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Sample records for cesarean section support

  1. Cesarean Section Birth

    Medline Plus

    Full Text Available ... classical cesarean sections, because the risk of uterine rupture with subsequent labor is greater, we generally don' ... With a BVAC, there's a risk of uterine rupture. With multiple cesarean sections, there's a risk of ...

  2. 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 ...

  3. Cesarean Section Birth

    Medline Plus

    Full Text Available ... opinion on this seemingly growing trend to undergo electric cesarean section instead of traditional vaginal delivery, especially ... that we've got a completely dry operative field. And it looks really great. So we sort ...

  4. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Just a moment, please. You've saved this page It's been added to your dashboard . Cesarean section: ... Map Premature birth report card Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness ...

  5. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Your e-mail was sent. Save to my dashboard Sign in or Sign up to save this ... saved this page It's been added to your dashboard . Cesarean section: The operation 3:12 Dr. Siobhan ...

  6. 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 ...

  7. Cesarean Section Birth

    Medline Plus

    Full Text Available ... We've already started, so things are going well. 00:05:37 FEMALE VOICE: [Unintelligible.] 00:05: ... D. RIDGWAY, MD: Sure. The repeat cesarean section. Well, typically we try not to do elective deliveries ...

  8. 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- ...

  9. 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, ...

  10. Cesarean Section Birth

    Medline Plus

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

  11. Cesarean Section Birth

    Medline Plus

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

  12. Cesarean Section Birth

    Medline Plus

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

  13. 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 ...

  14. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Just a moment, please. You've saved this page It's been added to your dashboard . Cesarean section: ... Map Premature birth report card Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness ...

  15. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Your e-mail was sent. Save to my dashboard Sign in or Sign up to save this ... saved this page It's been added to your dashboard . Cesarean section: Recovering after surgery 3:47 Dr. ...

  16. [Cesarean section and eye disorders].

    Science.gov (United States)

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

    2016-01-01

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

  17. MedlinePlus: Cesarean Section

    Science.gov (United States)

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

  18. 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

  19. 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 ...

  20. 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 ...

  1. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Product Catalog Volunteer Volunteer leaders Team Youth National service partners Advocate Get informed Take action Participate & Support ... Get Involved Volunteer Volunteer leaders Team Youth National service partners Advocate Get informed Take action Participate & Support ...

  2. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Youth National service partners Advocate Get informed Take action Participate & Support Make a donation Giving opportunities Our ... Youth National service partners Advocate Get informed Take action Participate & Support Make a donation Giving opportunities Our ...

  3. Cesarean Section Birth

    Medline Plus

    Full Text Available ... for granted and feel that this is not something that's potentially dangerous, and therefore, maybe we might ... be with the family as much, so it's something to consider always when performing a c-section ...

  4. Cesarean Section Birth

    Medline Plus

    Full Text Available ... sections sometimes have a good bit of scar tissue. Sometimes there's really not a whole lot there. ... there's an increased risk of there being scar tissue, which may increase the patient's risk for complications ...

  5. 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 ...

  6. 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 ...

  7. Cesarean Section Birth

    Medline Plus

    Full Text Available ... need a lot of special help. So it's real important when c-sections are performed that we ... patients, the particular risks of both, and both options need to be discussed. And then the patient ...

  8. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... youth volunteer leader Partner Spotlight Become a partner World Prematurity Day Your support helps babies We are ... Newborn care: Breastfeeding 3:48 Groundbreaking Partnership Ohio 1:10 Stanford Prematurity Research Center 5:57 Severe ...

  9. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... learned since the establishment of the GNMIH What we fund The impact of premature birth on society ... partner World Prematurity Day Your support helps babies We are determined to find the causes of premature ...

  10. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Fighting premature birth About us Annual report Our work Community impact Global programs Research Need help? Frequently ... leader Partner Spotlight Become a partner World Prematurity Day Your support helps babies We are determined to ...

  11. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Lead and pregnancy Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Prescription medicine before and during ... Get Involved Volunteer Volunteer leaders Team Youth National service partners Advocate Get informed Take action Participate & Support ...

