8. A case of Klumpke's obstetric brachial plexus palsy following a Cesarean section.

    Science.gov (United States)

    Al-Qattan, Mohammad M; El-Sayed, Amel A F

    2016-09-01

    It is generally thought that Klumpke's palsy is not seen as obstetric injury. The authors present a case of Klumpke's palsy with Horner syndrome following delivery by emergency Cesarean section. Neurolysis and nerve grafting partially corrected the paralysis. PMID:27648266

  9. Influence factors of cesarean section and interventions to reduce the rate of cesarean section%剖宫产率增高的影响因素及降低剖宫产率的干预措施

    Institute of Scientific and Technical Information of China (English)

    王秋芳

    2016-01-01

    目的 探析剖宫产的影响因素及降低剖宫产率的干预措施.方法 选取2012年1月至12月1 195例产妇为干预前组,选取2014年1月至12月行干预措施的1 280例产妇为干预后组.分析高剖宫产率的影响因素及降低剖宫产率的干预措施的效果.结果 2012年550例剖宫产产妇中胎儿因素220例(40.0%),包括宫内窘迫、巨大儿、双胎、臀位、胎位异常等因素;母亲因素207例(37.6%),包括妊娠并发症、瘢痕子宫、高龄初产、盆骨狭窄、产程异常等;社会因素123例(22.4%).干预前剖宫产率为46.0%,干预后降低至38.0%,干预前后比较差异有统计学意义(P<0.05).结论 阴道分娩为自然生理过程,值得提倡,可通过产前保健、提高产科质量、严格掌握剖宫产指征、心理干预与生理支持等干预措施来降低剖宫产率.%Objective To investigate the influence factors of cesarean section and interventions to reduce the rate of cesarean section.Methods From January 2012 to December 2012, 1 195 pregnant women were selected as the before intervention group, 1 280 pregnant women from January 2014 to December in 2014 were selected as the after intervention group, and to analyze the influence factors of cesarean section and interventions to reduce the rate of cesarean section.Results Among the 550 cases of cesarean seltion in 2012, fetal factors was 220 cases(40%), including fetal distress, fetal macrosomia, twins, breech presentation and abnormal fetal position;maternal factors was 207 cases(37.6%), including pregnancy complication, uterine scar, older primipara, narrow pelvis, abnormal stage;social factors was 123 cases(22.4%).The rate of cesarean section before the intervention was 46.0%, it was 38.0%after the intervention, the difference was statistically significant (P < 0.05).Conclusions Vaginal delivery is a natural physiological process which is worth advocating.The rate of cesarean section can be reduced

  10. Cimethidine pre-anesthetic. A prophylactic method against Mendelson's syndrome in cesarean section

    DEFF Research Database (Denmark)

    Qvist, N; Storm, K

    1983-01-01

    Twenty patients undergoing cesarean section received cimethidine 400 mg intramuscularly as pre-anesthetic approximately 70 minutes prior to gastric aspiration. The average pH was 5.05, as against 2.97 in the control group (p less than 0.01). No significant reduction in the aspirated volumes...... in the infants. Hence, cimethidine is a safe and useful pre-anesthetic for patients undergoing cesarean section, irrespective of indication and, consequently, much to be preferred to oral antacids....

  11. 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.

  12. [Cesarean section on request because of labor pain--bioethical and legal views].

    Science.gov (United States)

    Frković, Aleksandra; Bosković, Zvonko

    2010-03-01

    Non-medical reasons that influence the decision to perform cesarean section are the subject of numerous medical and bioethical debates. The questions to be answered are: can a pregnant woman demand cesarean section based on her right to make decisions, i.e. on patient rights? Do such a request and permission given by the woman justify the physician to perform the procedure without clear medical indication, knowing that cesarean section is associated with higher maternal morbidity and mortality rate than vaginal delivery? Among the numerous reasons stated by pregnant women or their families when demanding cesarean section, this paper is focused on labor pain. The experience of pain during delivery is the result of many complex physiologic and psychosocial factors that act on the woman's personal interpretation of the nociceptive delivery stimuli. A mother's request for cesarean section should not be motivated by the lack of efficiency of pain management. Such motivation points to inadequate prenatal care and patient education offered by the obstetrician and anesthesiologist. Decisions to perform cesarean section upon request are not in accordance with the guidelines of declarations and codes of medical ethics, and have no legal basis in our country.

  13. 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.

  14. 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.

  15. Risk Factors for Endometritis Following Low Transverse Cesarean Section

    Science.gov (United States)

    OLSEN, Margaret A.; BUTLER, Anne M.; WILLERS, Denise M.; GROSS, Gilad A.; DEVKOTA, Preetishma; FRASER, Victoria J.

    2012-01-01

    Objective To determine independent risk factors for endometritis (EMM) following low transverse cesarean section (LTCS). Study design We performed a retrospective case-control study from July 1999 to June 2001 in a large tertiary-care academic hospital. EMM was defined as fever beginning > 24 hours or continuing for ≥ 24 hours after delivery plus fundal tenderness in the absence of other causes for fever. Independent risk factors for EMM were determined by multivariable logistic regression. A fractional polynomial method was used to examine risk of EMM associated with the continuous variable, duration of rupture of membranes. Results EMM was identified in 124/1605 (7.7%) women within 30 days after LTCS. Independent risk factors for EMM included age (odds ratio (OR) for each additional year 0.93; 95% confidence interval (CI): 0.90-0.97) and anemia/perioperative blood transfusion (OR 2.18; CI:1.30-3.68). Risk of EMM was marginally associated with a proxy for low socioeconomic status, lack of private health insurance (OR 1.72; CI: 0.99-3.00), amniotomy (OR 1.69; CI:0.97-2.95), and longer duration of rupture of membranes. Conclusion Risk of EMM was independently associated with younger age and anemia, and was marginally associated with lack of private health insurance, and amniotomy. Although duration of rupture of membranes was only marginally associated with increased risk of EMM, increased risk was observed very soon after rupture of membranes. Knowledge of these risk factors is important to guide selective use of prophylactic antibiotics during labor and heighten awareness of the risk in subgroups at highest risk of infection. PMID:19951198

  16. Vaginal delivery versus cesarean section for term breech delivery

    Directory of Open Access Journals (Sweden)

    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

  17. Correlation Questions Clinical Discussion of Uterine Artery Embolization in Induced Abortion Patients with Management of Cesarean Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

    Ai-hua FAHG; Qin-fang CHEN; Zao-xia QIAN; Qun-ying LI; Yu MENG

    2009-01-01

    Objective To analyze retrospectively the utility of uterine arterial embolization(UAE)for cesarean scar pregnancy(CSP).Methods Fifty-one women with CSP were pretreated with UAE before dilatation & curettage(D&C).Indexes such as blood loss volume,operation-associated complications,serum hCG level,ultrasound imaging and hospitalization cost were analyzed.Results Thirty-eight women accepted D&C following UAE(group A),10 patients had medicine(3 took trichosanthin injection,7 took MTX injection)before UAE and D&C(group B).Uterine packing following emergency UAE were performed in another 3 women due to severe hemorrhage during direct curettage without pretreatment (group C).There were no statistically significant differences between group A and group B about the serum β-hCG level resolution time and the blood loss in the opertation.Patients had shorter duration of hospital stay(P<0.01)and cheaper cost of hospitalization(P<0.05)of group A than group B.Conclusion Pretreatment with UAE before curettage is safe and effective in terminating CSP,reducing hospitalization cost.UAE followed by curettage is recommended to medical facilities where UAE is available.

  18. Discussion of therapeutic method of cesarean scar pregnancy%瘢痕部位妊娠治疗方式的探讨

    Institute of Scientific and Technical Information of China (English)

    李蕾; 庄雅丽; 汪海妍; 张莉; 朱婷婷; 吴芳

    2015-01-01

    目的:近年来剖宫产瘢痕妊娠(CSP)发生率不断提高,该文对比研究CSP各种治疗方法的优缺点。方法:回顾性分析37例剖宫产CSP患者的临床资料,对比3种治疗方法(A:B超引导下囊内注射甲氨蝶呤(MTX)+5-FU静滴+B超下清宫术;B:腹腔镜下子宫切口处妊娠组织取出术;C:经阴道切口妊娠物取出术)的治疗效果及费用、愈后等。结果:B、C治疗方法明显优于A方法,而C不需要腹腔镜等特殊设备。结论:经阴道切口妊娠物取出术更适合在广大基层医院开展应用。%The morbidity of cesarean scar pregnancy (CSP) is increasing in recent years, but the effects of differ-ent therapeutic methods are little known. In this study, the clinical data of 37 cesarean scar pregnancy patients from 2009 to 2014 were collected and divided into three groups according to their therapies:group A (received injection of methotrexate (MTX), 5-FU intravenous infusion and surgery curettage), group B (received laparoscopic surgery) and group C (received cesarean scar pregnancy tissue taking-out technique through vaginal incision). Through compara-tive analysis, we found the cure rates and the decreased ratios of HCG of group B and group C were significantly higher than that of group A. Laparoscopic surgery and cesarean scar pregnancy tissue taking-out technique through vaginal incision were both safe and effective therapies for CSP treatment. But cesarean scar pregnancy tissue taking-out technique through vaginal incision do not need special medical devices, such as laparoscope, and easily to operate. So it is more suitable to carry out in primary hospitals.

  19. 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

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

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    Piotr Niziurski

    2013-08-01

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

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

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    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.

  2. Uterine Artery Embolization Combined with Local Methotrexate and Systemic Methotrexate for Treatment of Cesarean Scar Pregnancy with Different Ultrasonographic Pattern

    International Nuclear Information System (INIS)

    Purpose: This study was designed to compare the effectiveness of systemic methotrexate (MTX) with uterine artery embolization (UAE) combined with local MTX for the treatment of cesarean scar pregnancy (CSP) with different ultrasonographic pattern, and to indicate the preferable therapy in CSP patients. Methods: The results of 21 CSP cases were reviewed. All subjects were initially administrated with systemic MTX (50 mg/m2 body surface area). UAE combined with local MTX was added to the patients who had failed systemic MTX. The transvaginal ultrasonography data were retrospectively assessed, and two different ultrasonographic patterns were found: surface implantation and deep implantation of amniotic sac. The management and its effectiveness for patients with the two ultrasonographic patterns were studied retrospectively. Ultrasound scan and serum β-hCG were monitored during follow-up. Data were analyzed with the Student’s t test. Results: Nine patients were successfully treated with systemic MTX. The remaining 12 cases were successfully treated with additional UAE combined with local MTX. According to the classification by Vial et al. of CSP on ultrasonography, most surface implanted CSPs (8/11, 72.7%) could be successfully treated with systemic MTX, whereas most deeply implanted CSPs (9/10, 90%) had failed systemic MTX but still could be successfully treated with additional UAE combined with local MTX. All patients recovered without severe side effects. Most patients with a future desire for reproduction achieved subsequent pregnancy. Conclusions: For CSP patients suitable for nonsurgical treatment, UAE combined with local MTX would be the superior option compared with systemic MTX in the cases with deep implantation of amniotic sac.

  3. 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

  4. Cesarean section in the People’s Republic of China: current perspectives

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    Feng XL

    2014-01-01

    Full Text Available Xing Lin Feng,1 Ying Wang,1 Lin An,2 Carine Ronsmans3 1Department of Health Policy and Administration, School of Public Health, Peking University, Beijing, People’s Republic of China; 2Department of Women, Children and Adolescent Health, School of Public Health, Peking University, Beijing, People’s Republic of China; 3Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England Objective: To review the current knowledge on the prevalence, reasons, and consequences of cesarean sections in the People’s Republic of China. Methods: Peer-reviewed articles were systematically searched on PubMed. The following Chinese databases were comprehensively searched: the China National Knowledge Infrastructure, Wanfang, and the VIP information. The databases were searched from inception to September 1, 2013. Two reviewers independently screened the titles and abstracts for eligibility. Full texts of eligible papers were reviewed, where relevant references were hand-searched and reviewed. Findings: Sixty articles were included from PubMed, 17 articles were intentionally picked out from Chinese journals, and five additional articles were added, for a total of 82 articles for the analysis. With a current national rate near 40%, the literature consistently reported a rapid rise of cesarean sections in the People’s Republic of China in the past decades, irrespective of where people lived or their socioeconomic standing. Nonclinical factors were considered as the main drivers fueling the rise of cesareans in the People’s Republic of China. There was a lively debate on whether women’s preferences or providers’ distorted financial incentives affected the rise in cesarean sections. However, recent evidence suggests that it might be the People’s Republic of China’s health development approach – focusing on specialized care and marginalizing primary care – that is playing a role. Although 30 articles

  5. 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

  6. [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

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

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    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

  8. The evaluation of myomectomies performed during cesarean section in our clinic

    Science.gov (United States)

    Celal, Kadı; Hülya, Çıçek

    2011-01-01

    Background: We evaluated the data of patients who had applied myomectomy during cesarean section operation in our clinic between April, 2008 and December, 2010. Objective: I0 n this period, 3689 cesarean sections were done in our clinic, we analyzed their data retrospectively and determined 27 myomectomy cases during cesarean section operation. The age of the patients, the numbers of pregnancy, parities, the rates of abortus, indications of cesarean, pregnancy weeks, residential areas of myoms detected during the cesarean and their size, were recorded. Furthermore, pre-operative and post-operative hemoglobin (Hb) values, differences between hemoglobin values, whether there was bleeding or not, the need of blood transfusion if it occurred, the duration of operation and hospitaization and the pathological diagnoses of myomectomy materials, were examined. Materials and Methods: Retrospective study of myomectomies. Results: The mean age of patients was 29.6±5.9 (19-42) and mean gestational age was 39.2±1.0(37-42) weeks. The mean size of the fibroids was 5.94±6.29 cm3 (0.96-26.50 cm3). Subserous myoms were the most frequently seen ones (24 of 27 patients=89%) with fundal, corporal localizations in most of the instances. T0 he pre-operative and post-operative values of Hb were 11.8±1.52 (8.6-10.5) and 10.3±2.6 (6.9-13.3) g/dl respectively and the difference was statistically significant (P<0.001). Blood transfusion was not necessary in any patient. The mean duration of the operation was found to be 40.7±13.9 (13-60) minutes. Conclusion: Myomectomies can be performed safely during cesarean section by experienced obstetricians and gynecologists, and myomectomy performed for fibroids in appropriate localizations does not increase post-operative bleeding or maternal morbidity or mortality. PMID:22083246

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

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    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.

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

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    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.

  11. [Characteristic features of systemic hemodynamics during cesarean section under general anesthesia with ketamine].

    Science.gov (United States)

    Moiseev, V N

    1983-02-01

    On the basis of a comparative investigation of the central hemodynamics by the method of integrative rheography of the body in two groups of women during the operation of cesarean section under general anesthesia with ether or ketamin the author makes a conclusion that ketamin is a good drug for anesthesia in urgent surgical situations.

  12. 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.

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

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    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. 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

  15. Effectiveness of Onion Extract Gel on Surgical Scars in Asians

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    Kumutnart Chanprapaph

    2012-01-01

    Full Text Available Background. Onion extracts have been shown in vitro to accelerate wound healing. Results from clinical studies on surgical scars in Caucasians were disappointing. The aim of this study is to evaluate the effectiveness of onion extract gel in improving the cosmetic and symptoms of surgical scars in Asians. Patients/Methods. Twenty Asians who had new Pfannenstiel’s cesarean section scars were recruited in this prospective double-blinded, split-scar study. Each side was randomly assigned treatment with onion extract gel or placebo at 7 days after surgery. The product was applied three times daily for 12 weeks. Subjects were evaluated at baseline and 4th and 12th weeks. Scar redness was assessed by calorimeter, scar height and pliability were assessed by blinded investigators, and scar symptoms and overall cosmetic improvement were assessed by subjects. Results. Sixteen subjects completed the study. A statistically significant difference between two sides of scar in terms of scar height and scar symptoms was found. There was no statistically significant difference in scar redness, scar pliability, and overall cosmetic appearance between two sides. Conclusions. The early use of topical 12% onion extract gel on Pfannenstiel’s cesarean section scar in Asians resulted in the improvement of scar height and scar symptoms.

  16. 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.

  17. 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...

  18. Clinical analysis of 38 cesarean scar pregnancy cases%剖宫产瘢痕妊娠38例临床分析

    Institute of Scientific and Technical Information of China (English)

    张磊; 关华; 胡金菊

    2015-01-01

    Objective To investigate choice of treatment strategies for uterine lower segmental cesarean scar pregnancy, and to provide method and reference for rationally clinical diagnosis and treatment. Methods Clinical data of 38 patients with cesarean scar pregnancy were retrospectively analyzed, along with their diagnosis and treatment process. Results Menolipsis occurred in all the 38 cases. There were 32 cases with vaginal bleeding (84.2%), 6 cases with vaginal bleeding and complicated mild lower abdominal pain (15.8%), and all of the cases with increased human chorionic gonadotropin (HCG). Pelvic color Doppler ultrasound was used in detection and diagnosis for all the 38 cases. There were 32 cases receiving drug therapy + uterine curettage, while 1 case among them received hysterectomy. The other 6 cases received laparoscopic removal of cesarean scar pregnancy with successful process. Conclusion Among multiple treatment methods for uterine lower segmental cesarean scar pregnancy, uterine curettage after decreased HCG to 1000 U/L by gestational sac injection of methotrexate (MTX) and laparoscopic lesion resection can provide few bleeding and precise effect. Improvement of clinical diagnosis for cesarean scar pregnancy, early diagnosis and treatment are necessary for avoiding occurrence of severe adverse reactions, and guaranteeing fertility function and health in patients.%目的:探讨子宫下段剖宫产瘢痕妊娠治疗策略的选择,为临床合理诊治提供方法及依据。方法回顾性分析38例剖宫产瘢痕妊娠患者的临床资料,分析其诊断及其治疗过程。结果38例患者均有停经,阴道流血者有32例(84.2%),6例表现为阴道流血伴下腹部轻微疼痛(15.8%),全部伴有血人绒毛膜促性腺激素(HCG)升高。38例均由盆腔彩超检测诊断,32例行药物治疗+清宫术,其中1例行子宫切除术;6例行腹腔镜下子宫切口瘢痕妊娠清除术,过程顺利。结论子宫下段剖宫产瘢痕妊娠的治

  19. Avaliação ultrassonográfica de cicatriz uterina pós-cesariana segmentar transversa Ultrasound evaluation of uterine scar after segmental transverse cesarean surgery

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    Jorgete Maria Buso Bazzo

    2012-05-01

    Full Text Available OBJETIVO: Avaliar a medida do segmento uterino inferior pela ultrassonografia transvaginal em um grupo de mulheres não grávidas e descrever os achados morfológicos na cicatriz daquelas submetidas à cesárea. MÉTODOS: Estudo retrospectivo para o qual foram avaliadas 155 imagens de ultrassonografias transvaginais obtidas de mulheres no menacme, não grávidas. Os exames foram realizados entre janeiro de 2008 e novembro de 2011. Foram selecionados três grupos: mulheres que nunca ficaram grávidas (Grupo Controle I, mulheres com partos vaginais anteriores (Grupo Controle II e mulheres com cesárea prévia (Grupo de Estudo. Foram excluídas as mulheres com útero em retroflexão, usuárias de dispositivo intrauterino, gestantes e mulheres com menos de um ano do último evento obstétrico. Os dados obtidos foram submetidos à análise estatística com o programa Statistica®, versão 8.0. Para a comparação dos grupos em relação às variáveis quantitativas foram utilizados os testes ANOVA e LSD. Para a comparação entre a espessura do istmo anterior e posterior utilizou-se o teste t de Student. Para a associação entre variáveis quantitativas estimou-se o coeficiente de correlação de Spearman. Valores pPURPOSE: To evaluate the thickness of the lower uterine segment by transvaginal ultrasound in a group of non-pregnant women and to describe the morphologic findings in the scar of those submitted to cesarean section. METHODS: A retrospective study of 155 transvaginal ultrasound images obtained from premenopausal and non-pregnant women, conducted between January 2008 and November 2011. the subjects were divided into three groups: women who were never pregnant (Control Group I, women with previous vaginal deliveries (Control Group II and women with previous cesarean section (Observation Group. We excluded women with a retroverted uterus, intrauterine device users, pregnant women and those with less than one year of tsince the last

  20. Evaluation of antihypotensive techniques for cesarean section under spinal anesthesia: Rapid crystalloid hydration versus intravenous ephedrine

    Science.gov (United States)

    Kulkarni, Kalpana Rajendra; Naik, Amruta Girish; Deshpande, Sunetra Girish

    2016-01-01

    Background: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. Aims: We aimed to evaluate the efficacy of 15 mL.kg- 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section. Methods: A prospective randomized double blind study was conducted in hundred ASA grade I/II parturient undergoing cesarean section, allocated to group P (n=50) who received preloading with ringer lactate 15 mL.kg- 1 over 20 minutes before spinal anesthesia and group E (n=50) received intravenous bolus of 10mg ephedrine within one minute of spinal anesthesia with 10mg of hyperbaric bupivacaine 0.5% at L2-3/L3-4 level. They were monitored for incidences of hypotension, need of rescue doses of ephedrine, Apgar score and adverse events. Appropriate statistical tests were applied and P Apgar score were better in group E than in group P delivered babies. Conclusion: Prophylactic intravenous bolus of 10mg ephedrine with spinal injection is more effective in maintaining maternal hemodynamic stability and better neonatal outcome as compared to crystalloid preloading during cesarean delivery. PMID:27746565

  1. Fatores Associados à Realização de Cesárea em Primíparas com uma Cesárea Anterior Factors Associated with Cesarean Section in Primipara Women with One Previous Cesarean Section

    Directory of Open Access Journals (Sweden)

    José Guilherme Cecatti

    2000-04-01

    1996. The cases were 153 women whose second delivery was through a cesarean section and the controls were 203 women whose second delivery was vaginal. For analysis, means, standard deviation, Student's t-test, Mann-Whitney test, chi² test and odds ratio (OR with 95% CI for each factor possibly associated with cesarean section on the second delivery were used. Results: the route of the second delivery was vaginal for 57% of the women. Among the several variables studied, those which showed to be significantly associated with a cesarean section on the second delivery were: higher maternal age (for women over 35 years, OR = 16.4, previous abortions (OR = 2.09, induced labor (OR = 3,83, premature rupture of membranes (OR = 2.83, not having an epidural analgesia performed during labor (OR = 5.3, the finding of some alteration in fetal well-being (OR = 2.7 and the delivery occurring during the afternoon (OR = 1.92. Conclusions: these results indicate that the factors associated with the repetition of cesarean section in women with a previous scar of cesarean section in this population are predominantly medical; however, there is still the possibility of proposing interventions directed to decreasing the rates of repeated cesarean sections.

  2. 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...

  3. 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-sections

  4. 剖宫产指征10年回顾%Retrospective analysis on the indications of cesarean section from 2000 to 2009

    Institute of Scientific and Technical Information of China (English)

    施华珍; 曹树军; 陈晓玲

    2012-01-01

    目的:分析剖宫产指征变化,探讨剖宫产率居高不下的原因及降低剖宫产率的可行性措施.方法:对松江分院2000年1月1日~2009年12月31日住院剖宫产分娩的8 888例患者的病历资料进行回顾性分析.结果:①在剖宫产指征构成比中,社会因素位居第一,其次依次为胎儿窘迫、头盆不称、疤痕子宫、臀位等.②10年来社会因素剖宫产指征呈快速上升趋势,在3个阶段的剖宫产指征构成比中分别为8.2%、54.4%和37.6%.第三阶段社会因素剖宫产指征构成比较前明显下降,P<0.01,是总剖宫产率明显下降的主要原因,P<0.01,但仍维持在一个较高水平.10年来以疤痕子宫为指征在剖宫产指征构成比中有逐年上升趋势,P<0.05或<0.01.③围产儿死亡率无统计学差异(P>0.05).结论:①降低剖宫产率的关键在于严格掌握剖宫产指征,提高产科质量,提高阴道助产技术水平;加强孕产期保健及其健康教育,提高人们对剖宫产并发症的认识,降低以社会因素为指征的剖宫产率.②剖宫产率在一定范围内降低了围产儿死亡率,但剖宫产率的进一步升高,围产儿死亡率并未随之下降.因此,应合理掌握剖宫产指征,降低剖宫产率.%Objective; To analyze the change of indications of cesarean section, explore the causes of high cesarean section rate and the feasible measures to reduce cesarean section rate. Methods; The medical data of 8 888 hospitalized cases who underwent cesarean section in the hospital from January first, 2000 to December 31st, 2009 were analyzed retrospectively. Results; Among the proportions of indications of cesarean section, social factor ranked the first, followed by fetal distress, cephalopelvic disproportion, scar uterus, and breech presentation, and so on. From 2000 to 2009, cesarean section rate induced by social factor increased rapidly, the proportions among three stages of indications of cesarean section

  5. Technology use, cesarean section rates, and perinatal mortality at Danish maternity wards

    DEFF Research Database (Denmark)

    Lidegaard, O; Jensen, L M; Weber, Tom

    1994-01-01

    Fifty-eight Danish maternity units, managing 99% of Danish deliveries, participated in a cross sectional study to assess the relationship between use of birth-related technologies, cesarean section rates and perinatal mortality for births after 35 completed weeks of gestation. A regional technology...... index (0-10) was calculated for each maternity unit according to its use of ante and intra partum fetal heart rate monitoring (FHM), hormone analysis (human placental lactogen (HPL) and/or estriol (O3)), fetal blood samples (scalp-pH), intrauterine catheter and umbilical cord-pH. Maternity units using......, and unplanned cesarean section rates in the eight regions were all without significant association to the perinatal mortality in the same regions. For births after the 35th completed week of gestation, this study could not confirm a relationship between different degrees of use of birth-related technologies...

  6. Risk adjustment for inter-hospital comparison of primary cesarean section rates: need, validity and parsimony

    Directory of Open Access Journals (Sweden)

    Dallolio Laura

    2006-08-01

    Full Text Available Abstract Background Cesarean section rates is often used as an indicator of quality of care in maternity hospitals. The assumption is that lower rates reflect in developed countries more appropriate clinical practice and general better performances. Hospitals are thus often ranked on the basis of caesarean section rates. The aim of this study is to assess whether the adjustment for clinical and sociodemographic variables of the mother and the fetus is necessary for inter-hospital comparisons of cesarean section (c-section rates and to assess whether a risk adjustment model based on a limited number of variables could be identified and used. Methods Discharge abstracts of labouring women without prior cesarean were linked with abstracts of newborns discharged from 29 hospitals of the Emilia-Romagna Region (Italy from 2003 to 2004. Adjusted ORs of cesarean by hospital were estimated by using two logistic regression models: 1 a full model including the potential confounders selected by a backward procedure; 2 a parsimonious model including only actual confounders identified by the "change-in-estimate" procedure. Hospital rankings, based on ORs were examined. Results 24 risk factors for c-section were included in the full model and 7 (marital status, maternal age, infant weight, fetopelvic disproportion, eclampsia or pre-eclampsia, placenta previa/abruptio placentae, malposition/malpresentation in the parsimonious model. Hospital ranking using the adjusted ORs from both models was different from that obtained using the crude ORs. The correlation between the rankings of the two models was 0.92. The crude ORs were smaller than ORs adjusted by both models, with the parsimonious ones producing more precise estimates. Conclusion Risk adjustment is necessary to compare hospital c-section rates, it shows differences in rankings and highlights inappropriateness of some hospitals. By adjusting for only actual confounders valid and more precise estimates

  7. 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

  8. 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...

  9. 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...

  10. 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. ...

  11. 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...

  12. 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/...