  12. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... Our work Community impact Global programs Research Need help? Local Chapters Frequently asked questions Contact us Tools & ... partner World Prematurity Day World Prematurity Your support helps babies We are determined to find the causes ...

  13. Cesarean Section: The Operation

    Medline Plus

    Full Text Available ... 75 years of solving problems March of Dimes research grants have contributed to major medical breakthroughs and advancements. Learn more . Featured articles Become a youth volunteer leader Partner Spotlight Become a partner World Prematurity Day Your support helps babies We are ...

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

    International Nuclear Information System (INIS)

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

  15. 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.

  16. Youssef’s Syndrome following Cesarean Section

    Directory of Open Access Journals (Sweden)

    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.

  17. Educational strategies in performing cesarean section

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  18. Cesarean section for the second twin

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  19. Psychosocial Factors for Women Requesting Cesarean Section

    OpenAIRE

    Yajuan Zhao; Shuangyun Chen

    2013-01-01

    Background: Rates of caesarean section are progressively increasing in many parts of the world. As a result of psychosocial factors, there has been an increasing tendency for pregnant women without justifiable medical indications for caesarean section to ask for this procedure in China. The psychosocial factors for requesting cesarean section were analyzed in our study. Methods: A self-made questionnaire and the State-Trait Anxiety Inventory (STAI) and Self-rating Depression Scale (SDS) were ...

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

    Science.gov (United States)

    Habek, Dubravko; Kulas, Tomislav; Karsa, Matija

    2007-04-01

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

  1. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Product Catalog Volunteer Volunteer leaders Team Youth National service partners Advocate Get informed Take action Participate & Support ... Get Involved Volunteer Volunteer leaders Team Youth National service partners Advocate Get informed Take action Participate & Support ...

  2. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Youth National service partners Advocate Get informed Take action Participate & Support Make a donation Giving opportunities Our ... Youth National service partners Advocate Get informed Take action Participate & Support Make a donation Giving opportunities Our ...

  3. 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.

  4. 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.

  5. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... youth volunteer leader Partner Spotlight Become a partner World Prematurity Day Your support helps babies We are ... Newborn care: Breastfeeding 3:48 Groundbreaking Partnership Ohio 1:10 Stanford Prematurity Research Center 5:57 Severe ...

  6. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... learned since the establishment of the GNMIH What we fund The impact of premature birth on society ... partner World Prematurity Day Your support helps babies We are determined to find the causes of premature ...

  7. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Fighting premature birth About us Annual report Our work Community impact Global programs Research Need help? Frequently ... leader Partner Spotlight Become a partner World Prematurity Day Your support helps babies We are determined to ...

  8. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Lead and pregnancy Zika virus and pregnancy Microcephaly Medicine safety and pregnancy Prescription medicine before and during ... Get Involved Volunteer Volunteer leaders Team Youth National service partners Advocate Get informed Take action Participate & Support ...

  9. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... Our work Community impact Global programs Research Need help? Local Chapters Frequently asked questions Contact us Tools & ... partner World Prematurity Day World Prematurity Your support helps babies We are determined to find the causes ...

  10. Cesarean Section: Recovering After Surgery

    Medline Plus

    Full Text Available ... 75 years of solving problems March of Dimes research grants have contributed to major medical breakthroughs and advancements. Learn more . Featured articles Become a youth volunteer leader Partner Spotlight Become a partner World Prematurity Day Your support helps babies We are ...

  11. Fetomaternal hemorrhage in women undergoing elective cesarean section

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  12. 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...

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

    Directory of Open Access Journals (Sweden)

    2005-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Gordon C S Smith

    2005-09-01

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

  15. 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: *...

  16. 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

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

    Directory of Open Access Journals (Sweden)

    Silvia Minicucci

    2012-01-01

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

  18. Cesarean Section and Chronic Immune Disorders

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  19. Cesarean Section - Multiple Languages: MedlinePlus

    Science.gov (United States)

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

  20. 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.

  1. 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.

  2. Using Amniotic Membrane as Wound Covering After Cesarean Section Operation

    International Nuclear Information System (INIS)

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

  3. 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.

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

    OpenAIRE

    Zongo, Koudnoaga Augustin

    2015-01-01

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

  5. 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...