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. The effects of indomethacin, diclofenac, and acetaminophen suppository on pain and opioids consumption after cesarean section

    Directory of Open Access Journals (Sweden)

    Godrat Akhavanakbari

    2013-01-01

    Full Text Available Background: Cesarean section is one of the common surgeries of women. Acute post-operative pain is one of the recognized post-operative complications. Aims: This study was planned to compare the effects of suppositories, indomethacin, diclofenac and acetaminophen, on post-operative pain and opioid usage after cesarean section. Materials and Methods: In this double-blind clinical trial study, 120 candidates of cesarean with spinal anesthesia and American Society of Anesthesiologists (ASA I-II were randomly divided into four groups. Acetaminophen, indomethacin, diclofenac, and placebo suppositories were used in groups, respectively, after operation and the dosage was repeated every 6 h and pain score and opioid usage were compared 24 h after the surgery. The severity of pain was recorded on the basis of Visual Analog Scale (VAS and if severe pain (VAS > 5 was observed, 0.5 mg/kg intramuscular pethidine had been used. Statistical Analysis Used: The data were analyzed in SPSS software version 15 and analytical statistics such as ANOVA, Chi-square, and Tukey′s honestly significant difference (HSD post-hoc. Results : Pain score was significantly higher in control group than other groups, and also pain score in acetaminophen group was higher than indomethacin and diclofenac. The three intervention groups received the first dose of pethidine far more than control group and the distance for diclofenac and indomethacin were significantly longer (P < 0.001. The use of indomethacin, diclofenac, and acetaminophen significantly reduces the amount of pethidine usage in 24 h after the surgery relation to control group. Conclusions : Considering the significant decreasing pain score and opioid usage especially in indomethacin and diclofenac groups rather than control group, it is suggested using of indomethacin and diclofenac suppositories for post-cesarean section analgesia.

  18. Scar Endometriosis: a Case Report with Literature Review.

    Science.gov (United States)

    Gupta, Pratiksha; Gupta, Sangeeta

    2015-12-01

    Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. Endometriosis can sometimes occur in a previous surgical scar. Scar endometriosis is rare and difficult to diagnose. It mostly follows obstetrical and gynecological surgeries. This condition is often confused with other surgical conditions. We are reporting one case of scar endometriosis involving rectus sheath following cesarean section. The patient required wide surgical excision of the lesion. The pathogenesis, diagnosis, and treatment of this rare condition are being discussed.

  19. [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

  20. 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.

  1. 腹腔镜治疗剖宫产瘢痕妊娠%Clinical research of laparoscopy in the treatment of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    胡碧洪; 黄浩; 李莉芳; 王帅

    2014-01-01

    Objective To investigate the application value of laparoscopy on cesarean scar pregnancy(CSP). Methods Four-teen patients with CSP in this hospital from June 2009 to June 2011 were selected. Six of them had β-HCG average 24 271. 5 U/ L in blood. Their transvaginal sonography showed large uterus and gestational Sac or hypoechonic masses which were 3. 3 ~ 4. 8 cm (4. 1 cm average)with rich blood. The clinical data and treatment outcome of 6 patients with laparoscopic wedge resection of the lesion + uterine scar repair to treatments cesarean scar pregnancy were retrospectively analyzed. Results Six patients were suc-cessfully operated with less bleeding and hysterectomy,minimally invasive,effective,quick recovery treatment. Conclusion Ce-sarean scar pregnancy underwent laparoscopic resection of local lesions of uterine repair can not only effectively terminate the preg-nancy,and can also repair scar defect and repair the uterus to retain reproductive function,so it is a very valuable method.%目的:探讨腹腔镜技术治疗剖宫产瘢痕妊娠(CSP)的价值。方法回顾性分析2009年6月至2011年6月在南方医科大学附属南海人民医院住院治疗的14例剖宫产瘢痕妊娠患者,其中6例患者因血β-人绒毛膜促性腺激素较高,平均24271.5 U/ L,阴道彩超提示:子宫增大,剖宫产切口部位见孕囊或不均质中低回声包块,长径3.3~4.8 cm,平均4.1 cm,包块周围有丰富血流信号,均突向浆膜层。6例患者均采用腹腔镜下子宫瘢痕部位病灶切除术+子宫修补术治疗。结果6例均顺利完成手术,出血少,避免子宫切除术,达到微创、有效、恢复快的治疗效果。结论 CSP 行腹腔镜下局部病灶切除+子宫修补术不仅可以有效终止妊娠,同时可以修补瘢痕缺陷、修复子宫,保留生育功能,是一种有价值的方法。

  2. Oral administration of marine collagen peptides prepared from chum salmon (Oncorhynchus keta improves wound healing following cesarean section in rats

    Directory of Open Access Journals (Sweden)

    Junbo Wang

    2015-05-01

    Full Text Available Background: The goal of the present study was to investigate the wound-healing potential of marine collagen peptides (MCPs from chum salmon skin administered to rats following cesarean section (CS. Methods: Ninety-six pregnant Sprague-Dawley rats were randomly divided into four groups: a vehicle group and three MCP groups. After CS, rats were intragastrically given MCPs at doses of 0, 0.13, 0.38, 1.15 g/kg*bw, respectively. On postoperative days 7, 14, and 21, the uterine bursting pressure, skin tensile strength, hydroxyproline (Hyp concentrations, and histological and immunohistochemical characteristics of the scar tissue were examined. Results: In the MCP groups, the skin tensile strength, uterine bursting pressure, and Hyp were significantly higher than those in the vehicle group at all three time points (p<0.05. The formation of capillary, fibroblast, and collagen fiber, the expression of platelet-endothelial cell adhesion molecule-1, basic fibroblast growth factor, and transforming growth factor beta-1 were increased in the MCP groups (p<0.05. Conclusion: MCPs could accelerate the process of wounding healing in rats after CS.

  3. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    Science.gov (United States)

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

    2012-09-01

    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.

  4. Is scar tenderness a reliable sign of scar complications in labor?

    Directory of Open Access Journals (Sweden)

    Isha Gutgutia

    2012-12-01

    Full Text Available Background: Cesarean section has come a long way from being a risky & restrictive surgery to one that is safe and quick. Due to a rise in the rates of primary caesarean section globally, repeat cesarean section has also become very common. The chief concern during labor with scarred uteri is that of scar rupture which can have devastating fetal and maternal consequences, including mortality. Several studies monitoring for the features of scar rupture like abnormal cardiotocography (CTG, severe abdominal pain persisting between contractions, acute onset scar tenderness, hematuria or abnormal vaginal bleeding, maternal tachycardia or shock, cessation of uterine activity and loss of station of the presenting part exist with the exception of scar tenderness which has not been evaluated separately in any study. The present prospective observational study was undertaken in a tertiary care hospital to evaluate the sensitivity and specificity of scar tenderness as a sign of scar complications in labor. Methods: 78 women with one previous cesarean delivery in spontaneous labor at term undergoing trial of scar were monitored for progress of labor and observed for vaginal bleeding, scar tenderness, maternal pulse and blood pressure every 30 minutes. Scar tenderness was elicited by pressing below and behind the pubic symphysis in between uterine contractions while engaging the woman in conversation and noting for a visible wince. Fetal heart rate auscultation was done as per protocol. Trial of scar was terminated for scar tenderness, unexplained maternal tachycardia, fresh vaginal bleeding, fetal heart rate abnormalities and non-progress of labor. Results: The sensitivity and specificity of scar tenderness as a predictor of scar complications was 92.3% and 3.8%, while accuracy was 33.3%. The likelihood ratio of a positive sign of scar tenderness being associated with scar complications in labour is 1.48. Maternal tachycardia was not a significant predictor

  5. 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.

  6. 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

  7. Effect of Social Factors on Cesarean Birth in Primiparous Women: A Cross Sectional Study (Social Factors and Cesarean Birth)

    Science.gov (United States)

    ONER, Can; CATAK, Binali; SÜTLÜ, Sevinç; KILINÇ, Selçuk

    2016-01-01

    Background: P Cesarean delivery rates have been increasing throughout the world. Parallel to the developments in the world the cesarean rate in Turkey has risen to 48.1% in 2013. Some of the social factors were related with cesarean births. The purpose of this study was to determine cesarean birth rates and to find out social factors affecting the cesarean birth in primiparous women. Methods: This study was conducted in Burdur Province, Turkey between the dates of 1 Jan 2012–31 Dec 2012 on 223 primiparous women. The data was collected with data collection form prepared by the researchers by using face-to-face interview technique. In these analyses, chi-square and Backward Logistic regression analyses were used. Results: In multivariate analyses, the place of delivery (OR: 11.2 [2.9–42.46] in private hospital and OR: 6.1 [2.6–14.1] in university hospital); time of the birth (OR: 7.1 [3.1–16.0]); doctor’s effect (OR: 4.0 [1.8–8.95]) and husband’s employment status (OR: 2.23 [1.0–4.7]) have been identified as factors affecting the caesarean delivery in primiparous women. Conclusion: Although the results do not show all of the factors affecting the caesarean delivery in primiparous women, they reveal that medical reasons are not the only reason in this increase trend. Health policy makers and health professionals are required to identify the causes of this increase and to take measures. PMID:27648420

  8. Technology use, cesarean section rates, and perinatal mortality at Danish maternity wards

    DEFF Research Database (Denmark)

    1994-01-01

    Fifty-eight Danish maternity units, managing 99% of Danish deliveries, participated in a cross sectional study to assess the relationship between use of birth-related technologies, cesarean section rates and perinatal mortality for births after 35 completed weeks of gestation. A regional technology...... index (0-10) was calculated for each maternity unit according to its use of ante and intra partum fetal heart rate monitoring (FHM), hormone analysis (human placental lactogen (HPL) and/or estriol (O3)), fetal blood samples (scalp-pH), intrauterine catheter and umbilical cord-pH. Maternity units using...

  9. Cesarean section and rate of subsequent stillbirth, miscarriage, and ectopic pregnancy: a Danish register-based cohort study.

    Directory of Open Access Journals (Sweden)

    Sinéad M O'Neill

    2014-07-01

    Full Text Available BACKGROUND: With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. METHODS AND FINDINGS: We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996, with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28 was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI of 0.03% for stillbirth, and a number needed to harm (NNH of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31 and elective cesarean (HR 1.11, 95% CI 0.91, 1.35, although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15 and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21, yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85. Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment

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

    Science.gov (United States)

    O'Neill, Sinéad M.; Agerbo, Esben; Kenny, Louise C.; Henriksen, Tine B.; Kearney, Patricia M.; Greene, Richard A.; Mortensen, Preben Bo; Khashan, Ali S.

    2014-01-01

    Background With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of

  11. Planned Repeat Cesarean Section at Term and Adverse Childhood Health Outcomes: A Record-Linkage Study.

    Directory of Open Access Journals (Sweden)

    Mairead Black

    2016-03-01

    Full Text Available Global cesarean section (CS rates range from 1% to 52%, with a previous CS being the commonest indication. Labour following a previous CS carries risk of scar rupture, with potential for offspring hypoxic brain injury, leading to high rates of repeat elective CS. However, the effect of delivery by CS on long-term outcomes in children is unclear. Increasing evidence suggests that in avoiding exposure to maternal bowel flora during labour or vaginal birth, offspring delivered by CS may be adversely affected in terms of energy uptake from the gut and immune development, increasing obesity and asthma risks, respectively. This study aimed to address the evidence gap on long-term childhood outcomes following repeat CS by comparing adverse childhood health outcomes after (1 planned repeat CS and (2 unscheduled repeat CS with those that follow vaginal birth after CS (VBAC.A data-linkage cohort study was performed. All second-born, term, singleton offspring delivered between 1 January 1993 and 31 December 2007 in Scotland, UK, to women with a history of CS (n = 40,145 were followed up until 31 January 2015. Outcomes assessed included obesity at age 5 y, hospitalisation with asthma, learning disability, cerebral palsy, and death. Cox regression and binary logistic regression were used as appropriate to compare outcomes following planned repeat CS (n = 17,919 and unscheduled repeat CS (n = 8,847 with those following VBAC (n = 13,379. Risk of hospitalisation with asthma was greater following both unscheduled repeat CS (3.7% versus 3.3%, adjusted hazard ratio [HR] 1.18, 95% CI 1.05-1.33 and planned repeat CS (3.6% versus 3.3%, adjusted HR 1.24, 95% CI 1.09-1.42 compared with VBAC. Learning disability and death were more common following unscheduled repeat CS compared with VBAC (3.7% versus 2.3%, adjusted odds ratio 1.64, 95% CI 1.17-2.29, and 0.5% versus 0.4%, adjusted HR 1.50, 95% CI 1.00-2.25, respectively. Risk of obesity at age 5 y and risk of cerebral

  12. 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

    Full Text Available Ngozi S Okonkwo1, Oladosu A Ojengbede2, Imran O Morhason-Bello1, Babatunde O Adedokun31Department of Obstetrics and Gynecology, University College Hospital; 2Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan; 3Department of Epidemiology, Medical Statistics, and Environmental Health, College of Medicine, Ibadan, Oyo State, NigeriaBackground: Contrary to the widely reported aversion to cesarean section in the West African subregion, maternal demand for cesarean section (MDCS seems to be on the increase, and there is little evidence to explain this trend. The purpose of this study was to determine the perception and attitudes of Nigerian antenatal clients towards MDCS, their willingness to request MDCS, and the relationship between willingness to request MDCS and sociodemographic characteristics.Methods: A cross-sectional survey was undertaken among 843 antenatal clients at Agbongbon/Orayan primary health care centers (PHCs, Adeoyo Maternity Hospital (SHC, and UCH Ibadan (THC, representing the three different levels of health care in Nigeria, ie, primary, secondary, and tertiary.Results: The proportion of women aware of MDCS was 39.6%. Predictors of awareness were education and type of health facility. Women from THC and those with tertiary education and above were more likely to be aware of MDCS than others (P = 0.001. Doctors were major sources of information on MDCS (30.8% as well as friends (24.3%. Common reasons reported for MDCS were fear of labor pains (68.9%, and fear of poor labor outcome (60.1%, and fear of fecal (20.2% and urinary incontinence (16.8%. More women from the THC than other facilities believed that requests for MDCS should be granted (P < 0.001. However, willingness to request MDCS was low (6.6%. More than 50% of those willing to request MDCS would likely be criticized, mainly by their husbands. On multiple logistic regression, respondents at the THC were significantly more

  13. Hematoma and abscess formation caused by Mycoplasma hominis following cesarean section

    Directory of Open Access Journals (Sweden)

    Hisato Koshiba, Akemi Koshiba

    2011-01-01

    Full Text Available Hisato Koshiba1,2, Akemi Koshiba1,2, Yasushi Daimon3, Toshifumi Noguchi1,2, Kazuhiro Iwasaku2, Jo Kitawaki21Department of Obstetrics and Gynecology, Kyoto Prefectural Yosanoumi Hospital, Kyoto, Japan; 2Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; 3Department of Clinical Laboratory, Kyoto Prefectural Yosanoumi Hospital, Kyoto, JapanAbstract: Mycoplasma species cannot be identified by routine bacteriological culture methods and are resistant to common antimicrobial agents. Mycoplasma hominis usually colonizes the lower urogenital tract and causes pyelonephritis, pelvic inflammatory disease, chorioamnionitis, rupture of fetal membranes, preterm labor, postpartum fever, postabortal fever, and neonatal infection. This organism is highly prevalent in cervicovaginal cultures of sexually active women. M. hominis, M. genitalis, Ureaplasma urealyticum, and U. parvum may invade and infect placental and fetal tissues, leading to adverse pregnancy outcomes. M. hominis occasionally causes nongenitourinary infection of the blood, wounds, central nervous system, joints, or respiratory tract. We present a case of a 27-year-old woman who developed abdominal wound hematoma and abscess after cesarean section. The wound was drained, but her high fever persisted, in spite of antibiotic treatment using flomoxef sodium and imipenem•cilastatin sodium. Because the exudate exhibited M. hominis growth in an anaerobic environment, we administered the quinolone ciprofloxacin. This therapy resolved her fever, and her white blood cell count and C-reactive protein level diminished to the normal ranges. To our knowledge, there are four published articles regarding the isolation of M. hominis from postcesarean incisions. Based on the current study and the literature, infection by this pathogen may cause hematoma formation with or without abscess after cesarean section or in immunosuppressed

  14. 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...

  15. 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.

  16. Anesthetic management of patient with Sjogren's syndrome who underwent cesarean section: a case report

    Science.gov (United States)

    Kim, Na Eun; Lee, Jae Hyuk; Lee, Jun Yong

    2016-01-01

    Sjogren's syndrome is one of the most common autoimmune disorders and has a female predominance. Maternal circulating autoantibodies such as anti-Ro/SSA and anti-La/SSB antibodies can cause congenital heart block of fetus, and in severe case, emergency pacemaker implantation may be needed for neonate. Therefore, it is very important to understand maternal and fetal condition and pay attention to the status of the neonate during delivery. In this paper, we present a case of patient with Sjogren's syndrome who underwent cesarean section under spinal anesthesia. PMID:27274376

  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. The Effect of Subcutaneous Ketamine Infiltration on Postoperative Pain in Elective Cesarean Section under Spinal Anesthesia

    Directory of Open Access Journals (Sweden)

    N. Manouchehrian

    2015-01-01

    Full Text Available Introduction & Objective: Appropriate analgesia after cesarean section helps women feel more comfortable and increase the mobility of the mother's and also their ability to take better care of their newborns. The purpose of this study was to investigate the effects of subcutaneous infiltration of ketamine on postoperative pain reduction and hemodynamic status of patients after elective cesarean section. Materials & Methods: This study was designed as a double blinded prospective, randomized clinical trial and 60 cases of women undergoing elective cesarean section under spinal anes-thesia were randomly assigned into two groups. For 30 cases in the ketamine group, infiltra-tion of subcutaneous ketamine 0.5 mg / kg was administered after closure of surgical inci-sion. 30 patients in the placebo group received subcutaneous infiltration of saline. During the patient's recovery time and after transferring to the ward, the VAS of pain and vital signs were continuously assessed. if VAS ? 3, 100 mg diclofenac suppository was administered and if there were no response, 30 mg intravenous pethidine was also administered. Prescribed number of suppositories and pethidine dosage were compared. The complications, such as hallucination, nystagmus, nausea, vomiting and drowsiness in patients were also recorded and compared. Statistical analysis was performed by SPSS16 software and ?2 and t-test. P< 0.05 was considered statistically significant in all of the cases. Results: In the course of systolic blood pressure, heart rate and arterial blood oxygen satura-tion during the first 24 hours, no significant differences were mentioned between the two groups. At the time of arrival to the recovery room and 30 minutes later, the mean VAS was not significantly different in the groups. However, the mean VAS at 1, 2 , 4 , 6 , 8 and 12 hours after surgery were significantly lower in the ketamine group (0.61±059 than in the sa-line group (3.37±096 (P<0.001. The mean

  19. 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...

  20. 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.

  1. 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

  2. Analysis the Related Factors on Delivery Mode in Repregnant Women after Cesarean Section%剖宫产术后再次妊娠分娩的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    叶秀兰

    2011-01-01

    目的:探讨割宫产术后再次妊娠的适宜分娩方式.方法:回顾分析我院178例剖官产术后再次妊娠妇女的分娩方式,并随机选取同期非瘢痕子宫阴道分娩和再次剖官产孕妇资料进行对比分析.结果:剖宫产再次妊娠阴道试产的成功率为71.3%,其产后表现与正常孕妇相似,产后出血量、住院时间、并发症明显低于再次剖宫产者.结论:剖宫产史作为再次妊娠剖宫产的指征是不合理的,符合试产条件的在严密监护下可试产,以减少再次术后的各种危险和并发症.%Objective: To explore the appropriate delivery mode in repregnant women after cesarean section. Method: 178 cases of repregnant women after cesarean section were analyzed on delivery mode,and compared with uterine scar-grain vaginal delivery( VBNC) and primiparity cesarean section(PCS). Result: The rate of successful labour was 71.3% of vaginal delivery after cesarean section (VBAC). They were identical with normal expectant mother,but the volume of delivery blood loss, days of hospitalization and complication was lower than repeat cesarean section( RCS). Conclusion: We should try the vaginal delivery,which is under suitable condition of vaginal delivery. It can reduce risks and complications.

  3. 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

  4. [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

  5. Comparison of Intravenous Ranitidine with Pantoprazole in Decreasing Gastric Fluid Acidity in Emergency Cesarean Section

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    Alipour M

    2013-10-01

    Full Text Available Objectives: Peri-operative aspiration of gastric contents is a problem that causes certain respiratory problems including ARDS. Prophylaxis against aspiration of gastric contents is performed routinely in elective surgeries, but there is rare evidence on the efficacy of this method in emergency cesarean section. Materials and Methods: This is a randomized, controlled, double-blinded clinical trial. 60 parturients undergoing emergency cesarean section were randomly assigned into three groups of 20 each. They were allocated into two study and one placebo groups. The study group one and two received intravenous ranitidine (IV 50 mg or IV pantoprazole 40 mg, half an hour before induction of GA, respectively. The placebo group was administered just 5 ml of isotonic saline half an hour before GA induction. After intubation and confirmation of endotracheal tube insertion, the gastric contents were aspirated through a nasogastric tube for evaluation of acidity and volume. Results: A statistical difference between group one and two with the control group was observed in the acidity of gastric contents, but there was no difference in volume. Also, the PH level of gastric contents in patients receiving pantoprazole was significantly higher than the isotonic saline (p

  6. Timing of elective cesarean section and neonatal morbidity: A randomized controlled trial

    DEFF Research Database (Denmark)

    Glavind, Julie; Kindberg, Sara Fevre; Uldbjerg, Niels;

    2012-01-01

    Objective Neonatal complications related to timing of elective cesarean section (ECS) have never been studied in randomized trials. We designed the first randomized trial of timing of ECS and hypothesized a decrease in neonatal admission rate if ECS was scheduled after 39 completed weeks of gesta......Objective Neonatal complications related to timing of elective cesarean section (ECS) have never been studied in randomized trials. We designed the first randomized trial of timing of ECS and hypothesized a decrease in neonatal admission rate if ECS was scheduled after 39 completed weeks....... Diabetics and women with an estimated high risk of having ECS before 39 weeks and 5 days of gestation were excluded. The primary outcome was admission to the Neonatal Intensive Care Unit within 48 hours of birth. Results From March 2009 to June 2011 1274 women from seven Danish hospitals were enrolled....... Baseline characteristics were similar in intervention groups. No significant difference in primary outcome was found between ECS delivery at 38+3 weeks (88/635 neonates or 13.9% admitted) and ECS delivery at 39+3 weeks (76/637 neonates or 11.9% admitted), RR 0.86 (95% CI 0.65-1.15). Compliance was defined...

  7. Remifentanil at induction of general anesthesia for cesarean section: Double blind, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    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. Apgar score after induction of anesthesia for canine cesarean section with alfaxalone versus propofol.

    Science.gov (United States)

    Doebeli, A; Michel, E; Bettschart, R; Hartnack, S; Reichler, I M

    2013-11-01

    The effects of alfaxalone and propofol on neonatal vitality were studied in 22 bitches and 81 puppies after their use as anesthetic induction agents for emergency cesarean section. After assessment that surgery was indicated, bitches were randomly allocated to receive alfaxalone 1 to 2 mg/kg body weight or propofol 2 to 6 mg/kg body weight for anesthetic induction. Both drugs were administered intravenously to effect to allow endotracheal intubation, and anesthesia was maintained with isoflurane in oxygen. Neonatal vitality was assessed using a modified Apgar score that took into account heart rate, respiratory effort, reflex irritability, motility, and mucous membrane color (maximum score = 10); scores were assigned at 5, 15, and 60 minutes after delivery. Neither the number of puppies delivered nor the proportion of surviving puppies up to 3 months after delivery differed between groups. Anesthetic induction drug and time of scoring were associated with the Apgar score, but delivery time was not. Apgar scores in the alfaxalone group were greater than those in the propofol group at 5, 15, and 60 minutes after delivery; the overall estimated score difference between the groups was 3.3 (confidence interval 95%: 1.6-4.9; P < 0.001). In conclusion, both alfaxalone and propofol can be safely used for induction of anesthesia in bitches undergoing emergency cesarean section. Although puppy survival was similar after the use of these drugs, alfaxalone was associated with better neonatal vitality during the first 60 minutes after delivery.

  9. Clear cell carcinoma derived from an endometriosis focus in a scar after a caesarean section--a case report and literature review.

    Science.gov (United States)

    Dobrosz, Zuzanna; Paleń, Piotr; Stojko, Rafał; Właszczuk, Paweł; Niesłuchowska-Hoxha, Anna; Piechuta-Kośmider, Ilona

    2014-10-01

    Endometriosis is defined as the occurrence of endometrial glands and endometrial stromal cells outside their typical localization within the uterus. Malignant transformation of endometriosis foci in a scar after a caesarean section (cc) is very rare--until 2013 (in a span of 40 years), about 40 such cases have been described. In our article, we describe a case of a 42-year-old woman with a tumour localized in a scar after a caesarean section. The tumour was diagnosed as clear cell carcinoma derived from an endometriosis focus. The long time interval--17 years in average (from 3 to 39 years) between the surgery (cesarean section in most cases) and the tumor diagnosis is characteristic. In the case we describe, the patient was diagnosed 16 years after the endometriosis focus in the scar had arised. Even though endometriosis is a benign lesion, it has many features distinctive for invasive carcinoma; it may itself undergo a malignant transformation as well as increase the risk of endometrial carcinoma or clear cell ovarian carcinoma. Maybe in future, more exhaustive studies will allow establishing a therapeutic protocol in patients with extra-ovarian malignant transformation of endometriosis foci.

  10. The risk of emergency cesarean section after failure of vaginal delivery according to prepregnancy body mass index or gestational weight gain by the 2009 Institute of Medicine guidelines

    Science.gov (United States)

    Kwon, Ha Yan; Kwon, Ja-Young; Park, Yong Won

    2016-01-01

    Objective To evaluate the risk of emergency cesarean section according to the prepregnancy body mass index (BMI) and gestational weight gain per the 2009 Institute of Medicine guidelines. Methods A retrospective analysis of data from 2,765 women with singleton full-term births (2009 to 2012) who attempted a vaginal delivery was conducted. Pregnancies with preeclampsia, chronic hypertension, diabetes, planned cesarean section, placenta previa, or cesarean section due to fetal anomalies or intrauterine growth restriction were excluded. Odds ratios (ORs) and confidence intervals (CIs) for emergency cesarean section were calculated after adjusting for prepregnancy BMI or gestational weight gain. Results Three-hundred and fifty nine (13.0%) women underwent emergency cesarean section. The adjusted OR for overweight, obese, and extremely obese women indicated a significantly increased risk of cesarean delivery. Gestational weight gain by Institute of Medicine guidelines was not associated with an increased risk of cesarean delivery. However, inadequate and excessive weight gain in obese women was highly associated with an increased risk of emergency cesarean section, compared to these in normal BMI (OR, 5.56; 95% CI, 1.36 to 22.72; OR, 3.63; 95% CI, 1.05 to 12.54; respectively), while there was no significant difference between normal BMI and obese women with adequate weight gain. Conclusion Obese women should be provided special advice before and during pregnancy for controlling weight and careful consideration should be needed at the time of vaginal delivery to avoid emergency cesarean section. PMID:27200306

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

    DEFF Research Database (Denmark)

    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...... reasons given for preferring abdominal deliveries was the risk to the fetus, risks of perineal injury, and urinary and anal incontinence. Of Danish specialists in obstetrics and gynecology, 37.6% agreed with a woman's right to have an elective cesarean section on maternal request without any medical...

  12. 3种剖宫产术后2次剖宫产术盆腹腔粘连情况观察%Observation on the pelvic and abdominal adhesion during the second cesarean section after three kinds of cesarean section

    Institute of Scientific and Technical Information of China (English)

    伊丽努尔·伊力亚斯; 迪丽胡玛

    2011-01-01

    Pfannenstiel incision cesarean section ( C group) . The recovery of incision of abdominal wall and the occurrence of rectus abdominis, peritoneum, omentum majus and vesical peritoneal reflection adhesion after cesarean section were compared among the three groups; the operation times of cesarean section in the three groups were compared. Results: The healing of incision of abdominal wall was good, the scar was slender: the good healing rates of incision of abdominal wall in A group, B group and C group were 85.5% (59/69), 32. 0% (41/128) and 75.6% (31/41), respectively;the incidences of rectus abdominis adhesion in A group, B group and C group were 23.2%(16/69), 52.3%(67/128) and 12.2%(5/41), respectively; the incidences of omentum majus adhesion in A group, B group and C group were 11.6% (8/69), 55.5% (71/128)and 24. 4% (10/41), respectively; the incidences of peritoneum adhesion in A group, B group and C group were 15. 9% (11/69),46. 1% (59/128) and 12. 2% (5/41), respectively; the incidences of vesical peritoneal reflection adhesion in A group, B group and C group were 15.9% ( 11/69), 54. 7% (70/128) and 12. 2% (5/41), respectively. The recovery of incision of abdominal wall and the occurrence of rectus abdominis, peritoneum, omentum majus and vesical peritoneal reflection adhesion after cesarean section in A group were superior to those in B group, there was significant difference ( P < 0. 05 ); but there was no significant difference between A group and C group (P>0.05). The operation time in B group was longer than those in A group and C group (P < 0. 01 ); but there was no significant difference between A group and C group ( P > 0. 05 ) . Conclusion: The recovery of incision of abdominal wall and the occurrence of rectus abdominis, peritoneum, omentum majus and vesical peritoneal reflection adhesion after Stark cesarean section are superior to those after vertical lower segment cesarean section; although there is no significant

  13. 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.

  14. [Chemical peritonitis after a bladder lesion during a cesarean section. A case report and literature review].

    Science.gov (United States)

    Castro-Cuenca, Alejandro; Ángel-Muller, Edith; González-Carrillo, Viviana Andrea

    2015-02-01

    This paper reviews the case of a patient who underwent a cesarean surgery and re-entered with an oral way intolerance, postprandial emesis, abdominal pain and clear-fluid exit from surgical wound. After possible bladder injury and secondary chemistry peritonitis, the patient was taken to surgery where the diagnosis was confirmed, and the correction of bladder injury as well as peritoneal lavage were performed, it antibiotic therapy for three days and the patient had satisfactory evolution. Bladder injury is a rare complication of cesarean section with an estimated incidence between 0.0016 and 0.94%; but if it is not diagnosed intraoperative it can trigger a clinical setting of secondary chemical peritonitis, due to secondary irritation of the peritoneum. Chemical peritonitis is among the classification of secondary peritonitis. Within the pathophysiology, the mechanical, chemical or bacterial stimulus generates an inflammatory reaction, with progressive generation of exudate, leukocytes and fibrin deposit, which injure mesothelial cells, disrupt the defense and maintenance of peritoneal homeostasis, triggering serious complications, which can lead to multiple organ failure and death. The chemical peritonitis should be suspected with the clinical setting and the risk factors of recent surgical history and timely management should be instituted properly with correction of the cause, antimicrobial treatment, blood volume therapy and nutritional support, which leads to a favorable outcome for the patient and improves survival with fewer complications.

  15. 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.

  16. 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.

  17. Evaluation of immune system function in neonatal pigs born vaginally or by Cesarean section.

    Science.gov (United States)

    Daniel, J A; Carroll, J A; Keisler, D H; Kojima, C J

    2008-07-01

    Full term crossbred sows were selected to study the interaction of the immune system, hypothalamus-pituitary-adrenal axis, and growth in pigs born by Cesarean section (c-section; n=4 sows) or vaginal birth (n=4 sows). Gestation length and birth weight did not differ between vaginal birth and c-section pigs (P=0.34 and 0.62, respectively). Blood and tissue samples were collected from 44 pigs at birth. Forty-five pigs were weaned at 13 d. On d 14, pigs received an i.p. injection of lipopolysaccaride (LPS; 150 microg/kg) or saline at min 0, and blood samples were collected at -20, -10, 0, 5, 10, 20, 40, 60, 90, and 120 min. Vaginal birth pigs had 21% greater average daily gain than c-section pigs on d 14 (Ppigs at birth (P0.22). Basal serum concentrations of TNF-alpha tended to be greater in c-section vs vaginal birth pigs at 14 d (P=0.0967); however, basal serum concentrations of IFN-gamma tended to be lower in c-section pigs vs vaginal birth pigs at 14 d (P=0.0787). Expression of interleukin (IL)-6, IL-6 receptor, IL-1beta, and TNF-alpha mRNA did not differ between vaginal birth and c-section pigs but changed in an age and tissue dependent manner. Thus, reduced growth rate of c-section pigs is associated with altered immune system function.

  18. 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.

  19. [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

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. 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

  3. Attributable Costs of Surgical Site Infection and Endometritis After Low Transverse Cesarean Section

    Science.gov (United States)

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Hamilton, Barton H.; Fraser, Victoria J.

    2012-01-01

    BACKGROUND Accurate data on costs attributable to hospital-acquired infections are needed in order to determine their economic impact and the cost-benefit of potential preventive strategies. OBJECTIVE Determine the attributable costs of surgical site infection (SSI) and endometritis (EMM) after cesarean section using two different methods. DESIGN Retrospective cohort. SETTING Barnes-Jewish Hospital, a 1250-bed academic tertiary care hospital. PATIENTS 1,605 women who underwent low transverse cesarean section from 7/1999 – 6/2001. METHODS Attributable costs of SSI and EMM were determined by generalized least squares (GLS) and propensity score matched-pairs using administrative claims data to define underlying comorbidities and procedures. For the matched-pairs analyses, uninfected control patients were matched to patients with SSI or with EMM based on their propensity to develop infection, and the median difference in costs calculated. RESULTS The attributable total hospital cost of SSI calculated by GLS was $3,529 and by propensity score matched-pairs was $2,852. The attributable total hospital cost of EMM calculated by GLS was $3,956 and by propensity score matched-pairs was $3,842. The majority of excess costs were associated with room and board and pharmacy costs. CONCLUSIONS The costs of SSI and EMM were lower than SSI costs reported after more extensive operations. The attributable costs of EMM calculated using the two methods were very similar, while the costs of SSI calculated using propensity score matched-pairs were lower than the costs calculated by GLS. The difference in costs determined by the two methods needs to be considered by investigators performing cost analyses of hospital-acquired infections. PMID:20102279

  4. The effect of intravenous propofol on the incidence of post-dural puncture headache following spinal anesthesia in cesarean section

    Directory of Open Access Journals (Sweden)

    Parisa Golfam

    2016-09-01

    Full Text Available Introduction: Post Dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. Several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch, if headache persist. The aim of this study was evaluation the efficacy of intravenous propofol on post dural puncture headache incidence after cesarean section. Methods: In a randomized clinical trial 120 patients aged 18-45 years old in American Society of Anesthesiologist (ASA class I or II, who had no history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into intervention (propofol and control groups. The anesthesia method for both groups was precisely the same. After spinal anesthesia in the first group 30µg/kg/min of intravenous propofol have been infused slowly. Then at 1, 6, 18, 24 hours and 2nd to 7th days after surgery, anesthesiologist asked groups for presence or absence of headache. The data analyzed with SPSS 16.0 software. Results: Headache incidence rate in the group who receiving propofol was significantly reduced (P.V=0.001. Conclusion: This study showed that 30µg/kg/min of intravenous propofol caused reduced the incidence of post spinal headache in young women undergone elective cesarean section.

  5. Comparison of Costs of Surgical Site Infection and Endometritis after Cesarean Section Using Claims and Medical Record Data

    Science.gov (United States)

    Olsen, Margaret A.; Butler, Anne M.; Willers, Denise M.; Gross, Gilad A.; Fraser, Victoria J.

    2012-01-01

    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. PMID:20583923

  6. 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。

  7. 剖宫产术后子宫瘢痕部位妊娠53例诊治分析%Clinical analysis of diagnosis and treatment of 53 patients with cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    龙文香; 周春慧

    2012-01-01

    目的 探讨剖官产术后子宫瘢痕部位妊娠(CSP)的临床特点和治疗方法. 方法 回顾性分析株洲市妇幼保健院2004年1月至2011年3月收治的53例CSP患者的临床资料,进行归纳、总结. 结果 53例患者入院后均行彩超检查及血人绒毛膜促性腺激素(β-hCG)检测,结合患者病史,53例患者治疗前均明确诊断.24例早期CSP患者首选甲氨蝶呤(MTX)加米非司酮治疗后联合官腔镜行清官术,成功率100%,无一例中转开腹.10例患者因子官瘢痕处包块偏大并突向膀胱或入院时大出血(>1,000 ml),选择了开腹手术.7例患者行急诊清官术,4例一次性清宫干净,另3例病情平稳后官腔镜下第2次清官.6例孕囊与子宫肌层分界清楚者直接清官一次成功.4例MTX杀胚治疗后自行排出孕囊.2例子宫大于孕90 d者,MTX杀胚治疗后B超监视下清官. 结论 超声检查及血β-hCG检测是诊断CSP的主要方法,MTX加米非司酮治疗后联合官腔镜下清官术,是治疗早期CSP微创而安全有效的治疗方法.同时应根据患者不同情况采用个体化的治疗方法.%Objective. To analyze the clinical features and treatment method for the women with cesarean scar pregnancy. Methods: The data of 53 women with cesarean scar pregnancy -were analyzed retrospectively in our hospital from January 2004 to March 2011. Results: Fifty three patients were diagnosed as cesarean scar pregnancy by ultrasonography examination, serum β-hCG test and medical history before treatment. Twenty four patients with early cesarean scar pregnancy were preformed methotrexate (MTX) plus mifepristone treatment combined with hysteroscopic curettage. The success rate of induced abortion without operation was 100%. Ten patients with large mass in uterine scar which stretched to the bladder or bleeding 01,000 ml) were chosen to have surgery. Seven cases were done emergency curettage. Four of them were cleansed by once curettage, and the other 3

  8. Clinical analysis of uterine artery embolization in cases of cesarean scar pregnancy%子宫动脉栓塞术在急诊瘢痕妊娠中的治疗分析

    Institute of Scientific and Technical Information of China (English)

    黄晔; 林婉秋; 刘佳华

    2014-01-01

    目的:探讨近年来的子宫动脉栓塞术(uterine artery embolization,uaE)在治疗剖宫产术后导致的子宫瘢痕妊娠(cesarean scar pregnancy,csP)中的疗效及临床安全性。方法回顾性分析,探讨本院2010年1月至2013年6月75例剖宫产术后瘢痕妊娠患者的诊疗经过资料。结果74例患者行子宫动脉栓塞术成功,3例因大出血急诊行子宫动脉栓塞成功,其中1例不成功行次全子宫切除术。其中40例同时行甲氨蝶呤(mTX)动脉灌注,均在栓塞术后48~72小时行超声介导下刮宫术;74例患者术后随访6~36个月,清宫后无1例再次阴道大出血,均未出现继发性闭经或卵巢早衰。结论 csP早期行uaE治疗,有效保留子宫,提高生活质量,能明显减少出血量,是治疗csP安全、有效的方法。%ObjectiveTo investigate the clinical analysis of uterine artery embolization in the cases of cesarean scar pregnancy.Method 75 cases of cesarean scar pregnancy in fujian Provincial Hospital from January 2010 to June 2013 were included,and their clinical data were analyzed to summarize treatment experience.Result 74 cases of cesarean scar pregnancy succeeded in uterine artery embolization, and 40 cases succeeded in mTX uterine artery embolization, and the curettages were done after 48~72 hours. 3 cases succeeded in emergency uterine artery embolization.1 case did not succeed and was done by subtotal hysterectomy. amenorrhoea or ovarian failure were not present in 74 cases 6~36 months after operation. Conclusion The early uterine artery embolization in the cases of scar pregnancy is safe and highly recommended.

  9. Clinical Analysis of the Cesarean Scar Pregnancy%剖宫产术后疤痕妊娠的治疗研究

    Institute of Scientific and Technical Information of China (English)

    马俊华; 张峰莉

    2014-01-01

    Objective:To investigate the therapeutic method for cesarean scar pregnancy.Methods:The management process of 70 cases of the Cesarean scar pregnancy was retrospectively analyzed in our hospital from 2000 to 2012.Results:In the medical treatment process,Drug groups between the success rate 、bloodβ-HCG cloudy days and the gestational sac or mass disappearance days there are no difference to compare(P>0.05).In the process of operation treatment,Interventional operation + excision group is better than that of interventional operation + curettage group(P< 0.05),excision of focus group is better than that of inter-ventional operation + curettage group(P< 0.05),hysterectomy group is better than that of interventional operation + curettage group(P< 0.05)in the bloodβ-HCG cloudy days and the gestational sac or mass dis-appearance days.In the comprehensive treatment process,Intervention therapy + curettage + drug group is better than the drug + curettage in the treatment group(P< 0.05),interventional + curettage + drug group was significantly better than the intervention therapy and drug therapy group(P< 0.01)in the bloodβ-HCG cloudy days and the gestational sac or mass disappearance days.Conclusion:In CSP patients,sonog-raphy is the preferred auxiliary examination,comprehensive therapy is an ideal therapy scheme.%目的:探讨剖宫产术后子宫疤痕妊娠的治疗方法.方法:回顾性分析我院2000~2012年收治的70例 CSP 患者.结果:CSP在药物治疗过程中,治疗成功率、血β-HCG 转阴天数、以及在超声监测下孕囊或者包块消失天数方面,局部用药、全身用药等各组之间比较无差异(P>0.05).手术治疗过程中,在血β-HCG转阴天数以及在超声下孕囊或者包块消失天数方面比较,介入手术+病灶切除组优于介入手术+刮宫术组(P<0.05),病灶切除组优于介入手术+刮宫术组(P<0.05),子宫全切术组优于介入手术+刮宫术组(P<0.05).在

  10. Serial Change in Cervical Length for the Prediction of Emergency Cesarean Section in Placenta Previa.

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    Jae Eun Shin

    Full Text Available To evaluate whether serial change in cervical length (CL over time can be a predictor for emergency cesarean section (CS in patients with placenta previa.This was a retrospective cohort study of patients with placenta previa between January 2010 and November 2014. All women were offered serial measurement of CL by transvaginal ultrasound at 19 to 23 weeks (CL1, 24 to 28 weeks (CL2, 29 to 31 weeks (CL3, and 32 to 34 weeks (CL4. We compared clinical characteristics, serial change in CL, and outcomes between the emergency CS group (case group and elective CS group (control group. The predictive value of change in CL for emergency CS was evaluated.A total of 93 women were evaluated; 31 had emergency CS due to massive vaginal bleeding. CL tended to decrease with advancing gestational age in each group. Until 29-31 weeks, CL showed no significant differences between the two groups, but after that, CL in the emergency CS group decreased abruptly, even though CL in the elective CS group continued to gradually decrease. On multivariate analysis to determine risk factors, only admissions for bleeding (odds ratio, 34.710; 95% CI, 5.239-229.973 and change in CL (odds ratio, 3.522; 95% CI, 1.210-10.253 were significantly associated with emergency CS. Analysis of the receiver operating characteristic curve showed that change in CL could be the predictor of emergency CS (area under the curve 0.734, p < 0.001, with optimal cutoff for predicting emergency cesarean delivery of 6.0 mm.Previous admission for vaginal bleeding and change in CL are independent predictors of emergency CS in placenta previa. Women with change in CL more than 6 mm between the second and third trimester are at high risk of emergency CS in placenta previa. Single measurements of short CL at the second or third trimester do not seem to predict emergency CS.

  11. 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.

  12. 选择性减胎术成功治疗子宫疤痕妊娠合并宫内妊娠1例报道及文献复习%Successful Management of Cesarean Scar Pregnancy Combined with Intrauterine Pregnancy with Selective Embryo Reduction: A Case Report and Review the Literature

    Institute of Scientific and Technical Information of China (English)

    骆丽华; 刘雨生; 陈玲; 季静娟; 程东红; 胡美红; 付应云; 桑美英

    2013-01-01

    Objective:To explore the efficacy of embryo reduction of cesarean scar pregnancy (CSP) combined with intrauterine pregnancy after IVF-ET.Methods:A case of heterotopic CSP was diagnosed and selective embryo aspiration was performed by ultrasound-guided and the literatures on the current management were reviewed.Results:Cesarean scar pregnancy was terminated at 7-week gestational age and an intrauterine pregnancy was ongoing,a healthy infant was delivered at 35+3-week gestational age by cesarean section.Conclusion:Selective embryo reduction is a safe and minimally invasive method of treatment to terminate the CSP while simultaneously preserving the intrauterine pregnancy.%目的:探讨子宫疤痕妊娠合并宫内妊娠的选择性减胎术的治疗效果.方法:报道1例孕7周确诊为子宫疤痕妊娠合并宫内妊娠患者,经阴道超声指导下实施疤痕妊娠胚胎抽吸减胎术,同时进行文献复习.结果:成功实施了选择性减胎术,疤痕妊娠被终止,宫内妊娠继续,于孕35+3周剖宫产分娩一健康婴儿,无并发症发生.结论:疤痕妊娠选择性减胎术对需要保留宫腔妊娠的患者是侵入性最小且比较安全的治疗方法.

  13. 剖宫产术后再次妊娠分娩方式的临床探讨%Discussion on Clinical Pregnancy Delivery Modes after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    彭敏; 陈燕桢

    2012-01-01

    目的 探讨剖宫产术后再次妊娠分娩方式的选择.方法 对2005年1月至2010年12月在我院住院的150例剖宫产术后再次妊娠分娩者的临床资料进行回顾性分析,并将其中104例剖宫产术后再次妊娠剖宫产(RCS组)及46例剖宫产术后再次妊娠阴道分娩(VBAC组),与同期104例首次剖宫产(PCS组)及46例非瘢痕子宫阴道分娩(VBNC组)比较.分析各组分娩结局、新生儿Apgar评分以及住院时间等差异.结果 150例剖宫产术后再次妊娠者,再次剖宫产者104例(69.3%),阴道分娩者46例(30.7%).VBAC组与RCS组比较,两组在产时出血量、新生儿Apgar评分以及住院时间方面均有统计学意义(P<0.05).VBAC组与VBNC组相比较,两者在产程时间、产时出血量、新生儿Apgar评分、新生儿窒息数及住院时间方面均无统计学意义(P>0.05).RCS组与PCS组相比较,在手术时间、产时出血量、术后腹腔粘连及住院时间方面均有统计学意义(P<0.05),新生儿Apgar评分无统计学意义(P>0.05).结论 剖宫产术后再次妊娠分娩并非是剖宫产的绝对指征,符合试产条件者在严密监护下阴道试产是安全可行的,且能改善分娩结局.%Objective To discuss the selection of secondary deliver}' mode after cesarean section. Methods A total of 150 cases of second pregnancy after cesarean delivery admitted in our hospital during Jan. 2005 to Dec. 2010 were reviewed, of which 104 cases underwent repeat cesarean section( KCS group ),46 had vaginal birth after cesarean section( VBAC group ). 104 corresponding cases that underwent first cesarean section( PCS )and 46 that had non-scarred uterus with vaginal delivery( VBNC Muring the same period were also selected for comparison of delivery outcomes. Results Of the 150 cases, 104( 69. 3% )had HCS,46 ( 30.7% )had VBAC, and significant differences in blood loss volume, Apgar score, and hospital stay length were observed between the two groups( P 0

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

    Directory of Open Access Journals (Sweden)

    Al-Kadri HM

    2015-07-01

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

  15. Effect of Social Factors Cesarean Section on Parturient and Infant%社会因素剖宫产对母婴的影响

    Institute of Scientific and Technical Information of China (English)

    李彩芬; 李媛枫; 刘霞

    2002-01-01

    Objective To observe the effect of social factors cesarean section on parturient and infant.MethodsSelecting 126 cases of social factors cesarean section and dividing them into two groups in view regular uterine contraction,andtaking comparative analysis of situations of parturients and infants.Results Compared with group of irregular uterinecontraction,column of blood loss and newborn suffocation rate islower in the group of regular uterine contaction .ConclusionOn account of the high column of blood loss and suffocation rate caused by social factors cesarean section ,declining and banning it concerns safty and health of parturients and infants.

  16. 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.

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

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    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

  18. [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

  19. 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

  20. 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.

  1. The Intention of Delivery Room Staff to Encourage the Presence of Husbands/Partners at Cesarean Sections

    Directory of Open Access Journals (Sweden)

    Yaira Gutman

    2011-01-01

    Full Text Available Objective. In recent years, more and more delivery rooms have allowed husbands/partners to be present during a Cesarean section Nonetheless, many still oppose the idea. The study is designed to investigate the attitudes of Israeli gynecologists, anesthetists, operating-room nurses, and midwives on this issue. Design. The study's theoretical model comes from Fishbein and Ajzen's theory of reasoned action. A self-administered questionnaire was submitted to convenience sample. Subjects. 96 gynecologists, anesthetists, midwives, and operating-room nurses. Results. Significant differences were found between the occupational subgroups. Most of the findings supported the four hypotheses tested and confirmed earlier studies designed to verify the theoretical model. Conclusions. The main conclusion drawn is that delivery and operating-room staff need to be trained in the skills needed to promote the active participation of the baby's father in delivery and, if necessary, in a Cesarean section.

  2. 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...

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

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    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

  4. 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

    age, and education and paternal type 1 diabetes status at childbirth (HR 1.2; 95% CI 1.0 to 1.3), but not after additional adjustment for maternal type 1 diabetes status at childbirth (HR 1.1; 95% CI 0.95 to 1.2). Delivery by intrapartum cesarean section was not associated with childhood type 1...... diabetes. Paternal type 1 diabetes was a stronger risk-factor for childhood type 1 (HR 12; 95% CI 10 to 14) than maternal type 1 diabetes (HR 6.5; 95% CI 5.2 to 8.0). CONCLUSIONS: Delivery by prelabor cesarean section was not associated with an increased risk of childhood type 1 diabetes in the offspring....... 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...

  5. 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.

  6. Application of ultrasound in the diagnosis and treatment for cesarean scar pregnancy%超声在剖宫产瘢痕妊娠诊治中的应用

    Institute of Scientific and Technical Information of China (English)

    贾保霞; 刘滨月; 刘宇清; 陈金华; 于淑敏

    2011-01-01

    目的 探讨超声在剖宫产瘢痕妊娠诊治中的应用价值.方法 回顾性分析42例剖宫产瘢痕妊娠患者的声像图特征及超声辅助下的治疗方法.结果 42例患者中,超声正确诊断35例(83.3%,35/42).声像图表现:单纯妊娠囊型15例,混合回声型(或包块型)22例,部分位于宫腔型5例.根据患者临床情况及声像图特征,采取子宫动脉栓塞术、超声引导下病灶清除加子宫修补术2例,经腹超声引导下清官术15例,保守治疗20例,综合治疗5例.治疗过程中,超声检查显示病灶逐渐缩小,血流逐渐减少到消失,血β-人绒毛膜促性腺激素逐渐降低到正常.结论 超声检查可以对剖宫产瘢痕妊娠及时、准确地做出诊断;根据患者声像图特征,有助于临床选择恰当的治疗方案,并评估疗效.%Objective To explore the application value of ultrasound in the diagnosis and treatment for cesarean scar pregnancy. Method The ultrasonic features, clinical treatment of 42 cases of cesarean scar pregnancy were reviewed retrospectively. Results Among 42 patients,35 patients (83.3% ,35/42) were diagnosed accurately by ultrasound. The sonographic appearance showed 15 cases were gestational sac-type and 22 cases were mixed mass-type,the other 5 cases were classified into type three in which the gestational sac mostly located at the uterine cavity and only the inferior part implanted in the cesarean scar. Uterine artery embolisation and suction curettage with the sonographic guidance with 2 cases, intra-amniotic administration of MTX under sonographic guidance with 15 cases, expectant treatment with 20 cases or complex treatment with 5 cases. During treatment,ultrasonography showed focus of infection was shrinked gradually and blood flow disappeared, blood (3 -human chorionic gonadotrophin was decreased to normal level. ConclusionUltrasound can diagnose cesarean scar pregnancy promptly and accurately, proportionate treatment would be selected according

  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. ABDOMINAL SCAR ENDOMETRIOSIS: REPORT OF 28 CASES

    Institute of Scientific and Technical Information of China (English)

    向阳; 郎景和; 王友芳; 黄荣丽; 连丽娟

    1995-01-01

    Twenty-eight cases of abdominal scar endometriosis from Janurary,1989 to December,1993 are reported.Of these patients,twenty-four underwent term cesarean section,and four underwent a midtrimester abortion by abdominal hysterotomy.The majority of patients manifested symptoms 1 year after the operation.The most common was a painful mass of scar tissue that became swollen and tender during menstruation.The pathogenesis,diagnosis and treatment are discussed.In correlation with the pathological findings,the effects of drug therapy are evaluated.It was found that surgical excision is the best method of treatment.

  9. Analysis of Correlated Risk Factors of Postpartum Hemorrhage after Cesarean Section%剖宫产产后出血相关危险因素分析

    Institute of Scientific and Technical Information of China (English)

    马春艺; 刘增佑; 张小平

    2015-01-01

    Objective To explore the risk factors of postpartum hemorrhage after cesarean section . Methods A total of 5210 cases of cesarean section from Shenzhen City Nanshan People′s Hospital from Jan.2011 to Dec.2013 were selected,including 89 cases of postpartum hemorrhage,which were assigned to case group,and another 89 cases without postpartum hemorrhage were assigned to control group.The risk fac-tors of postpartum hemorrhage were analyzed .Results The influencing factors of postpartum hemorrhage after cesarean section included in multiple pregnancy(OR=2.568,95%CI 1.411-3.724),placenta praevia (OR=7.199,95%CI 4.663-9.736),placental adherence or implantation or placental abruption (OR =2.951,95%CI 1.735-4.166),uterus scar(OR =2.881,95%CI 1.683-4.078),uterine inertia(OR =8.207,95%CI 5.902-10.512),inhibitor of antepartum uterine contraction (OR =4.865,95%CI 3.073-6.656) and coagulation disorders (OR =3.004,95%CI 1.771-4.237).Conclusion The incidence of postpartum hemorrhage after cesarean section is still high .Preventive measures at the risk factors should be a-dopted to lower the incidence of the complication .%目的:探讨剖宫产产后出血的相关危险因素。方法选择2011年1月至2013年12月在深圳市南山人民医院妇产科实施剖宫产产妇5210例,术后发生出血89例,以发生产后出血的患者为病例组,同时选择未出血的89例剖宫产患者为对照组,研究可能影响产后出血的相关危险因素。结果影响产后出血的因素包括多胎妊娠(OR =2.568,95%CI 1.411~3.724)、前置胎盘(OR =7.199,95%CI 4.663~9.736)、胎盘粘连或植入或早剥(OR=2.951,95%CI 1.735~4.166)、子宫瘢痕(OR=2.881,95%CI 1.683~4.078)、子宫收缩乏力(OR=8.207,95%CI 5.902~10.512)、产前子宫收缩抑制剂( OR =4.865,95%CI 3.073~6.656)、凝血功能障碍( OR =3.004,95%CI 1.771~4.237)。

  10. 剖宫产手术部位感染临床特点分析%Clinical characteristics of surgical site infections after cesarean section

    Institute of Scientific and Technical Information of China (English)

    金丽君

    2012-01-01

    目的 探讨剖宫产手术部位感染(SSI)临床特点及预防措施.方法 回顾性分析剖宫产2450例产妇的临床资料;观察病原菌分布、SSI发生情况及相关因素、临床结果.结果 2450例剖宫产产妇合并SSI共80例,占3.26%;检出病原菌52株,革兰阴性杆菌40株,革兰阳性球菌12株,SSI组年龄大、检查和治疗次数多、体质量指数高、术前身体状况分级低、试产时间长、瘢痕子宫比例高、手术时间长,是SSI的危险因素,SSI经过治疗均痊愈,住院时间(7.12±2.56)d,长于非SSI组的(5.22±2.13)d,差异有统计学意义(P<0.05).结论 剖宫产术发生SSI发生率较高,虽然愈合良好,但延长住院时间,应采用合理方法预防SSI,做好产前检查保健工作、提高手术水平、合理使用抗菌药物.%OBJECTIVE To explore the clinical characteristics of surgical site infection (SSI) after cesarean section and preventive measures. METHODS The clinical data of 2450 cases receiving cesarean section were retrospectively analyzed; the incidence of SSIt distribution of the pathogens, related factors of SSI, and clinical outcomes were analyzed. RESULTS Totally 80 of 2450 cesarean section cases were complicated with SSI, accounting for 3. 26%; 52 trains of pathogens were detected, including 40 strains of gram-negative bacilli and 12 strains of gram-positive coccit the aduanced age, frequent examination and treatment, high body mass index, low ASA before surgery, long trial laboring time, high proportion of uterine scar, and long operation time were the risk factors for SSI. SSI patients were healed after treatment. Hospital stay was (7. 12±2. 56) days in SSI group, longer than that in non-SSI group(5. 22±2.13)days, with statistically significant difference (P<0. 05). CONCLUSION Cesarean section is with high incidence of SSI. Although the healing is good, it prolongs hospitalization time. We should adopt reasonable method to prevent SSI, make well

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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.