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Hyun Kyoung Kim

    2013-06-01

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

  8. 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

  9. 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.)

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Azam Azargoon

    2008-06-01

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

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

    Science.gov (United States)

    Malek, Janet

    2016-06-01

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

  13. Delivery by Cesarean Section and risk of childhood cancer

    DEFF Research Database (Denmark)

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

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  15. 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

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

    Science.gov (United States)

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

    2015-02-01

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

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

    OpenAIRE

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

    2000-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Murray F. Dweck

    2000-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ibrahim Al Busaidi

    2012-11-01

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

  3. 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.

  4. 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.

  5. 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.

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

    OpenAIRE

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

    1999-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-06-15

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

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

    OpenAIRE

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

  10. 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...

  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. 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.

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

    Science.gov (United States)

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

    2013-12-01

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

  14. 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.

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

    Science.gov (United States)

    Klein, Michael C

    2012-12-01

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

  16. Vaginal delivery versus cesarean section for term breech delivery

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    Babović Ivana

    2010-01-01

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

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

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    Liliana Strat

    2015-05-01

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

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

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    Venkata Sujatha Vellanki

    2010-12-01

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

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

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

    2013-01-01

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

  20. 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.

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

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    Naina Kumar

    2015-06-01

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

  2. 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

  3. 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

  4. 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

  5. [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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  7. Accidental intrathecal injection of magnesium sulfate for cesarean section

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    Mehryar Taghavi Gilani

    2014-01-01

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

  8. 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.

  9. 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

  10. 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

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

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    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.

  12. 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.

  13. 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

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

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    Mohammad Mahdi Majzoobi

    2014-10-01

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

  15. 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.

  16. 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...

  17. 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...

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

    OpenAIRE

    Maheshwari, Darshana; Ismail, Samina

    2015-01-01

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

  19. 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

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

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

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    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

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

    Science.gov (United States)

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

    2016-04-01

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

  3. 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...

  4. 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...

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

    OpenAIRE

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

    2011-01-01

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

  6. 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. ...

  7. 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...

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

    Directory of Open Access Journals (Sweden)

    Jonathan A Anson

    2014-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  11. 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/...

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

    OpenAIRE

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

    2015-01-01

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

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Hala Mostafa Gomaa

    2014-10-01

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

  15. 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.

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Reginaldo Roque Mafetoni

    2015-01-01

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

  18. 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.

  19. 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

  20. 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)

  1. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  4. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  6. [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

  7. 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

  8. 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.

  9. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    Science.gov (United States)

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

    2012-01-01

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

  10. 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

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

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    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.

  12. 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...

  13. 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.

  14. 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.

  15. Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar

    Directory of Open Access Journals (Sweden)

    Giampiero Francica

    2012-01-01

    Full Text Available AIM: To highlight sonographic and clinical characteristics of scar endometrioma with special emphasis on size-related features. METHODS: Thirty women (mean age 30.6 years, range 20-42 years with 33 scar endometriomas (mean diameter 27.1 mm, range 7-60 mm were consecutively studied by Sonography and Color Doppler examination prior to surgery. Pathological examination was available in all cases. RESULTS: The most frequent (24 of 33 nodules, 74% sonographic B-mode aspect of endometrioma was that of an inhomogenously hypoechoic roundish nodule with fibrotic changes (in the form of hyperechoic spots or strands, a peripheral inflammatory hyperechoic ring, spiculated margins and a single vascular pedicle entering the mass at the periphery. On average, 1.6 cesarean sections were recorded per patient (range 1-3. The median interval between the last cesarean section and admission to hospital was 36 mo (range 12-120 mo and the median duration of symptoms before admission was 25.7 mo (range 0.5-80 mo. 13 patients had 13 large endometriomas (≥ 30 mm with a mean lesion diameter of 41.3 ± 9.02 mm (range 30-60 mm. Seventeen women had 20 small endometriomas with a mean lesion size of 18.2 ± 5.17 mm (range 7-26 mm. The mean interval between the last cesarean section and admission to hospital (66.0 mo vs 39.6 mo, P < 0.01 and the mean duration of symptoms before admission (43.0 mo vs 17.4 mo, P < 0.01 were significantly longer in patients with large endometriomas; in addition, a statistically significant higher percentage of patients with large implants had undergone previous inconclusive diagnostic examinations, including either computed tomography/magnetic resonance imaging/fine needle biopsy/laparoscopy (38.4% vs 0%, P < 0.05. On sonography, large endometriomas showed frequent cystic portions and fistulous tracts (P < 0.02, loss of round/oval shape (P < 0.04 along with increased vascularity (P < 0.04. CONCLUSION: Endometrioma near cesarean section scar is