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

    Science.gov (United States)

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

    2014-06-01

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

  17. Cesarean Section Is Associated with Increased Peripheral and Central Adiposity in Young Adulthood: Cohort Study.

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    Denise N Mesquita

    Full Text Available Cesarean section (CS has been associated with obesity, measured by body mass index (BMI, in some studies. It has been hypothesized that this association, if causal, might be explained by changes in gut microbiota. However, little is known about whether CS is also associated with increased adiposity as measured by indicators other than BMI.To assess the association between CS and indicators of peripheral and central adiposity in young adults.The study was conducted on 2,063 young adults aged 23 to 25 years from the 1978/79Ribeirão Preto birth cohort, São Paulo, Brazil. CS was the independent variable. The anthropometric indicators of adiposity were: waist circumference (WC, waist-height ratio (WHtR, waist-hip ratio (WHR, tricipital skinfold (TSF, and subscapular skinfold (SSF. The association between CS and indicators of adiposity was investigated using a Poisson model, with robust adjustment of variance and calculation of incidence rate ratio (IRR with 95% confidence interval (95%CI, and adjustment for birth variables.Follow-up rate was 31.8%. The CS rate was 32%. Prevalences of increased WC, WHtR, WHR were 32.1%, 33.0% and 15.2%, respectively. After adjustment for birth variables, CS was associated with increased risk of adiposity when compared to vaginal delivery: 1.22 (95%CI 1.07; 1.39 for WC, 1.25 (95%CI 1.10;1.42 for WHtR, 1.45 (95%CI 1.18;1.79 for WHR, 1.36 (95%CI 1.04;1.78 for TSF, and 1.43 (95%CI 1.08;1.91 for SSF.Subjects born by CS had a higher risk for increased peripheral and central adiposity during young adult age compared to those born by vaginal delivery. The association of CS with adiposity was consistently observed for all indicators and was robust after adjustment for a variety of early life confounders.

  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. 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.

  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. Evaluation of the Effect of Intravenous Lidocaein Infusion on Postoperative Analgesia after Cesarean Section under Spinal Anesthesia

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    M. H. Bakhshaei

    2013-04-01

    Full Text Available Introduction & Objective: Many surgical patients still experience moderate to severe pain after surgery despite efforts to administer new drugs and techniques. Postoperative analgesia clearly enhances patient’s satisfaction and facilitates earlier mobilization and rehabilitation. lidocaein has been introduced as part of post operative pain management and clinical studies revealed analgesic actions in patients with chronic neuropathic pain. Our goal in this study was to determine the effect of intravenous lidocaein on post operative pain of women under-going cesarean section under spinal anesthesia. Materials & Methods: In this double blinded clinical trial study, 72 patients candidate for Ce-sarean section under spinal anesthesia were randomly selected and divided in two groups. In the case group, infusion of1.5 mg/kg lidocaein and in the control group infusion of the same volume normal saline started 15 minutes before the beginning of operation. After spinal anes-thesia with definite technique in both groups, infusion of 1.5 mg/kg/h lidocaein in case group and the same volume normal saline in the control group was administered and continued till 0.5 hour after finishing the operation. Data including systolic and diastolic blood pressure, heart rate, analgesic score according VAS and using of analgesic drugs were recorded during 24 hours after the operation. Results: Pain intensity according to VAS score in the time 2,6,12 hours post operation were significantly lower in the case group ( P2= 0.05, P6 = 0.01, P12= 0.05 .Analgesic consumption in form of suppository & IV,24 hours after surgery, was significantly lower in the case group.(P=0.001. Conclusion: Lidocaein infusion can decrease pain intensity & analgesic consumption after ce-sarean section under spinal anesthesia. (Sci J Hamadan Univ Med Sci 2013; 20 (1:9-14

  2. 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。

  3. 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.

  4. Analysis on maternal and fetal outcomes in 73 cases re-pregnant women with cesarean scar uterus complicating placenta previa%瘢痕子宫再次妊娠并发前置胎盘73例母婴结局分析

    Institute of Scientific and Technical Information of China (English)

    马红柳; 罗欣; 漆洪波; 彭方亮

    2016-01-01

    Objective To explore the maternal and fetal perioperative outcomes of re-pregnant women with cesarean scar uterus complicating placenta previa and its influential factors. Methods Seventy-three cases of cesarean scar uterus complicat-ing placenta previa delivered in the First Affiliated Hospital of Chongqing Medical University from January 2014 to December 2015 were retrospectively analyzed. The maternal general condition ,intraoperative situation as well as maternal and fetal outcome were compared. Seventy-three pregnant women were grouped according to whether complicating dangerous placenta previa occur-rence and whether previous pregnancy being elective cesarean section. Results (1)The probability of complicating dangerous placenta previa in re-pregnancy women with previous elective cesarean section was higher than that in re-preganat women with ce-sarean section after vaginal trial labor failure,the difference was statistically significant[40.00%(18/45) vs. 28.57%(8/28),P<0.01]. (2)The occurrence rates of placenta implantation,postpartum hemorrhage,hysterectomy,DIC,blood transfusion and poor neona-tal outcomes in the pregnant women with complicating dangerous placenta previa were significantly higher than those in the preg-nant women with non-dangerous placenta previa,the difference was statistically significant(P<0.05). Conclusion Re-pregnant women with cesarean scar uterus are easier to develop placenta previa;re-pregnancy women with previous elective cesarean sec-tion have the high occurrence rates of complicating dangerous placenta previa and poor maternal and neonatal outcomes;strictly mastering the indication of first cesarean section is the key to reduce the poor maternal and neonatal outcomes of re-pregnancy.%目的:探讨前次剖宫产后瘢痕子宫再次妊娠并发前置胎盘的母婴围生期结局及其影响因素。方法回顾性分析2014年1月至2015年12月于重庆医科大学附属第一医院住院分娩的瘢痕子宫(前次剖

  5. Clinical value of trans vaginal color doppler ultrasonic in diagnosis of cesarean scar pregnancy%经阴道彩超对剖宫产子宫瘢痕部位妊娠的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李瑞苗

    2014-01-01

    Objective To analyze early sonographic characteristics of cesarean uterine scar pregnancy to provide basis for improving the accuracy rate of diagnosis.Methods Analysis of February 2011 to September 2013, 14 hospitalized cases of cesarean uterine scar pregnancy were observed by ultrasonography, diagnosis of transvaginal two dimensional and color Doppler ultrasonography, and compared with clinical diagnosis. Results 14 cases of transvaginal ultrasound examination showed CSP, ultrasound examination revealed scar visible pregnancy, ultrasonography were: 9 cases of gestational sac type, 5 cases of non-uniform mixed echoic mass. Peripheral blood were rich, scar muscle wall thick. Among them 1 cases were misdiagnosed, the final diagnosis of intrauterine pregnancy, diagnosis coincidence rate 92.9%.Conclusion Transvaginal ultrasound examination is the best method of CSP and has important clinical significance for the early diagnosis of CSP, which has an important reference role for the choice of treatment and observation in the treatment of dynamic process.%目的:分析剖宫产子宫瘢痕部位妊娠(CSP)的早期超声声像图特征,为提高诊断准确率提供依据。方法分析2011年2月~2013年9月住院治疗的14例CSP病例,观察其经阴道二维及彩色多普勒超声诊断的声像图特征,并与临床诊断结果相对照。结果14例经阴道超声检查均提示CSP,超声检查发现瘢痕处可见妊娠物,声像图表现分别为:9例为单纯孕囊型,5例为不均匀混合回声包块型。周边血流均丰富,瘢痕处肌壁均菲薄。其中1例被误诊,最终诊断为宫内妊娠,诊断符合率92.9%。结论经阴道彩超检查是CSP的最佳检查手段,对于CSP的早期诊断具有重要的临床意义,对治疗方案的选择及在治疗过程动态观察方面有重要参考作用。

  6. 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.

  7. Cesarean Section and Subsequent Stillbirth, Is Confounding by Indication Responsible for the Apparent Association? An Updated Cohort Analysis of a Large Perinatal Database.

    Directory of Open Access Journals (Sweden)

    Stephen Wood

    Full Text Available Several studies and a recent meta-analysis have suggested that previous Cesarean section may increase the risk of stillbirth in a subsequent pregnancy. Given the high rates of Cesarean section in contemporary obstetric practice, this is of considerable public health importance. We sought to evaluate the potential that this association is the result of residual confounding bias.A large perinatal database (Alberta Perinatal Health Project was searched to identify a matched set of first and second births from the years 1992-2006. Data on pregnancy outcomes, demographics and potential confounding factors were obtained.The cohort was comprised of 98538 matched first and second births. Multivariate analysis did not reveal an association between previous Cesarean section and stillbirth, OR = 1.38 (0.98, 1.93. Restricting the analysis to a low risk group further attenuated the association, OR = .99 (0.62, 1.52. Analysis of the risk by indication for Cesarean section found that the risk was not increased for previous dystocia, OR = .91 (0.53, 1.55 nor for breech presentation, OR = 1.06 (0.50, 2.28 but only for other indications including non reassuring fetal status and fetal distress, OR = 1.96 (1.29, 2.98.The results of our cohort analysis suggest that previous Cesarean section does not cause an increased risk of stillbirth.

  8. Skills of unarmed delivery head in second cesarean section%第二次剖宫产徒手娩头的技巧

    Institute of Scientific and Technical Information of China (English)

    董立芸

    2013-01-01

    In the second cesarean section, due to uterine scar contracture, poor flexibility, the incision should not be forced shredded after lower uterine segment incision, while should be curved cut an enough uterine incision for delivery. The method described in this paper is simple and does not require special equipment, adapt any level hospitals, worthy of promotion.

  9. Clinical outcome and safety analysis of vaginal delivery after cesarean section%剖宫产术后阴道分娩的临床结局及安全性分析

    Institute of Scientific and Technical Information of China (English)

    李云秀; 纪艳洁; 陈敏红; 祝丽琼

    2015-01-01

    Objective To explore the clinical outcome and safety of vaginal delivery after cesarean section. Methods 512 cases of scarred uterus who delivered in Tangxia Hospital of Dongguan and Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January to December 2014 and had a second pregnancy were retrospectively analyzed. Results Among 512 cases of scarred uterus,163 cases were vaginal trial labour (VBAC group),accounting for 31.84% of scarred uterus delivery.Among them,vaginal trial labourwas carried out successfully in 126 cases,with the successful rate of vaginal trial labour of 77.3%.Trial labourwas failed in 37 cases and switched to cesarean section,with the failure rate of trial labour of 22.7%;Cesarean section without trial labourwas performed in 349 cases (ERCS group),accounting for 68.16% of the scarred uterus pregnancy;386 out of the 512 cases of scarred uterus were given a second cesarean sec-tion(including 37 cases of failed vaginal trial labour),accounting for 75.39%of scarred uterus delivery.In the comparison of pregnancy outcome in VBAC group and ERCS group,VBAC group was higher than ERCS group in the volume and rate of postpartum bleeding,but VBAC group was shorter than ERCS group in the length of stay and lower than ERCS group in the medical expenses,which were statistically different(P0.05). Conclusion As for the pregnant women with a second pregnancy after cesarean section,if the indication of trial labour is properly understood,severe monitoring is performed during the labour,and vaginal trial labour is safe and feasible with a high successful rate,then the rate of cesarean sec-tion can be reduced to a certain extent.%目的:探讨剖宫产术后阴道分娩的临床结局及安全性。方法对东莞市塘厦医院及中山大学孙≥仙纪念医院于2014年1~12月分娩的512例瘢痕子宫再次妊娠者进行回顾性分析。结果512例瘢痕子宫中,阴道试产163例(VBAC组),占瘢痕子宫分娩的31.84%,

  10. Comparing Propofol with Sodium Thiopental on Neonatal Apgar Score after Elective Cesarean Section

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Dadras

    2013-04-01

    Full Text Available Background: The Apgar score (Appearance, Pulse, Grimace, Activity, and Respiration of newborn babies immediately after birth is a determining factor involved with mortality of newborns after birth. Regarding the disagreement on advantages and possible disadvantages of propofol rather thiopental in the available references, the study was triggered with the aim of analyzing effects of two mentioned drugs on babies’ apgar score, mothers’ nausea, vomit and time necessary for mothers’ recovery. Materials and Methods: In this double-blind clinical trial, a total of 230 healthy women who were volunteered to undertake cesarean operation were selected and then divided randomly into two equal groups using statistical blocking. One group was treated by propofol while other one was treated by thiopental. The prescribed drugs for both groups were identical except the anesthesia induction drug. Babies’ Apgar score 1 and 5 minutes after birth and recovery period, mothers’ nausea and vomiting after operation were recorded. Results: Apgar score I minute 1 (p=0.041 and apgar score in minute 5 (p=0.034 for propofol group were meaningfully higher than those for thiopental group. Recovery time from anesthesia was not different meaningfully in two groups (p=0.67. Statistical analysis of nausea and vomit in both groups showed that they are lower in propofol group rather thiopental group (p=0.028.Conclusion: It seems that in cesarean operations, after sufficient fluid therapy, propofol can be a proper drug to achieve anesthesia. Moreover it exerts less impact on cesarean babies’ apgar and stimulates lower levels of nausea and vomiting in mothers.

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

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    Aliya Islam

    2011-01-01

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

  12. 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.

  13. 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

    目的 探讨某三甲医院产科剖宫产的原因及影响因素.方法 对2008年1月至2009年1月在某三甲医院产科526例产妇的临床资料进行收集和整理.结果 279例行剖宫产的产妇中,剖宫产手术指征前5位分别为胎儿因素(占25.45%)、社会因素(占20.07%)、异常妊娠分娩史(占20.07%)、胎位异常(占12.90%)、胎盘羊水异常(占8.96%);剖宫产排前5位的医学因素手术指征分别为瘢痕子宫(占24.66%)、胎儿宫内窘迫(占18.83%)、臀位(占8.97%)、巨大儿(占5.38%)、羊水过少(占4.93%);主要社会因素为产妇怕痛(占41.07%),担心顺产不成功,又要剖宫产,不想多受罪(占32.14%)而拒绝阴道试产;经多因素Logistic回归分析发现年龄、初产妇、产时出血量≥220 mL、有合并症或者并发症是剖宫产的危险因素.结论 普及妊娠分娩的知识,加强自然分娩益处的宣传,减少社会因素所致剖宫产,严格掌握剖宫产的指征可有效地控制剖宫产率.%Objective To investigate the causes of cesarean section and its influencing factors from a first class hospital. Methods Clinical data of 526 cases of puerpera were collected and surveyed in maternity department in a hospital from January 2008 to January 2009. Results The top 5 factors ranked among the 279 cases of cesarean section were:fetal factors( 25. 45% ), social factors( 20. 07% ),abnormal parturition history( 20.07% ),abnormal fetal position( 12.90% ),abnormal placenta and amniotic fluid( 8.96% ). The top five medical indications were:scar uterus( 24. 66% ),fetal distress( 18. 83% ),breech birth( 8.97% ), fetal macrosomia( 5. 38% ),hypamnion( 4. 93% ). The main social factor was the fear of maternal pains ( 41.07% ),the parturient did not want to surfer both natural parturition and cesarean section( 32.14% ),and so on. Univariate logistic analysis showed that age,primipara,blood loss when giving birth≥220 mL and and the complications were the risk factors for cesarean

  14. An operation for evangelization: Friar Francisco González Laguna, the cesarean section, and fetal baptism in late colonial Peru.

    Science.gov (United States)

    Warren, Adam

    2009-01-01

    By publishing a medical-theological treatise in 1781, Friar Francisco González Laguna of Lima initiated a campaign to train Andean priests to perform postmortem cesarean sections for the purpose of baptizing the fetus. Linking González Laguna's text to European works on cesarean sections and Peruvian decrees ordering priests to train in surgery, this paper argues the friar saw the operation's utility as extending beyond saving unborn souls. Writing in the aftermath of indigenous and peasant uprisings, he argued the procedure constituted a tool for defeating the devil's presence in the Andes and carrying out evangelization, teaching parishioners by pious example. PMID:20061669

  15. 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

  16. Curative effect analysis of hysteroscopic curettage for the treatment of cesarean scar pregnancy%宫腔镜下清宫术治疗剖宫产瘢痕妊娠的疗效分析

    Institute of Scientific and Technical Information of China (English)

    毛丽丽; 杨亚培

    2014-01-01

    目的:探讨宫腔镜下行清宫术对于治疗剖宫产瘢痕部位妊娠的效果。方法:收治剖宫产子宫切口瘢痕妊娠患者32例,均接受宫腔镜下清宫术,对其临床病例资料进行回顾性分析。术中宫颈注射缩宫素及垂体后叶素,术毕给予甲氨蝶呤宫颈注射,术后复查血β-HCG及盆腔彩超检查。结果:32例患者均一次性手术成功,无中转开腹、子宫穿孔发生。二者瘢痕厚度、血β-HCG值及血流阻力指数(RI)比较,差异均无统计学意义(P>0.05);术后3天血β-HCG下降平均(85.1%±10.3%);术后血β-HCG在7~23天降至正常。结论:宫腔镜下清宫术对于治疗剖宫产瘢痕妊娠具有创伤小、手术时间短、出血少、术后恢复快、住院时间短的特点,是微创、直接、准确、有效的治疗方法。%Objective:To explore the effect of hysteroscopic curettage for the treatment of cesarean scar pregnancy.Methods:32 patients with cesarean scar pregnancy were selected,they underwent hysteroscopic curettage.The clinical data of these patients were retrospectively analyzed.In the operation,all the patients were given the cervical injection of oxytocin and vasopressin;after operation,all the patients were given methotrexate cervical injection;after the operation,we checked the blood β-HCG and pelvic ultrasonography.Results:32 patients were all one-time successful without conversion to laparotomy and perforation of the uterus. The scar thickness,serum β-HCG and blood flow resistance index(RI) were compared,the differences were not significant(P>0.05).At 3 days after operation,serum β-HCG was decreased by an average of 85.1%±10.3%;at 7 to 23 days after operation, serum β-HCG was decreased to normal.Conclusion:There are many characteristics of application of hysteroscopic curettage for the treatment of cesarean scar pregnancy,such as little trauma,short operation time,less bleeding,faster postoperative recovery and

  17. Análise dos fatores de risco anteparto para ocorrência de cesárea Analysis of the risk factors for cesarean section

    Directory of Open Access Journals (Sweden)

    Simone Angélica Leite de Carvalho Silva

    2005-04-01

    Full Text Available OBJETIVOS: criar um modelo preditivo para ocorrência de cesárea na Maternidade Professor Monteiro de Morais após avaliação dos fatores de risco anteparto das gestantes que pariram no período de 1 de setembro de 1999 a 31 de agosto de 2000, e posteriormente verificar a eficiência do serviço na indicação de cesárea. MÉTODOS: foi realizado estudo longitudinal, do tipo caso-controle com 3626 gestantes, no qual se verificou quais os fatores anteparto foram considerados de risco para cesárea, no período de 1 de setembro de 1999 a 31 de agosto de 2000. Posteriormente, criou-se modelo preditivo ideal, o qual permitiu quantificar o risco de cesárea para cada paciente na presença de um ou mais fatores de risco. A seguir, aplicou-se o modelo à amostra do estudo a fim de verificar o grau de concordância entre o risco previsto de cesárea e a realização do ato cirúrgico, ou seja, a eficácia na indicação de cesariana. RESULTADOS: aplicando-se o modelo preditivo na amostra, verificou-se que na ausência dos fatores de riscos anteparto, o risco basal de cesárea foi de 15,2%. O grau de concordância entre o previsto pelo modelo logístico e a ocorrência de cesárea foi de 86,6%. CONCLUSÕES: o modelo logístico permitiu identificar o risco basal de cesárea e quantificar a probabilidade de cesárea a partir da introdução do fator de risco. O modelo pode ser considerado útil e eficaz, uma vez que houve concordância entre o acerto e o previsto em 86,6% para cesariana, e 53,6% das pacientes submetidas ao parto normal, de fato, não tinham fator de risco para cesárea.PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was

  18. Case with pyoderma gangrenosum abruptly emerging around the wound of cesarean section for placenta previa with placenta accrete.

    Science.gov (United States)

    Nonaka, Taro; Yoshida, Kunihiko; Yamaguchi, Masayuki; Aizawa, Atsuko; Fujiwara, Hiroshi; Enomoto, Takayuki; Takakuwa, Koichi

    2016-09-01

    A 39-year-old woman underwent emergency cesarean section (CS) due to placenta previa totalis with massive bleeding. Two major problems emerged in this patient after CS was carried out. One was partial retention of the placenta due to placenta accreta. Another major and more serious problem was pyoderma gangrenosum (PG) widely appearing at the skin of the abdomen around the CS wound. Conservative treatment was performed for the retained placenta, and it had completely disappeared by 76 days after the CS. The diagnosis of PG was promptly made in consultation with a plastic surgeon and a dermatologist when a wide ulcer emerged around the CS wound, and high-dose prednisolone was administered as treatment. At 90 days following the CS, near-complete epithelialization was achieved. This extremely rare case reflects the importance of rapid diagnosis and treatment of PG.

  19. 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

  20. 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.

  1. 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

  2. of mifepristone combined with methotrexate on cesarean scar pregnancy%米非司酮联合氨甲蝶呤治疗剖宫产瘢痕妊娠

    Institute of Scientific and Technical Information of China (English)

    王艳辉

    2015-01-01

    Objective To observe the clinical effect of mifepristone combined with methotrexate on cesarean scar pregnancy. Methods Sixty patients with cesarean scar pregnancy from May 2012 to December 2013 were selected, they were randomly divided into two groups. Thirty patients in control group were treated with mifepristone + methotrexate intra-muscular injections, 30 patients in observation group were treated with mifepristone + methotrexate vaginal ultrasound in-jection treatment, and then comparing the clinical effect, the bloodβ-HCG overcast time, the extinction time of mass, the duration of hospitalization and the adverse reactions between the two groups. Results The cure rate of the observation group was 93.33%, the cure rate of the control group was 73. 33%, there was significant difference (P<0. 05). The blood β-HCG overcast time, the extinction time of mass, the duration of hospitalization of the observation group respectively were (8.00 ±1.24)d, (15.54 ±1.22)d and (15.00 ±1.32)d; the blood β-HCG overcast time, the extinction time of mass, the duration of hospitalization of the control group respectively were (16. 20 ± 2. 54) d, (27. 20 ± 2. 42) d and (28. 12 ± 2. 64)d, there were significant differences (P<0. 01). In addition, the incidence of the adverse reactions in the observation group was significantly lower than that in the control group (P<0. 05). Conclusions It is safe and effective treatment of cesarean scar pregnancy with mifepristone orally combined methotrexate vaginal ultrasound injection treatment, and it is worthy of promotion.%目的:观察米非司酮联合氨甲蝶呤治疗剖宫产瘢痕妊娠的临床疗效。方法以安阳市妇幼保健院2012年5月至2013年12月收治的60例剖宫产瘢痕妊娠患者为研究对象,随机将其分为两组,每组30例。对照组给予米非司酮口服+氨甲蝶呤肌肉注射治疗,观察组行米非司酮口服+氨甲蝶呤阴道超声注入治疗,比较两组临床疗效、血β-人绒

  3. 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 (pApgar 1, the percentage of critical neonates, moderate viability neonates and normal viability neonates were 20.5%, 46.3% and 33.1% respectively; sixty minutes after birth, the critical neonates only represented 10.3% of the total puppies. Almost all neonates (238/239) showing moderate or normal viability at Apgar 1, survived for the first 24h after birth. The results of the study showed a direct relationship (pApgar score and neonatal viability. Therefore, the routine performance of the Apgar score would appear to be essential in the assessment of the status of brachycephalic breed puppies.

  4. Epidural anesthesia in repeated cesarean section. Anestesia epidural en la cesárea iterativa.

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    Norma Mur Villar

    2003-05-01

    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.

    Fundamento: La anestesiología ha experimentado durante los últimos años un desarrollo espectacular en las diferentes áreas de su competencia, entre las que se encuentra sin lugar a dudas, la que centra su actividad asistencial en la paciente obstétrica y todo lo relacionado con su práctica adecuada en estas. Objetivo: Evaluar la eficacia de la anestesia epidural en la cesárea iterativa. Métodos: Estudio descriptivo retrospectivo de una serie de casos (112 en que fue

  5. Study of efficacy of mifepristone as inducing agent for mid trimester medical termination of pregnancy in women with previous cesarean section

    Directory of Open Access Journals (Sweden)

    Shaila Chikkagowdra

    2016-09-01

    Conclusions: Combination regimen has abortion rate as higher as 99-100% and median induction to abortion interval is as low as 6 hours. Second trimester abortion in prior cesarean section women should be carried out with caution. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3051-3055

  6. 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.

  7. Patterns of deliveries in a Brazilian birth cohort: almost universal cesarean sections for the better-off

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    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.

  8. Clinical Curative Effect Observation of Methotrexate+Mifepristone Treatment of Cesarean Scar Pregnancy%甲氨蝶呤米非司酮药物治疗剖宫产术后瘢痕妊娠的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    朱天波; 吕燕玲; 容俊; 朱云翠

    2013-01-01

    Objective The clinical efficacy studies of methotrexate and mifepristone treatment after cesarean section scar pregnancy. Methods 15 cases of cesarean section scar pregnancy were the object of study will be divided into two groups by their respectively methotrexate combined with mifepristone and methotrexate simple method of treatment. Results The patients treated with treatment was significantly better than control group patients. Conclusion The use of methotrexate and mifepristone treatment effect on patients after cesarean section scar pregnancy.%  目的 研究甲氨蝶呤联合米非司酮药物治疗剖宫产术后瘢痕妊娠的临床疗效。方法 以15例剖宫产术后瘢痕妊娠的患者为研究对象,将所其分为两组,分别采用甲氨蝶呤联合米非司酮和单纯甲氨蝶呤的方法进行治疗。结果 治疗组患者的治疗有效率明显优于对照组患者。结论 运用甲氨蝶呤联合米非司酮的方式对剖宫产术后瘢痕妊娠患者进行治疗的效果明显。

  9. The comparison between suppository diclofenac and pethidine in post-cesarean section pain relief: a randomized controlled clinical trial

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    Ziba Zahiri Soroori

    2006-12-01

    Full Text Available BACKGROUND: Narcotic drugs are usually used for postoperative pain control which could cause several complications such as respiratory depression and apnea. Therefore, replacement of these drugs with safer analgesics is recommended. The aim of this study was to compare the analgesic effects of suppository diclofenac and pethidine in post-cesarean section (C/S patients. METHODS: In this clinical trial, pregnant women who were admitted to Alzahrah Hospital, Isfahan, Iran, between August and February 2004 and met the inclusion criteria were recruited. After obtaining informed consent, the patients were randomly assigned (block randomization to two groups. In group A, 100 mg rectal suppository diclofenac was used after operation at four time points: at the end of operation and 8, 16 and 24 hours after the operation. Group B received pethidine 1 mg/kg intramuscularly at similar time points. The pain scores were assessed at 2, 10, 18 and 26 hours after C/S using the Visual Analogue Scale (VAS. Age, gestational age, parity, history of previous abortion, C/S and abdominal surgery, level of education, pain score, side effects and satisfaction level were assessed. Analysis was carried out with ANCOVA model and χ2 Mantel Haenszel tests by SPSS.10 software. P<0.05 was considered significant. RESULTS: Two hundred forty patients met inclusion criteria. Age, parity, history of previous abortion, history of previous C/S and abdominal surgery, level of education and satisfaction level were similar in the two groups (P>0.05. There was no significant difference between side effects in the two groups except for dizziness in 11 cases in group B. There were significant statistical difference between pain intensity in 10, 18 and 26 hours after C/S in group A and group B (2.05 ± 2.07, 1.4 ± 1.6 and 0.5 ± 1.1 vs. 2.6 ± 2.2, 2.3 ± 2.2 and 1.3 ± 1.9 respectively. CONCLUSIONS: The results of the present study showed that the use of suppository diclofenac is an

  10. 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.

  11. Uterine Closure in Cesarean Delivery: A New Technique

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    K M Babu

    2012-01-01

    Full Text Available Fear of scar rupture is one of risks involved in a post caesarean pregnancy. This had led to an increased rate of repeat cesarean delivery in today′s times. Closure of the uterine incision is a key step in cesarean section, and it is imperative that an optimal surgical technique be employed for closing a uterine scar. This technique should be able to withstand the stress of subsequent labor. In the existing techniques of uterine closure, single or double layer, correct approximation of the cut margins, that is, decidua-to-decidua, myometrium to myometrium, serosa to serosa is not guaranteed. Also, there are high chances of inter surgeon variability. It was felt that if a suturing technique which ensures correct approximation of all the layers mentioned above with nil or minimal possibility of inter operator variability existed, there will not be any thinning of lower segment caesarean section (LSCS. Further, a scarred uterus repaired in this manner will be able to withstand the stress of labor in future. We hereby report a new technique for uterine closure devised by us, which incorporates a continuous modified mattress suture technique as a modification of the existing surgical technique of uterine closure.

  12. 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。

  13. Cesárea prévia como fator de risco para o descolamento prematuro da placenta Previous cesarean section as a risk factor for abruptio placentae

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    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.

  14. [Neuro-autonomic inhibition and haemodynamics management optimization during cesarean section under spinal anaesthesia in pregnant women with gestosis].

    Science.gov (United States)

    Gur'ianov, V A; Shumov, I V

    2012-01-01

    Results showed that autonomic nervous system (ANS) and blood circulation system (BCS) dysfunction in 3rd trimester pregnant women with gestosis are more pronounced, than in healthy pregnant women, despite the prescribed treatment. The most significant disturbances were vagotonia and hypokinetic haemodynamics type (often iatrogenic). Spinal anaesthesia (SA) during Cesarean section in pregnant women is accompanied by blood pressure decrease to the level demanding on vasopressors use. Considering normal indicators of SI, CI, oxygen transportation and electrocardiogram vasopressor was not introduced Apgar score assessment of newborns was within normal. However, vagotonia and hypokinetic haemodynamics type during anaesthesia that certifies autoregulation reserves insufficiency. Atropine introduction in pregnant women with vagotonia and hypokinetic haemodynamics type (often iatrogenic, owing to irrational therapy) before SA beginning of promoted neurovegetative inhibition optimization and haemodynamics stabilization in eukinetic range. Vagus blockade (elimination of ANS dysfunction) was accompanied by more physiologic sympathicotonia development with smaller decrease of blood pressure (without stroke index reduction!), absence of bradycardia and vomiting. Research showed that the blood pressure cannot be the only objective criterion of vasopressors use. PMID:23662521

  15. 剖宫产术后产后出血的原因分析及护理%Cause analysis and nursing of postpartum hemorrhage after cesarean section

    Institute of Scientific and Technical Information of China (English)

    秦宗玉

    2015-01-01

    ObjectiveTo investigate cause and nursing measures of postpartum hemorrhage after cesarean section.MethodsAnalysis and summarization were made on hemorrhage causes of 70 patients with postpartum hemorrhage after cesarean section.ResultsAmong the 70 patients with postpartum hemorrhage after cesarean section, there were 66 cases with uterine inertia (94.3%), 3 cases with placental factors (4.3%) and 1 case with coagulation disorders (1.4%). All the cases left the hospital without any death or hysterectomy cases after receiving timely rescue and detailed nursing.ConclusionIncidence of complications and mortality rate of postpartum hemorrhage after cesarean section can be reduced by good prenatal education, effective prevention of postpartum hemorrhage, close monitoring of disease, and timely health education.%目的:探讨剖宫产术后产后出血的原因及护理对策。方法70例剖宫产术后产后出血患者,对其出血的原因进行分析和总结。结果70例剖宫产产后出血患者,宫缩乏力66例(94.3%)、胎盘因素3例(4.3%)、凝血功能障碍1例(1.4%)。经过及时抢救和精心护理,无一例发生死亡或切除子宫,均痊愈出院。结论做好产前教育,对产后出血进行有效预防,密切观察病情变化,及时进行健康教育,可以降低剖宫产术后产后出血并发症发生率及死亡率。

  16. [General Anesthesia Using Remifentanil for Cesarean Section in a Parturient with Marfan Syndrome Associated with Heart Failure due to Severe Mitral Regurgitation].

    Science.gov (United States)

    Fujita, Masahide; Satsumae, Tsuyoshi; Tanaka, Makoto

    2016-05-01

    A 24-year-old woman with Marfan syndrome was scheduled for cesarean section in order to avoid progression of heart failure due to severe mitral regurgitation and aortic dissection during labor. Cesarean section was performed under general anesthesia using remifentanil. Anesthesia was induced and maintained with remifentanil (0.1-0.3 μg x kg(-1) x min(-1)) and continuous administration of propofol (target-controlled infusion, 2-3 ng x ml(-1)). The trachea was intubated without a significant hemodynamic change. The patient's systolic blood pressure was maintained between 90 and 120 mmHg during surgery. Intraoperatively, we conducted a transesophageal echocardiography examination, and no remarkable change was seen in the severity of mitral regurgitation and the size of an ascending aorta. An infant was delivered 6 minutes after anesthesia induction. The Apgar scores were 4 at 1 min, 5 at 5 min and 8 at 10 min. Postoperative course was uneventful. We conclude that remifentanil can be used successfully to manage cesarean section of a parturient with Marfan syndrome associated with heart failure due to severe mitral regurgitation under general anesthesia. PMID:27319100

  17. Effect of low B-Lynch suture on menstrual cycle recovery and sex hormone levels in patients after cesarean section for placenta previa

    Institute of Scientific and Technical Information of China (English)

    Su-Lan Zhang; Wan-Cheng Feng; Yan Mi

    2016-01-01

    Objective:To explore the effect of low B-Lynch suture on the menstrual cycle recovery and sex hormone levels in patients after cesarean section for placenta previa.Methods:A total of 40 patients who were admitted in our hospital from August, 2013 to August, 2015 for cesarean section due to placenta previa were included in the study and randomized into the observation group and the control group. The patients in the observation group were given low B-lynch suture, while in the control group, yarns were plugged in the uterus. The bleeding during operation and 24 h after operation, the postpartum lochia duration, and menstrual cycle recovery in the two groups were observed. The postpartum FSH, E2, and LH levels in the two groups were determined.Results:The amount of bleeding during operation and 24 h after operation in the observation group was significantly less than that in the control group (P0.05). The comparison of FSH, E2, and LH levels between the two groups was not statistically significant (P>0.05).Conclusions:Low B-Lynch suture can effectively reduce the amount of bleeding after cesarean section for placenta previa, and has no effect on the menstrual recovery and ovarian function with a simple operation and less postoperative complications; therefore, it deserves to be widely recommended in the clinic.

  18. 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.

  19. 天花粉蛋白治疗子宫切口瘢痕妊娠的临床疗效及不良反应%Clinical application of trichosanthin in cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    戴良图; 张华; 曾敏华; 吴蕾; 李扬

    2014-01-01

    Objective To investigate the clinical value of trichosanthin in the treatment of cesarean scar pregnancy and in-curred adverse reactions.Methods Twenty-one cases of cesarean scar pregnancy were chosen for our study.With the knowledge and consent of the patients and in accordance with different sites of injection, the patients were divided into the muscular injection group (10 cases) and the intracervical injection group (11 cases) .Following negative skin test, the patients respectively received muscular and intracervical trichosanthin injection at a dosage of 1.8-3.6 mg.Seven days after treatment, close observation was made on the decrease of human chorionic gonadotropin (β-HCG) and adverse reactions induced by the drug.Results The patients in the 2 groups all respon-ded quite well to the treatment.After 7 days of treatment, a sharp reduction ofβ-HCG by over 70%was noted in 8 cases of the muscu-lar injection group, and a reduction ofβ-HCG by less than 50%was seen in 2 cases.Of the 2 cases, one had a secondary muscular in-jection and one was supplemented with methotrexate.The patients in the muscular injection group had such adverse reactions as fever, pain in the limbs, swelling and pain in the injection sites and skin rash.One case displayed chest distress and dyspnea, but symptoms were soon relieved following antianaphylactic treatment and oxygen breathing.Seven days after treatment with trichosanthin, the level ofβ-HCG in the patients of the intracervical injection group all dropped by over 70%.Four patients had such symptoms as fever, pain in the limbs, however, symptoms were lighter than those of the muscular injection group.Conclusion Trichosanthin injection seemed to produce good effect on cesarean scar pregnancy, however, adverse reactions might occur in the course of treatment, with muscular injec-tion having severer reactions, and trichosanthin injection having lighter reactions.For this reason, close observation should be made on the adverse

  20. Acne Scars

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    ... care Kids’ zone Video library Find a dermatologist Acne scars Overview Acne scar treatment: This woman's dermatologist ... At 3 months (right), she has noticeable improvement. Acne scars: Overview If acne scars bother you, safe ...

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

    Directory of Open Access Journals (Sweden)

    Zeel

    2014-03-01

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

  2. Effect of number of cesarean section on pregnancy outcomes%剖宫产次数对妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    曾翠蓉

    2015-01-01

    Objective To explore the effect of number of cesarean section on pregnancy outcomes. Methods 70 cases of cesarean section in our hospital from January 2012 to January 2014 were selected as research object,and they were divided into the control group(the first cesarean section)and observation group(repeated cesarean section),with 35 cas-es in each group. Pregnancy outcome between two groups was compared. Results Postpartum complication occurrence rate in observation group was lower than that of control group, postpartum breastfeeding rate,postpartum living quality satisfaction degree in observation group was higher than that of control group,the difference was significant (P<0.05). Conclusion The more times the number of cesarean section in maternals,the lower the postpartum living quality,the worse the postpartum breastfeeding,and the higher the postpartum complication occurrence rate.The clinical must act according to the special details choice appropriate delivery way,so as to ensure maternal and child health, improve the quality of medical services.%目的:探讨剖宫产次数对妊娠结局的影响。方法选取2012年1月~2014年1月在本院行剖宫产分娩的70例产妇作为研究对象,根据产妇剖宫产次数分为对照组(初次剖宫产)和观察组(多次剖宫产),每组35例。比较两组产妇的妊娠结局。结果观察组产妇的产后并发症发生率低于对照组,母乳喂养率、产后生活质量满意度高于对照组,差异有统计学意义(P<0.05)。结论产妇剖宫产次数越多,产后生活质量越低,母乳喂养情况越差,且产后并发症发生率越高。临床上应根据产妇的具体体征选择合适的分娩方式,从而保障母婴健康,提高医疗服务质量。

  3. Analysis on 48 cases with cesarean scar pregnancy treated by the combination of trichosanthin and mefepristone%天花粉、米非司酮联合治疗剖宫产瘢痕妊娠48例分析

    Institute of Scientific and Technical Information of China (English)

    赵富鲜; 周萍; 杨泽星

    2013-01-01

    目的:探讨天花粉、米非司酮联合治疗剖宫产瘢痕妊娠的疗效。方法回顾性分析2006年11月~2012年12月48例剖宫产瘢痕妊娠经天花粉、米非司酮联合治疗的临床资料,观察其疗效。结果48例患者,39例成功,成功率81.25%,3例破裂,6例疗程结束后血β-HCG未降至正常而行手术治疗。结论天花粉、米非司酮联合治疗剖宫产瘢痕妊娠是有效的,安全的,而且费用低,风险小,可供同行参考。%Objective: To discuss the curative effect of trichosanthin and mifepristone combined therapy for cesarean scar pregnancy. Methods: The clinical data of 48 cases with cesarean scar pregnancy treated by the combination of trichosanthin and mifepristone from November 2006 to December 2012 were retrospectivly analysed to observe their curative effect. Results:in 48 patients, 39 cases were successful, the success rate was 81.25%. 3 cases ruptured, 6 cases whose blood β-HCG did not decreased to normal level after the end of treatment were treated by operation. Conclusions : The treatment of Cesarean scar pregnancy by the combination of trichosanthin and mifepristone is effective and safe, and with low cost, low risk, which can be used for reference by peers.

  4. [Post-mortem cesarean sections in Puerto Rico, 1805-1807].

    Science.gov (United States)

    Rigau-Pérez, J G; Villaizán, M

    1991-03-01

    The idea of saving an infant by incising the abdomen of the recently deceased mother was first put into practice in ancient times, and the Catholic Church endorsed its use to provide baptism for the infant's soul. The practice received official support in Madrid in 1804 with a Real Cédula (royal order) of Charles IV to the civilian and ecclesiastic officials of the Indies and the Philippines. This operation was used, before the cédula, in Spain, Mexico, Venezuela and Peru, but in Puerto Rico this order seems to have provoked the practice of post-mortem caesarean section. In a review of burial records of the San Juan cathedral for 1797 to 1814, one such operation is mentioned (1807), but the records of Cayey (a town in the mountains) from 1801 to 1812 show three cases (1805-6). We transcribe here (with modern spelling) the cédula and burial certificates, and we then comment on their significance. PMID:1854384

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 疤痕子宫对再次妊娠分娩结局危险性的分析%Analysis on the Risk of Uterine Scar Pregnancy and Delivery Outcome

    Institute of Scientific and Technical Information of China (English)

    窦伯梅; 范明秀

    2014-01-01

    目的:探讨疤痕子宫孕妇的分娩结局,了解疤痕子宫孕妇再次分娩的风险及并发症。方法将2004~2013年入住我院的有剖宫产史的孕妇,妊娠结局、分娩方式的选择以及其风险性明显增高。结果疤痕子宫妊娠的分娩方式仍以剖宫产为主,社会因素仍是主要原因。结论疤痕子宫再次妊娠后分娩风险明显较非疤痕子宫高,临床应该严格控制无临床医学指征性剖宫产。%Objective To investigate the scar uterus of pregnant women give birth outcomes, to understand the risks and complications of uterine scar pregnancy to childbirth. Methods From 2004 to 2013 in our hospital with a history of cesarean section pregnant women, pregnancy, delivery mode and its risk significantly increased. Results Cesarean uterine scar pregnancy is stil in cesarean section, the main reason is the social factors. Conclusion Uterine scar pregnancy after delivery risk compared with non scar uterus, clinical should strictly control without clinical medical indications of cesarean section.

  7. Analysis on pregnancy outcome of cases with cesarean scar pregnancy combined with hypertensive disorder complicating pregnancy%疤痕子宫再次妊娠并发妊娠期高血压疾病的妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    韩悦

    2013-01-01

    Objective: To analyze and explore the pregnancy outcome of cases with cesarean scar pregnancy (CSP) combined with hypertensive disorder complicating pregnancy (HDCP) . Methods: Eighty - five pregnant women with HDCP were selected as study objects, and 23 pregnant women had the history of cesarean section; 120 normal pregnant women during the same period were selected as control group; the incidence rates of antenatal hemorrhage and postpartum hemorrhage, delivery modes, perinatal situations, and maternal complications in the three groups were analyzed and compared. Results: There were statistically significant differences in the incidence rates of antenatal hemorrhage and postpartum hemorrhage, the rate of hysterectomy, birth rate of premature infants, incidence rate of fetal asphyxia, and the rate of cesarean section between CSP group and non - CSP group, control group ( P 0. 05) , compared with control group, there was statistically significant difference (P < 0.05 ) ; the incidence rate of adverse pregnancy outcome in case with preeclampsia was statistically significantly higher than that in cases with simple hypertension, there was statistically significant difference in pregnancy outcome between severe preeclampsia group and mild preeclampsia group (P <0. 05) . Conclusion: CSP combined with HDCP has important impact on pregnancy outcome, thus, gestational monitoring for parturient women should be enhanced, timely coping with the emergency situations during operation is helpful to maternal and infantile prognosis.%目的:对疤痕子宫再次妊娠并发妊娠期高血压疾病的妊娠结局进行分析及探讨.方法:选取85例并发妊娠期高血压疾病孕妇为研究对象,其中有剖宫产史25例,并选择同期正常分娩的产妇120例为对照组,分析比较3组产妇产前产后出血、分娩方式、围产儿出生情况及产妇并发症发生情况.结果:疤痕子宫组产前产后出血、子宫切除、早产儿出生率、胎儿窒息

  8. 剖宫产瘢痕部位妊娠不同治疗方式及其疗效分析%Cesarean scar pregnancy different treatment and curative effect analysis

    Institute of Scientific and Technical Information of China (English)

    习红丽; 洪莉

    2015-01-01

    Objective The aim of this study is to investigate the clinical treatment and therapeutic effect of cesarean scar pregnancy. Methods Between December 2008 to March 2015,the records of 90 cases of gynecologic clinical diagnosis of cesarean scar pregnancy patients were included into this study. The curative effect of different treatments and the influence on ovarian function were retrospectively analyzed. All these patients were be randomly assigned according to the different treatment,24 patients with group A undergoing line medicine conservative treat-ment(mifepristone combined methotrexate),group B 28 patients undergoing laparoscopic resection of the lesions of pregnancy + uterine defect re-pair;C group of 38 cases of patients with uterine artery embolization. The clinical therapeutic effect and safety of three groups of patients were com-pared. Results ①The three groups of patients with blood βHCG levels were significantly reduced compared with before treatment( P ﹤ 0. 05), the comparison between groups(group A ﹥ group B ﹥ group C)had statistically significant( P ﹤ 0. 05). ②The hormone levels between groups was no significant difference( P ﹥ 0. 05). ③The recovery time in the menstrual cycle and blood β HCG normal time - consuming,vaginal bleed-ing time,bleeding volume,length of hospital stay on indicators,time consuming group C ﹤ group B ﹤ group A,statistically F test,there were significant difference( P ﹤ 0. 05). Conclusion Three kinds of treatment are to preserve the uterus and ovarian function,conform to the require-ments of the have fertility patients,uterine artery embolization in patients with short cure time,little trauma,quick recovery. Therefore,this treat-ment was recommended the uterine artery embolization to treatment uterine scar pregnancy.%目的:研究剖宫产瘢痕部位妊娠的临床治疗方式及疗效。方法选取2008年12月至2015年3月妇科收治的90例临床确诊剖宫产瘢痕部位妊娠患者作为研

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

    Directory of Open Access Journals (Sweden)

    Voronin K.V.

    2013-12-01

    Full Text Available Clinical features of vaginal dysbiosis as a factor in the high risk of septic complications, especially in pregnant women diagnosed with anaerobic vaginal dysbiosis were examined. Low efficiency of the traditional methods of treating bacterial dysbiosis, a high rate of recurrences and the risk of preterm delivery dictate the need to find alternative methods of treatment and prevention of antenatal and post-natal complications. The widespread introduction of caesarean section into obstetric practice contributed to the reduction of perinatal loss. However, together with the expansion of indications for cesarean section, increase in the frequency and severity of post-natal chronic inflammatory diseases is associated. The number of purulent-inflammatory diseases in the early postoperative period and in the long-term period after C-section is large, reaching 3,3-54,3%. Postpartum period, even in physiological course and particularly in the presence of risk factors is favorable for the development of infectious complications. Almost all the authors identify caesarean section as a significant risk factor for postpartum endometritis, since, making only 10 - 20% of the total number of deliveries, cesarean section causes 80% of all postpartum endometritis. We propose a diagnostic algorithm, drug correction and prevention for this common group of patients.

  14. A 10-year appraisal of cesarean delivery and the associated fetal and maternal outcomes at a teaching hospital in southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Onoh RC

    2015-05-01

    Full Text Available Robinson Chukwudi Onoh,1 Justus Ndulue Eze,2 Paul Olisaemeka Ezeonu,1 Lucky Osaheni Lawani,1 Chukwuemeka Anthony Iyoke,3 Peter Onubiwe Nkwo3 1Department of Obstetrics and Gynaecology, Federal Teaching Hospital Abakaliki, Abakaliki, 2Department of Obstetrics and Gynaecology, College of Health Sciences, Ebonyi State University, Abakaliki, 3Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria Background: The global rise in cesarean delivery rate has been a major source of public health concern. Aim: To appraise the cesarean deliveries and the associated fetal and maternal outcomes. Materials and methods: The study was a case series with data collected retrospectively from the records of patients delivered by cesarean section at the Ebonyi State University Teaching Hospital, Abakaliki over a 10-year period, from January 2002 to December 2011. Ethical approval was obtained. Results: Of 14,198 deliveries, 2,323/14,198 (16.4% were by cesarean deliveries. The overall increase of cesarean delivery was 11.1/10 (1.1% per annum from 184/1,512 (12.2% in 2002 to 230/986 (23.3% in 2011. Of 2,097 case folders studied, 1,742/2,097 (83.1% were delivered at term, and in 1,576/2,097 (75.2%, the cesarean deliveries were emergencies. The common indications for cesarean delivery were previous cesarean scars 417/2,097 (19.9% and obstructed labor 331/2,097 (15.8%. There were 296 perinatal deaths, giving a perinatal mortality rate of (296/2,197 134.7/1,000 births. Also, 129/2,097 (6.1% maternal case fatalities occurred, giving a maternal mortality rate of 908.6/100,000 total births. Hemorrhage 57/129 (44.2% and sepsis 41/129 (32.6% were the major causes. Conclusion: The study recorded a significant increase in cesarean delivery rate. Previous cesarean scars and obstructed labors were the main indications. Perinatal and maternal case fatalities were huge. Hence, there is need for continued community education for its reduction

  15. 护理干预对剖宫产术后母乳喂养的影响%Impact on Nursing Intervention on Breastfeeding after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    王文兰

    2014-01-01

    Objective: To explore the nursing intervention to improve the ef ects of cesarean section of breastfeeding. Method: select 2011 January to 2013 June in our hospital ful -term cesarean section maternal 400 cases, were randomly divided into observation group and control group with 200 cases in each group, the observation group was treated with nursing intervention; the control group was given routine nursing care. Results: the group of early sucking, frequent sucking, control group on-demand feeding significantly bet er, improve breastfeeding. Conclusion: the nursing intervention after cesarean section, improve the success rate of breastfeeding, conducive to maternal and child health.%目的:探讨护理干预对提高剖宫产术母乳喂养的影响。方法选择2011年1月~2013年6月在我院足月剖宫产分娩的产妇400例,随机分为观察组和对照组各200例,观察组采用护理干预;对照组给予常规护理。结果观察组早吸吮,勤吸吮,按需喂养情况明显优于对照组,提高母乳喂养。结论剖宫产术后采用护理干预措施,提高母乳喂养的成功率,利于母婴的健康。

  16. Investigation of the health education on 86 maternal with cesarean section%剖宫产产妇86例健康教育的探讨

    Institute of Scientific and Technical Information of China (English)

    姜秀

    2015-01-01

    目的:探讨健康教育在剖宫产围术期中的应用效果。方法:收治子宫下段剖宫产产妇86例,对其进行健康教育。结果:86例产妇无静脉血栓、腹胀、乳腺炎等,只有1例尿管拔出后小便未能自解,需重新导尿。结论:在剖宫产围术期对产妇进行健康教育,使产妇积极参与新生儿护理和自我护理,有利于促进产妇身心康复,增进母子感情。%Objective:To explore the application effect of health education in perioperative period of cesarean section.Methods:86 patients with lower uterine segment cesarean section were selected,and then we carried on the health education for them.Results:All of those 86 maternal had no venous thrombosis,abdominal distension,mastitis or other symptoms,and only 1 case could not self urination after pulling out the catheter,and needed to recatheterization.Conclusion:Taking health education on maternal in the perioperative period of cesarean section can help the maternal actively participate in the self nursing and the newborn care,so it is helpful to promotion of maternal physical and mental rehabilitation,and enhance the bonding.

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

    International Nuclear Information System (INIS)

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

  18. Effect of different labor cesarean section on maternal and neonatal outcomes%不同产程剖宫产术对母婴结局的影响

    Institute of Scientific and Technical Information of China (English)

    李海英

    2012-01-01

    Objective To study the effect of different labor cesarean section on maternal and neonatal outcomes. Methods The clinical data of 80 patients of cesarean section in the first stage of labour in our hospital from June 2009 to June 2011 (the study group) were retrospectively analyzed, as well as that of 85 patients of cesarean section in the second stage of labour (the control group). All the patients were followed up for 3-6 months. The intra-operative status of patients, incidence of postoperative complications, and neonatal clinical outcomes were compared between the two groups. Results The intraoperative status, incidence of postoperative complications, and neonatal clinical outcomes after treatment were all significantly better in the study group than the control group (P<0.05). Conclusion Cesarean section in the first stage of labor can significantly reduce the risk of surgery, lower the incidence of maternal complications, and enhance the life quality of newboms.%目的 探讨不同产程剖宫产术对母婴结局的影响.方法 选择本院2009年6月至2011年6月收治的第一产程剖宫产80例产妇病例资料(实验组)进行回顾性分析,另选择同期85例第二产程剖宫产的产妇作为对照组.随访3~6个月,比较两组产妇的术中情况、并发症发生率和新生儿临床结局.结果 两组比较,治疗后实验组产妇的术中情况、术后并发症发生率和新生儿临床结局均优于对照组,差异有统计学意义(P<0.05).结论 第一产程剖宫产术可明显降低术中风险,减少产妇术后并发症发生率,增强新生儿生命质量.

  19. Effect of aromatherapy massage on pain easing after cesarean section%香薰按摩对减轻剖宫产术后疼痛的效果

    Institute of Scientific and Technical Information of China (English)

    黄丽燕; 周嘉燕; 陈毓婵; 贺辉; 刘伟平; 罗震; 廖拾零; 余凤仙; 陈霞萍; 蔡丽萍

    2010-01-01

    目的 探讨香薰按摩对减轻剖宫产产妇术后疼痛的效果.方法 随机选择无慢性躯体疾病、无精神障碍、新生儿出生时健康、术后不使用麻醉镇痛泵的住院行剖宫产的初产妇456例,随机分成对照组和干预组各228例.对照组实施产后常规护理,干预组在常规护理的同时实施全身植物精华香薰按摩,比较两组剖宫产术后产妇切口疼痛、子宫收缩疼痛及产后相关的其他躯体疼痛不适和镇痛药物的使用情况.结果 干预组产妇术后不同时间的疼痛程度明显优于对照组(P<0.05),干预组产妇术后24 h后不再需要使用镇痛药物.结论 香薰按摩能有效减轻剖宫产产妇术后的疼痛程度,减少镇痛药物的使用次数.%Objective To discuss the effect of aromatherapy massage on pain easing after cesarean section.Methods 456 primiparas without chronic body disease,mental disorder,postoperative analgesia or unhealthy neonates were selected and randomly divided into control group(228 cases)and experimental group(228 cases).The control group received routine care,and the experimental group received plant essence aromatherapy massage besides routine care. Postpartum incision pain,uterine contraction pain and other body discomfort,as well as analgesic drug use after cesarean section were compared between the two groups. Results The degree of the pain at different stages in the experimental group was significantly lower than the control group(P <0. 05). Analgesic drug was not needed 24 hours after cesarean section in the experimental group. Conclusions Aromatherapy massage effectively eases pain after cesarean section and reduces analgesic drug use.

  20. 剖宫产术后阴道分娩的产程时限研究%Labor Time in Vaginal Birth after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    姜海利; 王欣

    2016-01-01

    Objective To investigate the labor time in vaginal birth after cesarean section ( VBAC ) so as to get definite evaluating and monitoring points of VBAC. Methods 75 pregnant women who underwent trial of labor after cesarean ( TOLAC)in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2012 to June 2015 were selected. Among them,70 cases(VBAC,93. 3%)had successful vaginal delivery,5 cases(6. 7%)with unsuccessful vaginal trial production underwent cesarean section again. According to the timing of previous cesarean section,70 pregnant women with VBAC were divided into cesarean section after vaginal trial of production group(n=23)and elective cesarean section group(n=47),and their stages of labor were recorded. Results The average age and parity of patients in elective cesarean section group were respectively younger and less than those of patients in cesarean section after vaginal trial of production group ( P﹤0. 05 );the comparison of gestational age,times of pregnancy,pre-pregnancy BMI,prenatal BMI,thickness of lower uterine segment and premature rupture of membrane through ultrasonic testing,and proportion of gestational diabetes and pregnancy complicated with hypertension among pregnant women in two groups was not significantly different ( P ﹥0. 05 ) . There was no significant difference in times of the first stage of labor,the second stage of labor and total stage of labor among pregnant women with no history of vaginal delivery in two groups(P﹥0. 05);there was no significant difference in times of the first stage of labor,the second stage of labor and total stage of labor among term delivery women with no history of vaginal delivery in two groups( P﹥ 0. 05). The amount of postpartum hemorrhage, neonatal weight, neonatal Apgar score, and the proportion of puerperal infection,fetal distress,amniotic fluid Ⅲ, neonatal morbidity, forceps delivery and maternal postpartum hemorrhage among pregnant women in two groups were not

  1. 护理干预对剖宫产并发寒战的效果分析%Effect Analysis of Nursing Intervention on Shivering after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    唐亚萍; 尤卫红; 朱富强

    2013-01-01

    Objective:To observe the effective nursing intervention on prevention and reducing the effect of cesarean section complicated with chills. Method:136 cases of cesarean mothers were randomly divided into experimental and control groups,each group had 68 cases,the experimental group used detailed nursing intervention measures,the control group used perioperative general care. Result:The experimental group shivering in 6 cases(9.68%),the control groups shivering in 22 cases(36.67%),the experimental group was significantly lower than the control group(P<0.05). Conclusion:Effective nursing intervention can significantly reduce the incidence of maternal shivering after cesarean section.%目的:观察实施有效护理干预对预防和减少剖宫产并发寒战的效果。方法:将136例剖宫产产妇按随机数字表法分成试验组和对照组,每组各68例,试验组制定详细的护理措施进行干预,对照组按照围术期一般护理常规进行护理。比较两组寒战发生率。结果:试验组发生寒战6例,占9.68%,对照组发生寒战22例,占36.67%,试验组明显低于对照组(P<0.05)。结论:术中实施有效护理干预可以明显降低剖宫产产妇寒战的发生率。

  2. Study on Application Value of Color Doppler Ultrasound in Diagnosis and Treatment of Cesarean Scar Pregnancy%探讨彩色多普勒超声在子宫瘢痕妊娠诊断及治疗中的应用价值

    Institute of Scientific and Technical Information of China (English)

    刘中芳

    2016-01-01

    Objective To study and observe the clinical application value of color Doppler ultrasound in clinical diagnosis and treatment of cesarean scar pregnancy. Methods 152 cases of patients with cesarean scar pregnancy diagnosed and treat-ed in our hospital from June 2014 to January 2016 were selected as the research object and all patients were examined by transvaginal and transabdominal color Doppler ultrasonic diagnosis, the clinical information and data were retrospectively analyzed, and the clinical application value of color Doppler ultrasound in diagnosis and treatment of cesarean scar preg-nancy was observed and discussed. Results The accuracy rates of transvaginal and transabdominal color Doppler ultrasonic diagnosis examinations were respectively up to 120 cases (78.95%) and 140 cases (92.11%), at the same time, the analysis of ultrasonic images of patients discovered that in terms of cesarean scar pregnancy types, 20 cases were in mixed type, (13.16%), 60 cases were in heterogeneous mass type(39.47%) and 72 cases were in embryo type(47.37%). Conclusion Color Doppler ultrasound in clinical diagnosis and treatment of cesarean scar pregnancy has a higher diagnostic accuracy rate, and it is of important value to the effective treatment of patients.%目的:探究在子宫瘢痕妊娠的临床诊断及治疗中,采用彩色多普勒超声进行诊断及指导其治疗,观察其临床应用价值。方法整群选取2014年6月—2016年1月来该院接受诊治的152例子宫瘢痕妊娠病人的临床信息资料作为研究的案例,全部152例病人均实施经阴道和经腹部的彩色多普勒超声诊断检查,回顾分析其临床信息资料,探究在子宫瘢痕妊娠的临床诊断及治疗中,采用彩色多普勒超声进行诊断及指导其治疗,观察其临床应用价值。结果经腹部的彩色多普勒超声诊断检查,其诊断正确率高达120例(78.95%),经阴道的彩色多普勒超声诊断检

  3. Clinical Value of Hysteroscopic Surgery for Type Ⅰ Cesarean Scar Pregnancy%宫腔镜诊治Ⅰ型剖宫产瘢痕妊娠的价值

    Institute of Scientific and Technical Information of China (English)

    陈滢; 王晶; 杨赛花; 童明

    2016-01-01

    目的:探讨宫腔镜在Ⅰ型剖宫产瘢痕妊娠( cesarean scar pregnancy,CSP)诊治中的价值。方法回顾性分析我院2010年12月~2014年8月阴道彩色超声提示Ⅰ型CSP 173例,其中A组83例行双侧子宫动脉栓塞术,术后24 h行宫腔镜检查联合清宫术;B 组90例行宫腔镜检查,并在宫腔镜直视下切除妊娠组织并电凝止血。比较2组术中、术后情况。结果宫腔镜检查证实为Ⅰ型CSP 148例,阴道彩色超声阳性符合率为85.5%(148/173),假阳性率14.5%(25/173)。 A组术中出血量(30.0±14.9)ml,显著多于B组(17.2±9.1)ml(t=6.362,P=0.000);A组住院费用(12046.4±984.8)元,显著多于B组(6511.3 ± 826.5)元(t=37.137,P=0.000);A组住院时间(5.6±0.9)d,显著长于B组(5.0 ± 0.9)d (t=4.052,P=0.000);A组盆腔疼痛和子宫穿孔的发生率显著高于B组(χ2=6.860,P=0.009;Fisher检验,P=0.024)。2组血β-hCG降至正常时间无统计学差异[(21.8±4.8)dvs.(20.9±4.9)d,t=1.127,P=0.261]。结论与双侧子宫动脉栓塞术联合清宫术相比,宫腔镜直视下切除妊娠组织处理Ⅰ型CSP术中出血量少,住院费用低,是治疗Ⅰ型CSP较理想的方法。%Objective To explore the clinical application value of hysteroscopic surgery for type Ⅰ cesarean scar pregnancy ( CSP) . Methods A retrospective analysis was made on data of 173 cases of CSP diagnosed with transvaginal color Doppler ultrasound from December 2010 to August 2014 in this hospital, including 83 cases treated with bilateral uterine artery embolization and hysteroscopic negative pressure suction 24 hours later ( Group A) and 90 cases treated with hysteroscopic exploration and pregnancy tissue resection with local electric coagulation ( Group B) . Perioperative situations were assessed between the two groups. Results Among the 173 cases, type Ⅰ CSP was confirmed by hysteroscopy in 148 cases, showing a positive coincidence rate of 85. 5%(148/173) and a false positive rate of 14. 5% (25/173). The

  4. Placenta accreta on the postoperative scar after previous caesarean section in late pregnancy:an analysis of 9 cases%妊娠晚期剖宫产切口瘢痕胎盘植入9例分析

    Institute of Scientific and Technical Information of China (English)

    申震; 周元元; 赵卫东; 陈玲

    2011-01-01

    目的:探讨妊娠晚期剖宫产切口瘢痕胎盘植入的诊治.方法:对2000年1月至2010年7月收治的9例妊娠晚期剖宫产切口瘢痕胎盘植入的临床诊治资料进行回顾性分析.结果:5例经保守治疗后于孕32~35周手术终止妊娠,4例在充分术前准备下行剖宫产术;9例均出现产后出血,1例粘连型胎盘植入者行子宫动脉结扎术,6例植入型和2例穿透型胎盘植入者均行子宫切除术;无孕产妇病死;早产5例,足月产2例,围生儿病死2例.结论:积极准确的诊断和有效的治疗是治疗晚期妊娠剖宫产切口瘢痕胎盘植入患者的关键.%Objective: To evaluate the diagnosis and treatment of the placenta accreta on the postoperative scar after previous caesarean section in late pregnancy. Methods: A retrospective study was conducted in 9 cases with placenta accreta on the postoperative scar after previous caesarean section in late pregnancy from Jan. 2000 to Jul. 2010. Results: Five cases were performed termination of pregnancy after conservative treatment during 32 - 35 weeks pregnancy and 4 cases were performed cesarean section after adequate preoperative preparation. All the 9 cases suffered from postpartum hemorrhage. One case with placental adherence underwent uterine artery ligation,and the other 6 cases with placenta accreta and 2 cases with placenta percreta received hysterectomy. No death occurred in the pregnant or lying-in women. Premature birth was observed in 5 infants and full term birth in 2 infants; perinatal deaths occurred in 2 infants. Conclusions: Accurate diagnosis and effective therapeutic procedure are essential for treatment of placenta accreta on the postoperative scar after previous caesarean section in late pregnancy.

  5. Cesarean section distribution in midwifery institutions in Hunan Province in 2012%2012年湖南省助产机构剖宫产率分布情况分析

    Institute of Scientific and Technical Information of China (English)

    陈小英; 吴颖岚; 王华

    2016-01-01

    Objective To analyze the distribution characteristics of cesarean section in midwifery institutions in 2012 (3 + 1) in Hunan province and provide some references for controlling cesarean section.Methods The distribution of cesarean delivery in 2012 (3 + 1) in Hunan province were retrospectively analyzed.Results The peaks of cesarean delivery rate in the midwifery institutions most appeared in the first quarter in 2012.That the county or township institutions hadn't properly control cesarean delivery played a key role in cesarean section rate staying at a high level.Conclusions Strengthening the control regulation and midwives training of county or township midwifery organizations will be the breakthrough for controlling cesarean delivery rate in our province.%目的 分析湖南省2012年度(3+1)模式各级助产机构剖宫产率分布情况,为探讨控制剖宫产率的有效途径提供科学依据.方法 对湖南省2012年(3+1)模式各市州剖宫产率分布情况进行回顾性分析.结果 2012年度各市州助产机构剖宫产率峰值大部分出现在一季度;剖宫产率居高不下的关键在于县级、乡级助产机构剖宫产率的控制不当.结论 加强对县级、乡级助产机构剖宫产率控制的监管及助产人员培训,将是我省控制剖宫产率的突破口.

  6. 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。

  7. 剖宫产术后切口愈合不良危险因素调查%CESAREAN SECTION RISK FACTORS FOR POOR WOUND HEALING RESEARCH

    Institute of Scientific and Technical Information of China (English)

    张洪星; 郭文玲; 李宁

    2012-01-01

    [目的]分析剖宫产术后切口愈合不良的危险因素,总结护理措施,以提高剖宫产患者切口愈合的质量.[方法]采用病例对照的研究方法,对某院110例行剖宫产术后伤口愈合不良患者的临床资料进行回顾性分析,与同时期剖宫产术后愈合良好组在有关不良危险因素方面进行比较分析,提出合理的护理措施.[结果]110例剖宫产患者伤口轻度愈合不良者72例(65.45%),中度25例(22.73%),重度13例(11.82%);与对照组比较发现,影响切口愈合的危险因素为:BMI高、基础疾病、术前未预防应用抗生素、无菌操作不严格、手术时间长.[结论]多种危险因素影响切口的愈合.提高认识,正确指导孕期保健,做好产前检查、围术期给予药物进行预防、控制病房内细菌的数量,积极采取应对护理措施,以提高切口愈合质量.%[Objective] To analyze the risk factors of poor wound healing during cesarean section, and summary care measures to improve the quality of wound healing in patients with cesarean section. [Methods] A case-control study of 110 hospital routine cesarean section wound healing in patients with clinical data were retrospectively analyzed, and compared the risk factors with the same period a good set of healing after cesarean section to propose effective preventive measures. [Results] Among 110 cases of cesarean section, 72 patients had mild wound healing (65.45%) , 25 cases had moderate wound healing (22,73%), 13 cases had severe wound healing (11.82% ). Compared with the control group, we found that the impact of risk factors for wound healing, inclding higher BMI, underlying disease, preoperative antibiotic prophylaxis, non-strict aseptic and long time surgery. [Conclusion] Multiple risk factors affect wound healing, awareness, proper guidance to prenatal care, good prenatal care, preoperative administration of drugs for the prevention, control the number of bacteria within ward, take

  8. 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

  9. 剖宫产术后再次妊娠分娩方式分析%Analysis of the delivery mode of secondary pregnancy after cesarean section

    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

  10. 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

  11. 阴道彩超及MRI诊断剖宫产术后子宫疤痕妊娠的临床价值%Transvaginal color doppler ultrasonography and magnetic resonance imaging for identifying cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    汤佩玲; 李新春

    2013-01-01

    Objective To evaluate the diagnostic value of transvaginal color doppler ultrasonography (TVCD) and magnetic resonance imaging (MRI) for identifying cesarean scar pregnancy (CSP).Methods Clinical profiles of 20 patients with pathologically and clinically confirmed diagnosis of CSP who underwent TVCD followed by MRI in 17 cases at week 1 were retrospectively analyzed.Results Of 20 cases,15 (75%) and 5 (25%) were correctly and incorrectly diagnosed by TVCD,corresponding to a diagnostic accuracy of 75%,which was lower than that of MRI (100%).Images result could be classified into gestational sac [n=14 (70%) vs n=9 (52.9%)] and mixed mass type [n=6 (30%) vs n=8 (47.1%)] based on TVCD and MRI,respectively.Conclusion The main image findings of CSP comprises cystic,solid and cystic nodules or masses,which can be properly identified by TVCD and MRI,of which the latter is superior and can be regarded as a crucial surrogate for assessment of CSP.%目的 探讨阴道彩超及MRI对剖宫产术后子宫疤痕妊娠的诊断价值.方法 回顾性分析经手术病理及临床证实的20例剖宫产术后子宫疤痕妊娠的临床资料,20例行阴道彩超,17例1周内行MRI检查.结果 20例中,阴道彩超诊断正确15例(75%),误诊5例(25%),阴道彩超诊断准确率为75%.阴道彩超分为两型:单纯妊娠囊型14例(70%);混合回声包块型6例(30%).MRI分为两型:单纯妊娠囊型:9例(约52.9%);混杂团块型:8例(约47.1%),17例MR检查均正确诊断.结论 剖宫产术后子宫疤痕妊娠的主要影像学表现为子宫疤痕处的囊性、囊实性结节或肿块.阴道彩超及MRI均可作出准确诊断,MRI在诊断子宫疤痕妊娠方面优于阴道彩超,可作为子宫疤痕妊娠的重要补充.

  12. Clinical value of color Doppler ultrasound on monitoring the debridement surgery of hysteroscopic previous caesarean section scar pregnancy%彩色多普勒超声监测宫腔镜下剖宫产子宫瘢痕妊娠病灶清除术的临床价值

    Institute of Scientific and Technical Information of China (English)

    林炳钦; 张泽玫; 钟红珠; 杨楚香; 李婵粧

    2014-01-01

    目的:探讨彩色多普勒超声监测宫腔镜下剖宫产子宫瘢痕妊娠病灶清除术的临床价值。方法回顾性分析1999年1月至2012年12月汕头市第二人民医院在彩色多普勒超声监测宫腔镜下剖宫产子宫瘢痕妊娠病灶清除术的8例患者的临床资料。结果术前8例剖宫产子宫瘢痕妊娠患者彩色多普勒超声均表现为子宫下段前壁剖宫产瘢痕处混合性包块,在彩色多普勒超声监测宫腔镜下病灶清除术保守治疗成功,术中出血少。结论彩色多普勒超声是诊断剖宫产子宫瘢痕妊娠的主要方法。彩色多普勒超声监测宫腔镜下剖宫产子宫瘢痕妊娠病灶清除术,能够明显缩短手术时间,减少盲目性,保证了宫腔镜手术安全,具有很重要的临床实用价值。%Objective To investigate the clinical value of color Doppler ultrasound on monitoring the hysteroscopic previous caesarean section scar pregnancy debridement. Methods From January 1999 to December 2012,the clinical data of 8 patients with previous caesarean section scar pregnancy debride-ment under color Doppler ultrasound monitoring in the second people’s hospital of Shantou were retro-spectively analyzed. Results Preoperative color Doppler ultrasound of the 8 patients with previous caesar-ean section scar pregnancy showed mixed mass at the cesarean section scar in lower uterine segment anterior wall. Hysteroscopic conservative treatment for debridement was successful by color Doppler ultrasound mo-nitoring,and the blood loss was less. Conclusions Color Doppler ultrasound is the main method for diag-nosis of previous caesarean section scar pregnancy. Color Doppler ultrasound in monitoring the hysteroscop-ic debridement of previous caesarean section scar pregnancy,can obviously shorten the operation time,re-duce blindness,ensure the safety of hysteroscopic surgery,and has very important clinical value.

  13. 超声在剖宫产子宫瘢痕妊娠诊治中的应用价值分析%Caesarean Section Scar Pregnancy, Ultrasound in the Diagnosis and Treatment Value Analysis

    Institute of Scientific and Technical Information of China (English)

    郭妮娜

    2013-01-01

    Objective This paper mainly discusses the ultrasound in the diagnosis of uterine cesarean section scar pregnancy patients clinical diagnostic value. Methods random selection from January 2010 to July 2012 to our this period were forty cases of cesarean section and postoperative uterine scar pregnancy patients as the research object, to al patients in B super mediated with percutaneous uterine artery embolization, quickly control vaginal bleeding, blocking the embryonic major blood supply and inhibition of embryonic growth, reduce the bleeding in the qing dynasty palace operation, to avoid the hysterectomy, summarize these patients after the ultrasonic image characteristics and the use of ultrasonography in uterine artery embolization in the treatment of curative ef ect was evaluated. Results the results showed that, forty cases of uterine scar pregnancy has simple gestational sac type 17 cases; Partly in uterine cavity type 9 cases;Mixed echo bag piece type 14 cases. Ultrasonic image display lower uterine segment scar place see pregnancy capsule or mixed echo bag piece, CDFI showed pregnancy capsule or bag piece perimeter visible rich blood flow through the low resistance, patients with conservative treatment after January, ultrasonic display gestational sac or bag piece of peripheral blood flow significantly reduced or even disappear, resistance index was also significantly increased before treatment, P<0.05. Conclusion the results showed that doppler ultrasound can clearly show the location of the uterine scar pregnancy, scope, uterine muscle wal thickness and blood supply, therefore, clinical use doppler ultrasonography can very accurate, timely to scar pregnancy for early diagnosis, ultrasonic technology can also dynamic observation scar pregnancy before and after treatment of the focus of the change, so ultrasonic inspection technology in scar pregnancy diagnosis, treatment in a very important meaning, it is worth clinical application.%目的本文主要探

  14. The main function of bionic air-bag midwifery skill reducing cesarean section rate%气囊仿生助产对降低剖宫产率的主要作用

    Institute of Scientific and Technical Information of China (English)

    黄崇梅; 王英; 何林清; 张琦

    2014-01-01

    目的:分析我国剖宫产率居高不下的原因,探讨应用气囊仿生助产技术对降低剖宫产率的可行性。方法:对我院未应用气囊仿生助产术前和已使用气囊仿生助产术后在我院分娩的孕产妇,从剖宫产指征、剖产率两方面进行回顾性对照研究。结果:未应用气囊仿生助产术前剖宫产指征中社会因素占56%,医学指征占44%,剖宫产率50%。应用气囊仿生助产术后社会因素占36%,医学指征占64%,剖宫产率下降至35%。讨论:运用气囊助产在分娩过程中缩短产程,减少会阴裂伤等优势。明显减少了剖宫产的社会因素指征,使剖宫产率明显下降。所以气囊仿生助产术是降低剖宫产率的有效措施,值得推广。%Objective: To analyze the reason of high cesarean section rate in our country, to investigate the feasibility of applying bionic air-bag midwifery skil to reduce cesarean section rate.Methods: We use the indication of cesarean section and cesarean section rate to undertake retrospective study about the differences of puerperal women in our hospital who apply bionic air-bag midwifery skil or not.Results: In the indication of cesarean section that puerperal women did not apply bionic air-bag midwifery skil, social factors account for 56% and medical indication accounts for 44%.The cesarean section rate is 50%.However, In the indication of cesarean section that puerperal women apply bionic air-bag midwifery skil, social factors account for 36% and medical indication accounts for 64%.The cesarean section rate drop to 35%.Discussion:Applying bionic air-bag midwifery skil have many advantages such as shortening the stage of labor during delivery and reducing perineal laceration. It makes the social factors of cesarean section and cesarean section rate decline obviously. In summary, bionic air-bag midwifery skil is an effective measure to reduce cesarean section rate and deserves popularity.

  15. The clinical efficacy of methotrexate and 5-fluorouracil in the interventional treatment of uterine incisional pregnancy after cesarean section: a comparative study

    International Nuclear Information System (INIS)

    Objective: To compare the interventional therapeutic efficacy of methotrexate (MTX) with that of 5-fluorouracil (5-FU) in treating uterine incisional pregnancy after cesarean section. Methods: A total of 92 patients with uterine incisional pregnancy after cesarean section, who were admitted to the hospital during the period from 2007 to 2010, were randomly divided into two groups: group MTX and group 5-FU. Patients in group MTX (n=46) received intra-arterial infusion of MTX (60-200) mg, which was followed by arterial embolization. Patients in group 5-FU (n=46) received intra-arterial infusion of 5-FU (1000-1250) mg, which was followed by arterial embolization. After the treatment the serum β-HCG and progesterone levels were determined daily for three succeeding days. The patients were followed up for three months. The clinical results were compared between the two groups. Results: The cure rates in group MTX and group 5-FU were 97.2% and 100%, respectively. No significant difference in cure rate existed between the two groups (P>0.05). A rapid fall in the serum β-HCG and progesterone levels within 1-3 days after the treatment were detected in 40 cases of group MTX and 38 cases of group 5-FU, and the decreasing extent was over 50%-80%, but the difference between the two groups was not significant (P>0.05). At the operation day, all patients of both groups had abdominal pain, and three patients in group MTX and 2 patients in 5-FU group had nausea and vomiting, but the difference between the two groups was not significant (P>0.05). During the follow-up period, no significant difference in the recovery time of the mental cycle and the hormone levels were found between the two groups (P>0.05). Conclusion: For the interventional treatment of uterine incisional pregnancy after cesarean section, the use of MTX has the same clinical efficacy as the use of 5-FU does. (authors)

  16. Influence of nursing intervention on breastfeeding after cesarean section%护理干预对剖宫产术后母乳喂养的影响

    Institute of Scientific and Technical Information of China (English)

    李敏

    2015-01-01

    目的:探讨护理干预对剖宫产术后母乳喂养影响。方法:收治剖宫产产妇100例,随机分为观察组和对照组各50例。对照组给予常规护理,观察组在常规护理的基础上给予一系列的护理干预。对两组数据进行对比。结果:观察组的母乳喂养率明显高于对照组。观察组的初次泌乳时间、产后泌乳充足率等情况均优于对照组。结论:针对性的护理干预能够较好地满足产妇的情感需要,增加剖宫产术后乳汁的分泌,提高母乳喂养质量。%Objective:To explore the influence of nursing intervention on breastfeeding after cesarean section.Method:100 cases of maternal with cesarean section were randomly divided into the observation group and the control group,with 50 cases in each group.The control group were given conventional nursing care,and the observation group were given a series of nursing intervention on the basis of conventional nursing care.The two sets of data were compared.Results:The breastfeeding rate of the observation group was obviously higher than that of the control group.The first lactation time,postpartum lactation ratios and so on of the observation group were better than those of the control group.Conclusion:Targeted nursing intervention could meet the emotional needs of maternal better and increase the lactation secretion after cesarean section and improve the quality of breastfeeding.

  17. Targeted monitoring of incision infection caused by cesarean section%剖宫产手术切口感染的目标性监测

    Institute of Scientific and Technical Information of China (English)

    蒋月平

    2012-01-01

    目的 探讨剖宫产切口感染的易感因素.方法 采用目标性监测,收集剖宫产手术切口感染危险因素及病原学资料.结果 1310例剖宫产中有62例发生切口感染,感染率4.73%,切口感染的危险因素为:肥胖、贫血、基础疾病、滞产或胎膜早破、应用抗菌药物、手术时间长、术中失血;62例切口感染者共培养病原菌30株,其中革兰阳性球菌17株,占56.67%,革兰阴性杆菌11株,占36.67%,真菌2株,占6.67%.结论 多种因素影响手术切口感染,对高危人群可采取有效措施,预防手术切口感染.%OBJECTIVE To explore the susceptible factors for incision infections due to cesarean section. METHODS Targeted monitoring was adopted, the risk factors for incision infections of cesarean section and the data on etiology were collected. RESULTS The incision infections occurred in 62 of 1310 cases who underwent cesarean section with the infection rate of 4. 73 %. The risk factors for incision infections included obesity, anemia, underlying diseases, prolonged labor or fetal premature rupture of fetal membrane, use of antibiotics, long duration of operation, and intraoperative hemorrhage. Of the 30 strains of pathogens cultured from patients with incision infections, there were 17 strains of gram-positive cocci, accounting for 56. 67%, 11 strains of gram-negative bacilli, accounting for 36. 67% and there were 2 strains of fungi, accounting for 6. 67%. CONCLUSION There are many factors that can influence the surgical incision infections. It is necessary for the high-risk population to take effective measures to prevent surgical incision infections.

  18. Experience of intraoperative uterus bleeding cesarean section among 15 cases%剖宫产术中子宫出血15例防治体会

    Institute of Scientific and Technical Information of China (English)

    丁云青

    2012-01-01

    OBJECTIVE To discuss the experience of intraoperative uterus bleeding cesarean section for 15 cases. METHODS 50 patients with uterine bleeding during childbirth and cesarean section were selected from January 2008 to December 2010 in obstetrics and gynecology. 50 cases were at the age of 20-35 years old; 16 cases were puerpera, and 34 cases were included. During recent 10 years, 50 cases entered intraoperative hemorrhage uterine cesarean section, eight suture of the uterus bleeding wound and oppression of the uterus were taken. RESULTS The uterus were preserved by effectively stopping bleeding. CONCLUSION Each case with massive bleeding may happen maternal, and need to alert instance lactation. Each instance surgery should take the strict preoperative discussion and risk assessment, prepare blood, especially for severe anemia, thrombocy-topenia or blood coagulation disorders.%目的 就剖宫产术中子宫出血15例防治体会进行探讨.方法 选取2008年1月~2010年12月某院妇产科进行剖宫产分娩且子宫出血的患者50例,50例中年龄为20~35岁;经产妇为16例,初产妇为34例.该院近10年来剖宫产术中遇到子宫大出血50例,采取了8字缝合子宫出血创面及压迫缝合子宫法.结果 有效制止出血成功保留子宫.结论 每一例产妇均有发生大出血可能,需要警觉每一例产妇.每一例手术需要有严格的术前讨论和风险评估,做好配血和备血,对重度贫血、血小板减少或凝血功能障碍术前要纠正.

  19. 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.

  20. Nursing Experience of Urinary Retention after Cesarean Section%浅谈产科术后尿潴留的护理研究

    Institute of Scientific and Technical Information of China (English)

    张亚伟

    2014-01-01

    Obstetric operation after catheter removal due to various causes of dysuria cause urinary retention, if processing is undeserved, prone to urinary tract infections, the clinical brought great suf ering to the patients. The nursing problems of urinary retention after cesarean section, talk about understanding yourself.%产科手术拔除尿管后常因各种原因引起排尿困难导致尿潴留,如处理不当容易发生泌尿系统感染,临床上给患者带来极大的痛苦。本文就剖宫产术后尿潴留的护理问题,谈一下自己的体会。

  1. El secuestro de Lucina (o cómo detener la epidemia de cesáreas Lucina's kidnap (or how to stop the cesarean section epidemic

    Directory of Open Access Journals (Sweden)

    Octavio Gómez-Dantés

    2004-02-01

    Full Text Available Las cesáreas han tenido un incremento explosivo en la mayoría de los países de ingresos altos y medios en años recientes. En América Latina los porcentajes de partos quirúrgicos alcanzan cifras de 30% en Brasil, 40% en Chile y 36% en México. En este ensayo se describe la relación de las cesáreas con diversas figuras mitológicas, se presenta una breve historia de esta operación y se discute el posible origen de su crecimiento reciente. Dentro de los factores relacionados con esta epidemia destacan los intereses económicos, la oferta de servicios especializados y la poca información que las mujeres embarazadas reciben respecto de las alternativas para el nacimiento de sus hijos. El trabajo concluye con un llamado al control de este tipo de intervenciones atendiendo a experiencias exitosas documentadas.Cesarean sections rates have increased considerably in high- and middle-income countries in recent years. In Latin America the rates of surgical births reached 30% in Brazil, 40% in Chile, and 36% in Mexico. This essay describes the relationship of cesarean section with several mythological characters, presents a brief history of surgical births, and discusses the possible origin of its explosive increase. Among the factors associated to this epidemic we can mention economic incentives, a mounting supply of specialists, and the lack of comprehensive information on birth alternatives for pregnant women.The essay concludes with a call for a generalized control of this procedure based on evidence gathered through different kinds of interventions.

  2. The Effects of Diclofenac Suppository and Intravenous Acetaminophen and their Combination on the Severity of Postoperative Pain in Patients Undergoing Spinal Anaesthesia During Cesarean Section

    Science.gov (United States)

    Niaki, Alireza Seyedi; Jafari, Seyed Yaghoub; Yousefi, Zahra; Aryaie, Mohammad

    2016-01-01

    Introduction The main tasks of postoperative care are postoperative pain and complications control which play an important role in accelerating the recovery of patient’s general condition. Aim This study was performed in order to compare the effects of diclofenac suppository, intravenous acetaminophen and their combination on the severity of postoperative pain in patients undergoing spinal anaesthesia for cesarean section in Sayyad Shirazi teaching Hospital, Gorgon, Iran. Materials and Methods This was a double-blind clinical trial on 90 patients undergoing cesarean section. The patients were randomly divided into three groups, group A: 100 mg diclofenac suppository, group B: 1000 mg intravenous acetaminophen, group C: 100 mg diclofenac suppository and 500 mg intravenous acetaminophen. The same spinal anaesthesia circumstances were applied for all the participants. At the end of surgery, pain severity was assessed according to VAS scale at different times. Data were then analysed by SPSS 18 statistical software. Results The mean age of participants was (28.27±6.07). There was significant difference between the mean pain scores of the three groups before the intervention (p=0.018), which was considered as co-variate. This difference was more notable between the combination of acetaminophen – diclofenac group and diclofenac alone. After the intervention, significant difference was observed in mean pain severity between acetaminophen group and the combination group and also between diclofenac and the combination group. During the study, the least mean pain severity was found in the combination group and the highest was observed in the diclofenac group. Conclusion Results of this study indicates a significant effect of concomitant use of intravenous acetaminophen and diclofenac suppository on pain severity reduction and reducing the need for repeated doses of narcotics and prolonging the postoperative analgesia. PMID:27630929

  3. 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

  4. 心理护理在剖宫产手术中的应用评价%Evaluation of the application of psychological nursing in cesarean section

    Institute of Scientific and Technical Information of China (English)

    杨英杰

    2015-01-01

    目的 讨论并分析在对剖宫产手术中引入心理护理的效果.方法 选取我院2011年8月~2012年6月收治的实施剖宫产的50例孕妇作为研究对象,随机分成观察组和对照组,对照组行常规护理,观察组患者在常规护理的基础上辅以心理护理,对两组孕妇的护理效果及基本情况进行分析和对比.结果 两组孕妇在产后恢复状况及护理满意度比较,观察组均优于对照组,差异有统计学意义(P<0.05).结论 对剖宫产患者行心理护理能够在一定程度提高产妇的恢复速度及护理满意度.%Objective To discussion and analysis on cesarean section surgery through introduction of the effect of psychological nursing.Methods Selection from August 2011 to June 2012 treated during the implementation of the cesarean delivery of 50 cases as the research object, takes the way of randomized patients were divided into observation group and control group on average, the control group patients with routine nursing care, observation group of patients on the basis of conventional nursing with psychological nursing, nursing effect and the basic condition of two groups of patients were analyzed and compared.Results Two groups of patients in maternal recovery and nursing satisfaction comparison, observation group were better than control group ,the difference was statistically signiifcant (P<0.05). Conclusion Line of psychological nursing in patients with cesarean delivery to a certain degree of improving maternal recovery rate and nursing satisfaction.

  5. 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.

  6. Analysis of 102 cases of repeat cesarean section within one year to previous%疤痕子宫间隔1年内妊娠再次足月剖宫产102例分析

    Institute of Scientific and Technical Information of China (English)

    王云霞; 余艳红; 葛绍明; 刘萍; 吴庆莉

    2014-01-01

    目的:探讨剖宫产后1年内妊娠再次足月剖宫产的安全性。方法:收集近3年深圳市福田区妇幼保健院及深圳福永人民医院收治的剖宫产术后1年内妊娠至足月的102例孕妇(研究组)及剖宫产术后2~3年妊娠至足月的100例孕妇(对照组)。分析孕妇再次妊娠距前次剖宫产的时间、再次妊娠的原因及此次妊娠的结局。结果:剖宫产术后1年内妊娠者多为4~11个月后妊娠,其终止妊娠方式均为剖宫产,其再次妊娠原因主要为未哺乳或母乳喂养少于4个月,未避孕或避孕失败;子宫下段厚度平均为(0.61±0.28) cm,与对照组(0.53±0.24cm)比较,差异有统计学意义(P0.05);两组的新生儿结局比较,差异无统计学意义(P>0.05)。结论:剖宫产术1年内妊娠并维持至足月,并未增加新生儿风险,但其安全性需高度重视。对剖宫产产妇,需在产褥期做好宣教,指导避孕,最好于术后2年再孕,若短期内已妊娠者,应密切观察及时予以适当的产科处理。%Objective:To explore the safety for pregnant women in one year after cesar-ean section and cesarean section again. Method:102 patients with term of pregnancy who ac-cepted cesarean section for less than 1 year and 200 cases with pregnancy after cesarean section 2 to 3 years were collected from recent 3 years from our hospital and Fuyong hospital. We ana-lyze its subsequent pregnancy from the time of previous cesarean section,pregnant reasons and the pregnant outcomes. Result:The time of these women was about 4 to 11 months after cesare-an section. The way of termination of pregnancy was cesarean section. Reasons of repeat preg-nancy due to not breastfeeding,less than 4 months breastfeeding,not contraception or contracep-tive failure. lower uterine segment thickness[(0. 61±0. 28)cm]compare to that in control group [(0.53±0. 24cm)]was significant difference(P0. 05). Their neonatal outcome were no significant differences(P>0 . 05

  7. 75 FR 3745 - NIH Consensus Development Conference on Vaginal Birth After Cesarean: New Insights; Notice

    Science.gov (United States)

    2010-01-22

    ... of uterine rupture during labor because a cesarean delivery leaves a scar in the wall of the uterus.... Some individual practitioners and hospitals in the U.S. have decreased or eliminated their use of...

  8. Obstetric Scar Endometriosis: Retrospective Study on 19 Cases and Review of the Literature.

    Science.gov (United States)

    Kaplanoglu, Mustafa; Kaplanoğlu, Dilek Kaya; Dincer Ata, Ceren; Buyukkurt, Selim

    2014-01-01

    Endometriosis is defined as the presence of functioning endometrial tissue outside the uterine cavity. This disease is one of the most common gynecologic disorders in reproductive age women. It generally occurs in pelvic cavity. But extrapelvic location has been defined (such as extremities, central nervous system, lungs, pleurae, liver, umbilicus, pericardium, urinary tract, intestines, and surgical scar tissue). Scar endometriosis is a rare disease and defined as presence of endometriotic lesions on the abdominal (such as cesarean section and hysterectomy) or vaginal (episiotomy) excision line. It is difficult to diagnose due to the extreme variability in presentation. The symptoms are nonspecific, typically involving pain, swelling at the incision site at the time of menstruation. Excision and histopathologic examination are necessary for diagnosis. We present a case series of obstetric scar endometriosis and review of the literature. PMID:27379258

  9. Clinical comparison of four treatment methods for cesarean scar pregnancy%剖宫产瘢痕部位妊娠的四种治疗方法的临床效果

    Institute of Scientific and Technical Information of China (English)

    林春丽; 廖湘玲; 聂岚; 陈晓翠

    2015-01-01

    Objective To explore the best approach to treatment of cesarean scar pregnancy (CSP). Methods A total of 138 patients with CSP treated between January and December, 2013 were retrospectively analyzed. The patients were treated with conservative drug therapy, direct curettage, uterine curettage after embolization, or open or transvaginal surgery. The amount of blood loss, proportion of patients with blooding loss greater than 50 mL, hospitalization days, and hospitalization expenses were compared among the groups. Results The median volume of blood loss was 370 mL in the conservative treatment group, 59 mL in direct curettage group, 67 mL in interventional therapy group, and 1425 mL in the surgical group, and the proportion of patients with blood loss over 50 mL was 76.9%, 38.8%, 27.5%, and 100%in the 4 groups, respectively. The midian hospital stay of the 4 groups was 9.0, 4.0, 6.0 and 10.0 days, with median hospitalization expenses of 12281.0, 3843.5, 14805.0, and 17202.2 RMB Yuan, respectively. All these data were significantly different among the 4 groups (P<0.05). Conclusions Direct curettage surgery should be encouraged for treatment of CSP. Embolization therapy can reduce the risk of bleeding but is associated with potential complications and more costly, and should be performed with caution. Open or trasnvaginal surgery can be considered in difficult cases of CSP, and its combination with interventional therapy is an option to better preserving the uterus.%目的:分析剖宫产瘢痕部位妊娠的(CSP)4种治疗方法有效性及优缺点。方法回顾性分析我科2013年1月~2013年12月共收治的138例CSP患者的病例资料。该138例患者根据其治疗方法分为4组:药物保守(药物组,13例),直接清宫(清宫组,80例),双侧子宫动脉栓塞后清宫手术(栓塞组,40例),剖腹或是经阴式手术行病灶清除术(手术组,5例),比较各组患者治疗过程中出血量、出血量

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

    Directory of Open Access Journals (Sweden)

    Paulo Fontoura Freitas

    2005-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张锦霞; 刘丽芳

    2015-01-01

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

  12. 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.

  13. 剖腹产术后母乳喂养的临床护理体会%Clinical Nursing Experience of Breastfeeding after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    黄利

    2014-01-01

    Objective Discuss the clinical ef ect of the nursing to breastfeeding after cesarean section operation .Methods Select 286 cases of the clinical data of cesarean section puerperas , al patients were randomly divided into two groups, the observation group were given comprehensive clinical care, and the control group were given maternity care based on clinical care. Compare the clinical ef icacy of two groups' puerperas. Results The observation group has 97.2% puerperas, breast milk is enough, breastfeeding rates is 93.7%,and the control group has 75.5% puerperas, breast milk is not enough, breastfeeding rates is 81.1%,it had statistical y significant difference ( <0.05). Conclusion The clinical care could significantly improve breast milk secretion,increase breastfeeding rate, it is worth to promote the application clinically.%目的:探讨临床护理对剖腹产术后母乳喂养的临床影响。方法选取286例破腹产产妇,随机分成两组,观察组给予全面临床护理和对照组实施基础产科护理,对比两组产妇的护理效果。结果观察组术后97.2%的产妇泌乳充足,母乳喂养率为93.7%,对照组术后75.5%的产妇泌乳充足,母乳喂养率为81.1%,两组差异有统计学意义(P<0.05)。结论临床护理可以显著改善剖腹产术后母乳分泌情况,提高母乳喂养率,值得在临床上推广。

  14. Related Factors of Elective Cesarean Section: A Case-Control Study%选择性剖宫产的相关因素研究

    Institute of Scientific and Technical Information of China (English)

    李艳芳; 李越游; 林黛

    2010-01-01

    目的 总结广州市番禺区妇幼保健院在过去十年剖宫产率的变化和趋势,分析2009年该院病人相关的和医师相关的因素与选择性剖宫产的关系.方法 这是一个病例对照研究,病例是应病人自己要求或手术指征不明确的选择性剖宫产分娩的妇女,对照则是有明确手术指征的剖宫产分娩妇女.PS power软件用于计算样本量,通过分层随机抽样的方法,在4176个2009年住院分娩的病历中随机抽取709个总样本(其中病例数是348个,对照是361个).通过病历回顾,收集所有与病人相关的及与医生相关的非医学因素.采用SPSS 16.0软件进行数据处理,运用卡方检验和Logistic回归方程进行检测.结果 该院的剖宫产率从2000年的41.8%到2009年的59.9%,总体呈一个线性的提高.选择性剖宫产更多发生在正常上班时间,产检次数越多的病人越容易在无手术指征的情况下选择剖宫产.结论 在本研究人群中,产科医师的偏好影响病人对剖宫产的选择,医师便利及害怕医疗纠纷可能是医师选择治疗方式的主要驱动因素.因此,选择性剖宫产率的控制措施应更侧重于改变医师的行为模式,而不仅仅是患者教育.%Objective To summarize the trend of CSR at a district public hospital in Guangzhou in the past decade and to identify patient and physician-related factors for elective cesarean section in 2009.Methods This was a case-control study. All available non-medical risk factors were collected from inpatient medical records. PS power software was used to calculate sample size. Cases were women who underwent Cesarean delivery at maternal recquest or for unclear obstetric indication and controls were women who underwent Cesarean delivery with one or more medical indications. A total sample size of 709 (348 cases and 361 controls) was obtained via stratified random sampling from 4176 in-patient delivery records in 2009.Risk factors for CS were examined

  15. ANALYSIS ON THE MAIN FACTORS OF INCREASING CESAREAN SECTION RATE IN LAST 6 YEARS%6年剖宫产手术指征变迁因素分析

    Institute of Scientific and Technical Information of China (English)

    潘翠金

    2011-01-01

    [Objective] To analyze the main factors of increasing cesarean section rate in recent 6 years, and to seek concrete measures to reduce the rate. [Methods] From 2001 to 2006, all cases of cesarean section in our hospital were analyzed on the composition and sequence of the main surgical indications by retrospective analysis. [Results]① Cesarean section rate increased year by year; ② Changes in the main factors included: the iincrease of cesarean delivery rate, social factors, oligohydramnios, huge children; and the decrease of fetal distress and the relative cephalopelvic disproportion; few change in fetal abnormalities, pregnancy after cesarean section and narrow pelvis. [Conclusion] Social factors are the main factor about the high cesarean section rate, and the rate must be reduced by full support from the whole society.%[目的]剖析近6年剖宫产率逐步升高的主要影响因素.为寻求降低剖宫产率的具体措施提供依据.[方法]对2001~2006年间某院剖宫产病例的主要手术指征的构成比及主要排序的变化进行回颐性分析.[结果]①剖宫产率呈逐年上升趋势;②剖官产主要手术指征的变迁因素:剖宫产构成比中,社会因素、羊水过少、巨大儿有显著升高;胎儿窘迫、相对头盆不称有所下降;胎位异常、剖宫产再孕、骨盆狭窄变化不大.[结论]社会因素是造成剖宫产率居高不下的主要因素,要降低社会因素造成的剖官产率必须全社会给予大力支持.

  16. 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。

  17. 甲氨蝶呤不同给药途径联合宫腔镜治疗子宫切口瘢痕妊娠患者的临床疗效观察%Clinical efficacy observation of Methotrexate of different administration routes combined with hysteroscopy in treatment of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    高丹; 李玲

    2016-01-01

    Objective:To investigate clinical efficacy of Methotrexate of different administration routes combined with hysteros-copy in treatment of cesarean scar pregnancy. Methods:50 cases with cesarean scar pregnancy were divided into group A and group B with 25 cases in each group according to a completely random method. The patients in group A were given Methotrexate through intra-muscular injection combined with hysteroscopy treatment, while those in group B group received Methotrexate through pregnancy sac in-jection combined with hysteroscopy treatment. The treatment effects of the two groups were compared. Results: The time for blood HCG value decreasing to 1000u/L, hysteroscopic operation time, hospitalization time and menstrual recovery time of group A were lon-ger than those of group B;intraoperative bleeding volume and Methotrexate dosage were significantly higher than those of group B;the complication rates were higher than those of group B, and all the differences were statistically significant (P<0. 05). Conclusions:For the patients with cesarean scar pregnancy, Methotrexate through pregnancy sac injection combined with hysteroscopy treatment has better effects than Methotrexate through intramuscular injection combined with hysteroscopy treatment.%目的::观察甲氨蝶呤不同给药途径联合宫腔镜治疗子宫切口瘢痕妊娠患者的临床疗效。方法:剖宫产后子宫切口瘢痕妊娠的患者50例按照完全随机的方法分成A组和B组,每组各25例。 A组患者给予甲氨蝶呤肌肉注射联合宫腔镜治疗;B组患者给予甲氨蝶呤妊娠囊注射联合宫腔镜治疗,对比两组患者的治疗效果。结果:A组患者血HCG值下降至1000 u/L的时间、宫腔镜手术操作时间、住院时间及月经恢复正常时间均长于B组,术中出血量甲氨蝶呤用量明显多于B组,且术后并发症发生率高于B组,其差异均具有统计学意义(P<0.05)。结论:对于剖宫产后子宫切口

  18. A comparative study of hysteroscopic electrocoagulation and vaginal operation in the treatment of cesarean scar diverticulum%宫腔镜电凝术与阴式手术治疗子宫切口瘢痕憩室的对比研究

    Institute of Scientific and Technical Information of China (English)

    于芳; 贾海军; 廖飞燕; 王杜平; 王庆一

    2015-01-01

    目的:对比分析宫腔镜电凝术与阴式手术治疗子宫切口瘢痕憩室的临床效果。方法选取2012~2014年在珠海市妇幼保健院30例子宫切口瘢痕憩室患者的临床资料,14例患者采用腹腔镜下行宫腔镜电凝术纳入电凝组,16例患者采用腹腔镜联合阴式手术纳入阴式组,比较两组患者手术时间、术中出血量、住院时间,术后2月、6月经期恢复情况。结果电凝组手术时间(31.50±7.03) min、术中出血量(4.25±1.39)mL,均少于阴式组[(75.38±10.88)min,(16.25±7.44) mL](P﹤0.05)。术后6月经期恢复正常率阴式组[93.8%(15/16)]高于电凝组[64.3%(9/14)](P﹤0.05)。结论宫腔镜电凝治疗子宫切口瘢痕憩室,具有手术时间短、术中创伤出血少,为近期有生育要求者的首选治疗方法,而阴式手术远期效果更佳。%Objective To compare the clinical effect of hysteroscopic electrocoagulation and vaginal operation in the treatment of cesarean scar diverticulum.Methods Clinical data of 30 patients with cesarean scar diverticulum in Zhuhai Maternal and Child Health Hospital from 2012 to 2014 were selected. 14 cases treated by hysteroscopic electrocoagulation were selected into electrocoagulation group, 16 cases treated by laparoscopy combined with vaginal operation were selected into vaginal operation group. The operation time, blood loss, hospital stay, and menstrual period recovery rates 2 months and 6 months after the operation were compared.Results The operation time [(31.50 ±7.03) min] and blood loss [(4.25 ±1.39) mL] of electrocoagulation group were less than that of vaginal operation group[(75.38 ±10.88) min, (16.25 ±7.44) mL] (P<0.05).The menstrual period recovery rate after 6 months of vaginal operation group [93.8%(15/16)]was higher than electrocoagulation group [64.3%(9/14)] (P <0.05 ) .Conclusion With shorter operation time and less blood loss during the operation

  19. 2011-2012年海南省临高县中医院剖宫产率影响因素分析%Investigation on the cesarean section rate of puerperants in Hainan Lingao hospital from 2011 to 2012

    Institute of Scientific and Technical Information of China (English)

    陈克芳

    2014-01-01

    目的:分析研究2011至2012年临高县中医院的剖宫产率,并探讨其相关影响因素。方法选取2011年1月至2012年12月该院2248例产妇为研究对象,对其分娩方式进行分析研究,比较不同病理性因素及非病理性因素者的剖宫产率。结果2248例产妇中共有428例剖宫产,剖宫产率为19.04%,其中存在胎儿宫内窘迫、胎位异常、妊娠期并发症、巨大儿的产妇剖宫产率高于其他产妇,低文化程度、高体质量指数、低社会支持程度及初产妇的剖宫产率高于其他产妇,且其均与剖宫产有密切关系(均P<0.05)。结论2011至2012年该院剖宫产率控制相对较好,且其中病理性及非病理性因素均相对较多,应给予针对性干预。%ObjectiveTo analyze and study the cesarean section rate of puerperants in our hospital from 2011 to 2012,and investigate the related influence factors.Methods2248 puerperants in our hospital from January 2011 to December 2012 were selected as research object,and the delivery mode of all the puerperants were analyzed and studied,then the cesarean section rate of puerperants with different pathological factors and non-pathological factors were analyzed and compared.Results428 cases of 2248 puerperants were with cesarean section,the cesarean section rate was 19.04%,and the cesarean section rate of puerperants with fetal distress,abnormal fetal position,pregnancy complications and giant baby were higher than those of other puerperants,the cesarean section rate of lower education degree,higher BMI,lower social support degree and primiparas were higher than those of other puerperants,and those factors all had closed correction to the cesarean section,allP<0.05,there were all significant differences.ConclusionThe cesarean section rate of puerperants in our hospital from 2011 to 2012 is well controlled,and the pathological factors and non-pathological factors are both more,so they should be paid to

  20. 育龄期妇女选择剖宫产的影响因素分析%Analysis of the Factors Affecting the Choice of Cesarean Section in Women of Childbearing Age

    Institute of Scientific and Technical Information of China (English)

    黄凯清

    2015-01-01

    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 outcomes showed no statistical significance(P ﹥ 0. 05). Conclusion Occupation,age,culture and social factors causing midwifery skills in women of childbearing age is the important reason for the choice of cesarean section,to improve the professional level of the medical staff,the operation indications and rational control,is conducive to reducing the rate of cesarean section.%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

  1. 剖宫产产后出血的原因及临床处理%Etiology and clinical treatment of postpartum hemorrhage following cesarean section

    Institute of Scientific and Technical Information of China (English)

    陈惠萍; 朱月华; 曹卉

    2011-01-01

    Objective To explore the etiology of postpartum hemorrhage following cesarean section and effective therapy.Methods A retrospective analysis was conducted on the clinical data of 76 cases of postpartum hemorrhage following cesarean section.Results The etiology of hemorrhage included: uterine atony in 48 cases ( 63.2% ), placental factors in 17 cases ( 22.4% ), uterine laceration in 8 cases ( 10.5% ) , and coagulative abnormalities in 3 cases (3.9%).There was a higher incidence of hemorrhage in the caesarean section group than in the vaginal delivery group ( 3.5% vs.1.3%, P < 0.01 ).The volumes of hemorrhage ranged from 700 ml to 3 500 ml.The cases with hemorrhage of less than 1000 ml, 1000 to 2 000 ml and more than 2 000 ml group accounted for 67.1%, 26.3% and 6.6%, respectively.The caesarean section group had a higher incidence of hemorrhage volume of 1 000 to 2 000 ml than the vaginal delivery group (P < 0.05).All the patients were successfully rescued, of whom 4 patients underwent hysterectomy (5.3% ).Conclusion Successful reduction of the incidence of postpartum hemorrhage following caesarean section rests on the proper awareness of the indications of cesarcan section; selection of rapid and effective methods targeting the etiology of hemorrhage, improvement of the surgical skills and reinforcement of the postoperative treatment, etc.%目的 探讨剖宫产产后出血的原因及有效的处理方法.方法 对76例剖宫产产后出血患者的临床资料进行回顾性分析.结果 出血原因为子宫收缩乏力 48 例(占63.2%),胎盘因素 17例(占22.4%),切口撕裂8例(占10.5%),凝血功能异常3例(占3.9%).剖宫产组产后出血发生率明显高于阴道产组(3.5% vs.1.3%,P<0.01).产后出血量700~3 500 ml,出血量<1 000 ml、1 000~2 000 ml和>2 000 ml的病例分别占67.1%、26.3%和6.6%.出血量在1 000~2 000 ml发生率剖宫产组高于阴道产组(P<0.05).76例剖宫产出血病

  2. 产科护理新模式在产科中的应用及对降低剖宫产率的影响%NewModelofObstetricCareAppliedinObstetricandtoReducetheRateofCesareanSection

    Institute of Scientific and Technical Information of China (English)

    黎秀梅

    2013-01-01

    Objective To explore speciifc implementation methods of obstetric new care model and its impact on reducing the rate of cesarean section. Methods 2800 cases pending production of healthy maternal were randomly divided into the study group of 1500 cases and the control group of 1300 cases, the control group were given conventional obstetric care, the study group were given a new model of obstetric care for prenatal care intervention. The cesarean section rate of two groups was compared. Results The cesarean section rate of the study group was signiifcantly lower than the control group (P<0.01). Conclusion The new model of obstetric care will help reduce the rate of clinical cesarean section, promote maternal and child healthy.%  目的探讨产科护理新模式的具体实施方法及其对降低剖宫产率的影响。方法将2800例待产的健康孕产妇随机分为研究组1500例和对照组1300例,对照组采用常规产科护理方法,研究组患者采用产科护理新模式实施产前护理干预。比较两组剖宫产率。结果研究组剖宫产率明显低于对照组(P<0.01)。结论产科护理新模式有利于降低临床剖宫产率,促进母婴健康。

  3. 产科急救流程对降低剖宫产术中出血的影响%Emergency procedures to reduce obstetrics cesarean section the influence of intraoperatie bleeding

    Institute of Scientific and Technical Information of China (English)

    向本凯

    2012-01-01

    目的探讨应用产科急救流程对剖宫产术中出血的影响.方法将实验组(2010年)完善产科急救流程后的剖宫产妇,与对照组(2007年)完善产科急救流程前的剖宫产妇,进行对比分析两组产妇术时出血的情况.结果实验组剖宫产产妇出血率明显降低(P<0.01),且术中平均出血量比对照组减少,差异有统计学意义(P<0.01).结论规范产科急救流程,可以提高产科救治能力及产科工作质量,降低剖宫产出血率及医疗风险,从而保障母婴的安全及健康.%objective to explore the application of emergency management program for maternity cesarean section the influence of intraoperatie bleeding. Methods will the experimental group (2010) improve obstetrics emergency procedures after cesarean section of the woman management, and control group (2007) perfect the emergency management program of maternity before cesareandelivery woman, Carries on the analysis to two groups of patients intraoperatie bleeding. Results the bleeding was obviously reduce maternal cesarean section (P <0.01), and the average amount of blood loss in this than the control group, reduce statistical significance was found between (P <0.01). Conclusion standard maternity emergency process, you can improve obstetrics treatment ability and maternity work quality, reduce the cesarean section rate and bleeding medical risk to guarantee the maternal and infant safety andhealth.

  4. 子宫动脉栓塞联合甲氨蝶呤治疗子宫切口瘢痕妊娠的临床分析%Clinical analysis of uterine artery embolism combined with Methotrexate in treatment of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    钟婉秀

    2014-01-01

    Objective To observe the clinical effect of uterine artery embolism ( UAE ) combined with Methotrexate in treatment of cesarean scar pregnancy ( CSP ) . Methods 64 cases of the patients were randomly divided into observation group and control group,with 32 cases in each group. The cases in observation group were treated with UAE and Methotrexate,and underwent curettage in 24 to 48 hours. The cases in control group were given Methotrexate by local injection and curettage. The clinical effects of two groups were compared. Results The cure rate,day 4 serumβ-HCG level decline in observation group were significantly higher than control group(P0. 05 ) . Conclusion Using uterine artery embolism combined with Methotrexate in treatment of CSP is effective,safe and reliable,which is worthy of clinical application.%目的:观察子宫动脉栓塞( uterine arterial embolization,UAE)联合甲氨蝶呤( Methotrexate, MTX)治疗子宫切口瘢痕妊娠( cesarean scar pregnancy,CSP)的临床疗效。方法将64例CSP患者随机分为观察组和对照组,每组各32例,观察组行UAE联合MTX治疗,栓塞治疗后24~48 h内在B超监测下行胚胎钳刮术;对照组在阴道超声引导下局部注射MTX,择期行清宫术,比较两组的临床疗效。结果观察组治愈率、第4天血清β-人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)的降幅高于对照组(P0.05)。结论 UAE联合MTX治疗CSP疗效显著,安全可靠,值得临床推广。

  5. A Complicated Case of Tacrolimus-Induced Rapid Remission after Cesarean Section in the Early Third Trimester for Refractory Severe Ulcerative Colitis Flaring in the Initial Period of Gestation

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    Takashi Mizushima

    2011-04-01

    Full Text Available A 36-year-old woman who had been diagnosed with ulcerative colitis at the age of 17 years was referred to our hospital because of severe abdominal pain and repeated bloody diarrhea that persisted during pregnancy despite combination therapy with high-dose corticosteroids and weekly granulocyte and monocyte adsorptive apheresis (GMA. She underwent combination therapy consisting of high-dose corticosteroids, intensive GMA (two sessions per week and vancomycin, which was used to eradicate Clostridium difficile, under total parenteral nutrition control until the estimated weight of her fetus reached 1,000 g. This combination therapy was partially successful, resulting in almost complete disappearance of abdominal pain and a marked decrease in stool frequency. However bloody diarrhea persisted and the patient developed anemia and hypoalbuminemia and was unable to prolong her gestation time. Cesarean section was conducted at 28 weeks of gestation without any congenital abnormalities or neurological defects. Oral administration of tacrolimus was begun 7 days after cesarean section, which was followed by rapid induction of remission. Corticosteroids were then gradually tapered off. Tacrolimus is one therapeutic option after cesarean section in pregnant patients who do not respond well to GMA and high-dose corticosteroids for persistent active ulcerative colitis.

  6. 影响剖宫产产妇母乳喂养的因素分析及护理对策%Impact of cesarean section factor analysis of breastfeeding and nursing strategy

    Institute of Scientific and Technical Information of China (English)

    高娟; 郭军(指导)

    2012-01-01

      Objective: To investigate the causes and care of the breastfeeding obstacles after cesarean section. Methods: The successful implementation of exclusive breastfeeding, breastfeeding factor analysis of 150 cases after cesarean section, taken missionary preoperative, intraoperative premature, postoperative early as sucking and select a comfortable breastfeeding position for cesarean section such as nursing response. Results: The maternal eliminate concerns to master the correct techniques of breastfeeding. Conclusion: 90% of mothers discharged from the hospital to have enough milk.%  目的探讨剖宫产术后母乳喂养障碍的原因及护理。方法为使剖宫产产妇成功地实施纯母乳喂养,通过对150例剖宫产术后影响母乳喂养因素的分析,采取术前宣教、术中早接触、术后早吸吮及选择舒适哺乳体位等护理对策。结果使产妇消除了顾虑,掌握了正确的母乳喂养技巧。结论90%的产妇在出院时有了足够的乳汁。

  7. 不同类型子宫瘢痕妊娠动脉栓塞治疗前后病灶血流变化的研究%Study on hemodynamic changes of pregnancy tissue material before and after the artery embolization in different types of cesarean scar pregnancy

    Institute of Scientific and Technical Information of China (English)

    陈莉婷; 陈向东; 汪洪

    2016-01-01

    目的:通过对各种类型的子宫瘢痕妊娠(CSP)进行子宫动脉栓塞治疗,观察动脉栓塞治疗前后病灶局部的血流动力学变化,探讨动脉栓塞治疗对各种类型子宫瘢痕妊娠的疗效。方法选择佛山市妇幼保健院2007年1月~2015年12月收治的CSP患者共124例,应用B超影像学将CSP患者分为Ⅰ型、Ⅱ型及ⅡⅢ型,分别对应为A(38例)、B(46例)、C(40例)三组,全部行双侧子宫动脉栓塞治疗,72h后行清宫术,比较三组患者介入治疗的有效率、介入治疗后血液β-HCG下降情况及妊娠组织物局部的血流阻力指数变化。结果(1)三组患者有效率分别为95.00%、95.83%及100.00%,无统计学差异(P>0.05)。总有效率达96.88%。(2)三组患者血流阻力指数下降50%所需时间分别为A组(42.65±13.17)h,B组(56.31±16.25)h, C组(29.72±9.26)h,三组患者时间差别之间的比较差异均有统计学意义(P<0.05)。(3)三组患者血液β-HCG下降50%所需时间分别为A组(5.37±1.52)d,B组(5.84±1.21)d,C组(3.52±1.02)d,其中A、B两组差异无统计学意义(P>0.05),A、C与B、C两组之间差异有统计学意义(P<0.05)。结论动脉栓塞治疗对各种类型的CSP均有较好的疗效,但对于治疗的个体化实施方案的确定,仍需要进一步研究。%Objective By performing uterine artery embolization in treating cesarean scar pregnancy, to observe hemodynamic changes of pregnancy tissue material before and after uterine artery embolization in different types of uterine scar pregnancy, and to explore the effects of uterine artery embolization in treating cesarean scar pregnancy. Methods 124 patients with cesarean scar pregnancy were divided into typeⅠ, typeⅡ and type Ⅲ by B ultrasound imaging, which were selected from January 2007 to December 2015 in the Maternal and Child Health Hospital of Foshan City in this

  8. History of Cesarean Section Associated with Childhood Onset of T1DM in Newfoundland and Labrador, Canada

    Directory of Open Access Journals (Sweden)

    J. Phillips

    2012-01-01

    Full Text Available Objectives. Newfoundland and Labrador (NL has one of the highest incidences of Type 1 diabetes mellitus (T1DM worldwide. Rates of T1DM are increasing and the search for environmental factors that may be contributing to this increase is continuing. Methods. This was a population-based case control design involving the linkage of data from a diabetes database with live birth registration data. 266 children aged 0–15 years with T1DM were compared to age- and gender-matched controls. Chi-square analysis and multivariate conditional logistic regression were carried out to assess maternal and infant factors (including maternal age, marital status, education, T1DM, hypertension, birth order, delivery method, gestational age, size-for-gestational-age, and birth weight. Results. Cases of T1DM were more likely to be large-for-gestational-age (P=0.024 and delivered by C-section (P=0.009 as compared to controls. C-section delivery was associated with increased risk of T1DM (HR 1.41, P=0.015 when birth weight and gestational age were included in the model, but not when size-for-gestational-age was included (HR 1.3, P=0.076. Conclusions. Birth by C-section was found to be a risk factor for the development of T1DM in a region with high rates of T1DM and birth by C-section. These findings may have an impact on health practice, health care planning, and future research.

  9. GENERALIZED PERITONITIS WITH UTERINE INCISION NECROSIS WITH DEHISCENCE FOLLOWING CESAREAN SECTION PRESE N TING AS GENITOURINARY FISTULA: A UNIQUE COMPLICATION

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    Madhuri

    2014-01-01

    Full Text Available Generalized peritonitis following lower segment caesarean section with uterine incision necrosis and dehiscence presenting as genitourinary fistula is very unusual. Herein we report a case of 28 years old woman who was received in emergency hours as a referred case from a private nursing home with history of caesarean section done 11 days back for premature rupture of membranes and pregnancy induced hypertension. She came w ith complaints of continuous watery discharge per vaginum , high grade fever with chills and rigor , nausea , vomiting , breathlessness , severe diffuse abdominal pain and distension of abdomen since last 4 - 5 days. Here acute abdomen series was done. The urologist ruled out genitourinary fistula. CECT of abdomen was done. She was diagnosed to be a case of generalized peritonitis following ca esarean section with necrosis and dehiscence of suture line of uterus through which ascitic fluid was being drained into vagina. Consequently , patient underwent laparotomy. Gentle adhesiolysis with supra cervical hysterectomy was done. Thorough drainage an d irrigation of pelvi - abdominal cavity was done. Post - operative period was uneventful

  10. 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.

  11. 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。

  12. 浅谈剖宫产术后伤口感染的因素调查与护理分析%Factors and nursing analysis of wound infection after cesarean section on the

    Institute of Scientific and Technical Information of China (English)

    徐红霞

    2015-01-01

    Objective To analyze the factors of wound infection after cesarean with care. Methods Cesarean section in our hospital's 63 cases of infected wounds were classified as Observer Group, 62 cases were uninfected control group to investigate and analyze the reasons for infected wounds, and its targeted care. Results The difference between the two groups of mothers in terms of the basic factors, pregnancy and surgical factors and other factors statistically significant (P<0.05), wound infection after cesarean section description associated with these factors. Conclusion Wound infection after cesarean is the result of the combined effects of multiple factors under.%目的:分析剖宫产术后伤口感染的因素与护理。方法将我院行剖宫产术的29例伤口受感染者列为观察组,30例未感染者为对照组,调查并分析伤口受感染的原因,并对其进行针对性护理。结果两组产妇在基本因素、妊娠因素及手术因素等方面的比较差异具统计学意义(P<0.05),说明剖宫产术后伤口感染与上述因素相关。结论剖宫产术后伤口感染是多因素综合作用下的结果。

  13. 体温维持对剖宫产产妇的保护作用%The Protective Effect of Body Temperature Maintenance on Puerpera under Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    邹彦; 王海艳

    2016-01-01

    Objective To study the protective effect of maintaining body temperature for the puerpera under cesarean section.Methods Total of 106 cases receiving cesarean section in Affiliated Hospital of Hainan Medical College from Jan.2013 to Dec.2013 were included in the study.They were divided into observation group and control group by random number table method,53 cases each.The control group was treated with conventional surgery,and the observation group received insulating measures on the basis of the control group.The perioperative changes in body temperature,intraoperative basic situation and postoperative shivering of the two groups were compared and analyzed .Results Three min after entering the operation room,there was no significant difference on the body temperature between the observation group and the con-trol group(P>0.05).However,during surgery and after surgery,body temperature of the observation group was significantly better than the control group.The postoperative temperature reached(36.82 ±0.57) ℃ in the observation group,the patient′s body temperature was gradually reduced as the surgery proceeded,but gradually picked up to normal at the end of the surgery .The operative time of the observation group was lower than the control group[(78 ±10) min vs (84 ±11) min],the difference was statistically significant(P 0.05 ) ,但在术中及术后,体温均明显优于对照组,术后体温达到(36.82 ±0.57 ) ℃,两组患者的体温随着手术的进行逐步降低,但于手术完结时逐步回升,直至正常;观察组患者手术时间短于对照组[(78 ±10) min 比(84 ± 12) min],差异有统计学意义(P <0.01),且术中出血量、输液量及尿量显著低于对照组[(233 ± 21) mL比(342 ±32) mL,(1354 ±211) mL比(1423 ±347) mL,(98 ±27) mL比(246 ±52) mL],差异有统计学意义( P <0.05 或 P <0.01 );经治疗,观察组患者寒战总发生率显著低于对照组[11.32%(6/53)比39.62%(21/53)],差异有统计学意义(P<0.05).

  14. 68 cases of cesarean section hemorrhage in clinical analysis and prevention measures%68例剖宫产术中出血的临床分析与预防措施

    Institute of Scientific and Technical Information of China (English)

    杨坤

    2016-01-01

    Objective To investigate the causes and preventive measures of hemorrhage during cesarean section.Methods 68 cases of postpartum hemorrhage during cesarean section were selected from January 2015 to November 2015. The clinical data were retrospectively analyzed. The causes of bleeding during cesarean section were analyzed, and the effective measures were given.Results 68 cases of cesarean section surgery bleeding women due to placental factors produce maternal bleeding in 22 cases(32.4%); because of blood coagulation disorders produce maternal hemorrhage in 14 cases(21.9%), due to incision and produce abnormal maternal hemorrhage 12 cases(17.6%); uterine inertia due to produce maternal hemorrhage in 16 cases(23.5%); due to uterine fibroids have maternal bleeding in 4 cases(5.9%).Conclusion Cesarean section caused by placental factors, coagulation dysfunction, abnormal incision and uterine atony, are the main factors of hemorrhage during cesarean section should be in the perinatal period to take corresponding preventive measures according to the specific situation of the maternal and maternal formulation scientific and reasonable treatment method, ensure the cesarean section operation smoothly.%目的:探讨剖宫产术中出血原因以及预防措施。方法选取2015年1月~2015年11月收治的剖宫产术中出血产妇68例,对其临床资料进行回顾性分析,分析剖宫产术中出血原因,并给出切实有效的预防措施。结果68例剖宫产术中出血产妇中因胎盘因素产生出血的产妇22例(32.4%);因凝血障碍产生出血的产妇14例(21.9%);因切口异常产生出血的产妇12例(17.6%);因宫缩乏力产生出血的产妇16例(23.5%);因子宫肌瘤产生出血的产妇4例(5.9%)。结论剖宫产手术中引发产妇术中出血的因素主要有胎盘因素、凝血功能障碍、切口异常以及宫缩乏力等,应该在围产期根据产妇具体情况采取相对应的预防措

  15. Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis

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    Gurol-Urganci Ipek

    2011-11-01

    Full Text Available Abstract Background Objective: To compare the risk of placenta previa at second birth among women who had a cesarean section (CS at first birth with women who delivered vaginally. Methods Retrospective cohort study of 399,674 women who gave birth to a singleton first and second baby between April 2000 and February 2009 in England. Multiple logistic regression was used to adjust the estimates for maternal age, ethnicity, deprivation, placenta previa at first birth, inter-birth interval and pregnancy complications. In addition, we conducted a meta-analysis of the reported results in peer-reviewed articles since 1980. Results The rate of placenta previa at second birth for women with vaginal first births was 4.4 per 1000 births, compared to 8.7 per 1000 births for women with CS at first birth. After adjustment, CS at first birth remained associated with an increased risk of placenta previa (odds ratio = 1.60; 95% CI 1.44 to 1.76. In the meta-analysis of 37 previously published studies from 21 countries, the overall pooled random effects odds ratio was 2.20 (95% CI 1.96-2.46. Our results from the current study is consistent with those of the meta-analysis as the pooled odds ratio for the six population-based cohort studies that analyzed second births only was 1.51 (95% CI 1.39-1.65. Conclusions There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated. Given the placenta previa rate in England and the adjusted effect of previous CS, 359 deliveries by CS at first birth would result in one additional case of placenta previa in the next pregnancy.

  16. Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section

    Science.gov (United States)

    Bizoń, Magdalena; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2016-01-01

    Abstract Background: Surgical site infections (SSI) occur in 1.8%–9.2% of women undergoing cesarean section (CS) and lead to greater morbidity rates and increased treatment costs. The aim of the study was to evaluate the efficacy and cost-effectiveness of dialkylcarbamoyl chloride (DACC) impregnated dressings to prevent SSI in women subject to CS. Methods: Randomized, controlled trial was conducted at the Mazovian Bródno Hospital, a tertiary care center performing approximately 1300 deliveries per year, between June 2014 and April 2015. Patients were randomly allocated to receive either DACC impregnated dressing or standard surgical dressing (SSD) following skin closure. In order to analyze cost-effectiveness of the selected dressings in the group of patients who developed SSI, the costs of ambulatory visits, additional hospitalization, nursing care, and systemic antibiotic therapy were assessed. Independent risk factors for SSI were determined by multivariable logistic regression. Results: Five hundred and forty-three women undergoing elective or emergency CS were enrolled. The SSI rates in the DACC and SSD groups were 1.8% and 5.2%, respectively (p = 0.04). The total cost of SSI prophylaxis and treatment was greater in the control group as compared with the study group (5775 EUR vs. 1065 EUR, respectively). Independent risk factors for SSI included higher pre-pregnancy body mass index (adjusted odds ratio [aOR] = 1.08; [95% confidence interval [CI]: 1.0–1.2]; p SSD application (aOR = 2.94; [95% CI: 1.1–9.3]; p < 0.05). Conclusion: The study confirmed the efficacy and cost-effectiveness of DACC impregnated dressings in SSI prevention among women undergoing CS. PMID:26891115

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

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    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

  18. Scar Ectopic Pregnancy.

    Science.gov (United States)

    Patel, Madhuri Arvind

    2015-12-01

    Scar ectopic pregnancy is the rarest form of ectopic pregnancy and has been increasingly diagnosed all over the world. This is a life-threatening form of abnormal implantation of embryo within the myometrium and fibrous tissues in a previous scar on the uterus, especially following caesarean section. With the increasing rate of caesarean section, there is a substantial increase in this condition with better understanding of this disease. The early and accurate diagnosis with timely management can prevent pregnancy complications such as haemorrhage, uterine rupture and can preserve fertility.

  19. Effect of clinical nursing pathway applying in cesarean section%临床护理路径在剖宫产中的效果研究

    Institute of Scientific and Technical Information of China (English)

    吴永媚

    2010-01-01

    Objective To explore the efficacy of healthy care on applying the clincial nursing pathway into cesaresn section.Methods 120 patients were randomly divided into traditional group (GP) and clinical nursing pathway group (CP) .Conventional nursing strategy was used in the GP,and in the other group,daily medical attention,nursing and rehabilitation were provided according to the planned strategies involving the doctors,nurses and patients.The patient's age,civilization,pregnancy,hospitalization period and cost,satisfaction and healthcare knowledge commanging were respectively observed.Results The average hospital day and costs of the CP were significantly lower than those of the GP (P < 0.05),and the former group had also greater scores for patient satisfaction and healthcare knowledge (P < 0.05) .Conclusion On the basis of HIS ,we carry out the clincial pathway into cesarean section,which reducing average hospital day and costs,enhanceing the satisfaction of the parturient,standard diagnosis and treatment nursing methods,increasing the rate of reaching the standard.%目的 探讨应用临床护理路径对剖宫产手术患者实施健康教育的效果.方法 选择120例患者,按入院先后顺序分成两组:单号为传统组,采用传统的护理方法行健康教育;双号为临床路径组采用临床路径行健康教育.分别记录各例病人的年龄、文化程度、产次、住院费用、住院时间、满意度及健康知识掌握度.结果 实验组平均住院日、平均住院费用明显低于对照组(P<0.05);产妇满意度和健康知识评分明显高于对照组,比较有统计学意义(P<0.05).结论 在电子病历基础上实施临床路径,对提高产妇的满意度、规范诊疗护理手段、提高健康教育达标率、减少住院费用及时间等方面起到了积极的作用.

  20. Significant differences in cesarean section rates between a private and a public hospital in Brazil Diferença notável nas taxas de parto cesariano em hospital público e hospital privado no Brasil

    Directory of Open Access Journals (Sweden)

    Sueli de Almeida

    2008-12-01

    Full Text Available This paper evaluates the association of maternal variables and of variables related to prenatal and delivery care with cesarean sections at a public and at a private maternity. A retrospective cross-sectional study was performed at a public maternity clinic (2,889 deliveries and at a private maternity clinic (2,911 deliveries in the city of Ribeirão Preto, São Paulo State, Brazil. The prevalence of cesarean sections was 18.9% at the public maternity clinic and 84.3% at the private one. The factors associated with cesarean sections at both hospitals were: mothers from other cities, aged > 25 years and with hypertension. Having more than one child was a protective factor. At the public hospital, cesarean sections were more frequent on Wednesdays and from 12:00 to 23:59 hours of any day of the week, whereas at the private hospital they occurred on any day, though were less common on Sundays, and at any time except in the early morning. At the private hospital, cesarean sections were more frequent when performed by the doctor who had provided the prenatal care. Non-medical factors were more associated with cesarean sections in the private maternity clinic than biological or clinical factors related to pregnancy.Este artigo avalia a associação de variáveis maternas e aquelas relacionadas ao cuidado pré-natal e ao parto com a ocorrência de cesáreas em um hospital público e em um hospital privado. Um estudo de corte transversal, retrospectivo, foi desenvolvido em uma maternidade pública (2.889 partos e em uma maternidade privada (2.911 partos em Ribeirão Preto, São Paulo, Brasil. A prevalência de cesárea foi 18,9% e 84,3%, respectivamente, na maternidade pública e na particular. Os fatores associados ao parto cesariano nos dois hospitais foram: mães procedentes de outras cidades, com idade > 25 anos e hipertensas. Ter mais de um filho foi fator protetor. No hospital público, a cesárea foi mais freqüente às quartas-feiras e das 12h00

  1. Hematometra Formation- A Rare Complication of Cesarean Delivery

    Science.gov (United States)

    Kaur, Gurpreet; Sharma, Abha; Vaid, Neelam Bala

    2014-01-01

    Hematometra resulting from partial or complete obstruction of lower genital tract may be congenital or acquired. Commonest congenital causes are imperforate hymen and transverse vaginal septum. Acquired causes are senile atrophy of endocervical canal, scarring of the isthmus by synechiae, radiation and endocervical malignancy or due to surgical procedures. Various surgical procedures associated with hematometra are dilatation and curettage, cone biopsy, endometrial ablation, cryocoagulation and electrocautery. Hematometra following an abortion or cesarean delivery is rare. We report a case of hematometra following obstruction of outflow tract due to prior cesarean delivery. PMID:25302239

  2. Cesarean Section: Recovering After Surgery

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  15. THE COMPARATIVE STUDY OF STANDARD MACINTOSH HANDLE VERSUS SHORT HANDLE FOR LARYNGOSCOPY AND INTUBATION IN OBSTETRIC PATIENTS FOR LOWER SEGMENT CESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Neeharika

    2014-09-01

    Full Text Available : INTRODUCTION: The incidence of failed intubation is higher in obstetrics (1:280 than other surgical patients (1:2230. The anatomical factors that place the pregnant patient at increased risk for airway complications and difficult intubation include pregnancy induced generalized weight gain particularly increase in breast size, respiratory mucosal edema, and an increased risk of pulmonary aspiration. In the supine position, the enlarged breasts tend to fall back against the neck, which can interfere with insertion of the laryngoscope. The aim of our study is to assess the efficacy of short handle laryngoscope versus standard Macintosh handle laryngoscope for laryngoscopy and intubation in obstetric patients posted for Lower Segment Cesarean Section. PLAN OF STUDY: Randomized prospective study. ASA grade I and II full term obstetric patients posted for elective or emergency LSCS studied in two groups[ Group I (n=20 - Standard Macintosh handle, Group II (n=20 - Short / stubby handle (Anesthetics make, India]. Height and weight of patients were recorded. Head, neck and oral cavity of the patient were examined to rule out any obvious pathology and to detect any anticipated difficult intubations for exclusion. Examination of the airway included: neck length, sternomental distance, thyromental distance, inter incisor gap, chest circumference and modified Mallampati grading. The observations noted during laryngoscopy: number of attempts for insertion of laryngoscope into oral cavity, ease of insertion of laryngoscope blade into oral cavity, number of attempts for successful intubation, duration of laryngoscopy and intubation, perpendicular distance from the lower edge of distal end of laryngoscope handle to patient’s chest wall. OBSERVATIONS: The perpendicular distance was significantly higher in group II (16 cm than group I (13.6 cm.The time for laryngoscopy and intubation hard a significant correlation to weight as well as chest circumference in

  16. 缩宫素给药时间对剖宫产术后出血量影响的临床研究%Clinical study of oxytocin dose administration for cesarean section postpartum hemorrhage

    Institute of Scientific and Technical Information of China (English)

    李瑛娜

    2011-01-01

    目的 讨论剖宫手术后缩宫素给药时间预防产后出血的临床效果.方法 将本院收治的364例足月妊娠、剖宫产分娩的产妇,术后分别采用缩宫素20μ维持静滴12小时的2种不同静滴方法来观察其对术后24小时的出血量的影响.结果 快速静滴组与维持静滴组的出血量比较,差异有统计学意义(P<0.05).结论 剖宫产术后缩宫素维持静滴能更好地促进子宫收缩,减少产后出血.%Objective To discuss clinical effect of oxytocin dose administration of hemorrhage after cesarean section. Methods The influence of two different methods of intravenous drip, I. E. Oxytocin 20u fast intravenous drip and 12h last intravenous drip, on amount of bleeding 24 hours after the operation based on 364 examples of delivery woman of full-termpregnancy and cesarean section delivery were observed. Results There were statistical significance in diversity between the amount of bleeding of fast intravenous drip group and last intravenous drip group (P<0. 05). Conclusion Oxytocin last intravenous drip can stimulate uterine contraction and reduce postpartum hemorrhage flooding after Cesarean section.

  17. Factors analysis and nursing measures of abdominal distension after cesarean section%剖宫产术后腹胀因素分析及护理措施探讨

    Institute of Scientific and Technical Information of China (English)

    张桂兰

    2016-01-01

    Objective:To explore the factors and nursing measures of abdominal distension after cesarean section.Methods:120 cases of cesarean section were selected.They were randomly divided into the control group and the observation group with 60 cases in each group.The control group was given routine nursing,and the observation group was given targeted nursing intervention.We compared the nursing effect of two groups.Results:In the observation group,the incidence of abdominal distension, anal exhaust time,incidence of complications were significantly lower than those in the control group(P<0.05).Conclusion:Targeted nursing intervention for cesarean section can effectively reduce the incidence of abdominal distension,shorten the time of anal exhaust and effectively avoid the occurrence of postoperative complications.%目的:探讨剖宫产术后产妇腹胀原因及护理对策。方法:收治剖宫产产妇120例,随机分为对照组和观察组各60例,对照组采用常规护理,观察组采用针对性护理干预,比较两组的护理效果。结果:观察组腹胀发生率、肛门排气时间、并发症发生率均明显低于对照组(P<0.05)。结论:针对剖宫产患者给予针对性护理干预可有效降低腹胀发生率,缩短肛门排气时间,有效避免术后并发症发生。

  18. Effect of low dose of intrathecal pethidine on the incidence and intensity of shivering during cesarean section under spinal anesthesia: a randomized, placebo-controlled, double-blind clinical trial

    Science.gov (United States)

    Shami, Shoaleh; Nasseri, Karim; Shirmohammadi, Mousa; Sarshivi, Farzad; Ghadami, Negin; Ghaderi, Ebrahim; Pouladi, Mokhtar; Barzanji, Arvin

    2016-01-01

    Introduction Shivering is among the unpleasant and potentially harmful side effects of spinal anesthesia. The aim of this randomized double-blind clinical trial was to compare the antishivering effect of two different doses of intrathecal pethidine on the incidence and intensity of shivering and other side effects in patients who underwent cesarean section. Methods In this study, 150 parturient females scheduled for nonemergent cesarean section were randomly allocated to three groups. Spinal anesthesia was performed with 0.5% hyperbaric bupivacaine (12.5 mg), plus 0.5 mL of 0.9% saline in the standard group (S group), and the same dose of bupivacaine with 5 mg (P5 group) or 10 mg of pethidine (P10 group). Demographic and surgical data, incidence and intensity of shivering (primary outcome), hemodynamic indices, forehead and core temperatures, maximum sensory level, Apgar scores, and adverse events were evaluated by a blinded observer. Results There were no significant differences between the three study groups regarding the demographic and surgical data, hemodynamic indices, core temperatures, and maximum sensory level (P>0.05). The incidence and intensity of shivering were significantly less in the P5 and P10 groups (P<0.001) when compared with the S group. There were no significant differences between groups for secondary outcomes, except pruritus, which was more common in the P5 and P10 groups when compared with the S group (P=0.01). Conclusion Low dose of intrathecal pethidine is safe, and can decrease the incidence and intensity of shivering during cesarean section, without having major side effects. PMID:27703328

  19. Acne Scars

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    ... for treating acne scars include: Improved appearance Enhanced self-esteem Promotion of better skin health What you need ... 480px View Render 320px View Connect with ASDS: Facebook LinkedIn YouTube Twitter Quick Links About ASDS Advocacy ...

  20. 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...