  16. Emergency cesarean section in an epidemic of the middle east respiratory syndrome: a case report

    Science.gov (United States)

    Kim, Hee Ryun; Sung, Ji Hee; Kim, Jong Hwa

    2016-01-01

    Only a few reports have been published on women with an infectious respiratory viral pathogen, such as Middle East Respiratory Syndrome (MERS) Coronavirus delivering a baby. A laboratory confirmed case of MERS was reported during a MERS outbreak in the Republic of Korea in a woman at gestational week 35 + 4. She recovered, and delivered a healthy baby by emergency cesarean section (C-sec). We present the clinical course and the emergency C-sec in a pregnant woman with MERS. PMID:27274377

  17. 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...

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

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    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

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

    International Nuclear Information System (INIS)

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

  20. 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.

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

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    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

  2. 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. 

  3. [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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  6. 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.

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

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    Vijayasree

    2014-01-01

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

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

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    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.

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

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    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.

  10. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  12. [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

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  14. 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。

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

    OpenAIRE

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

    2010-01-01

    We used administrative and clinical data from a case-control study to calculate the costs of surgical site infection and endometritis after cesarean section. Attributable costs determined by generalized least squares with the two data sources were similar, suggesting that administrative data can be used to calculate infection costs.

  16. 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

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

    Directory of Open Access Journals (Sweden)

    Bastani P

    2011-08-01

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

  18. Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section

    Directory of Open Access Journals (Sweden)

    Nikhil Kothari

    2011-01-01

    Full Text Available Aims and Context: The objective of the present study was to evaluate the analgesic and adverse effects of intrathecal clonidine with hyperbaric bupivacaine in spinal anesthesia. Settings and Design : Randomized single blind trial. Methods: 210 ASA I-II pregnant females undergoing emergency cesarean section were randomized in a single-blind fashion to one of the three groups. In group I (n=70 patients received 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. In group II (n=70 patients received intrathecal mixture of 0.5% hyperbaric bupivacaine (8 mg and clonidine 50 μg. In group III (n=70 , patients received 0.5% hyperbaric bupivacaine (10 mg intrathecally along with 50 μg of clonidine. Statistical Analysis Used: Groups were compared using one-way ANOVA with the Bonferroni multiple comparison post hoc test. The proportion of adverse events was compared using the chi-square test (χ2 =57.2410. Results: On adding 50 μg clonidine, we were able to reduce intrathecal dose of bupivacaine for cesarean section to 8 mg. Patients receiving intrathecal clonidine along with bupivacaine had significantly long lasting analgesia with lower bupivacaine dose [246.21±5.15 min. (group II vs 146.0±4.55 min (group I, P=0.021; 95% confidence interval: 238.01-257.40, group II and 134.99-157.0 group I]. Conclusions: Addition of intrathecal clonidine causes some sedation in the postoperative period, but it provides adequate analgesia and motor paralysis at lower dose of bupivacaine. It also significantly prolongs postoperative pain relief.

  19. 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

  20. The Type of Anesthesia Used during Cesarean Section Is Related to the Transient Tachypnea of the Newborn.

    Science.gov (United States)

    Keleş, Esengül; Yazgan, Hamza; Gebeşçe, Arzu; Pakır, Emine

    2013-01-01

    Aim. To demonstrate whether transient tachypnea of the newborn (TTN) is found more frequently in women undergoing general or combined epidural-spinal (CES) anesthesia during Cesarean section. Methods. This study was done retrospectively. A total of 1447 Cesarean sections (C/S) were performed in our clinic between January 2008 and December 2011. General anesthesia was performed in 1078 (74.5%) of the Cesarean cases. CES anesthesia was performed in 369 cases (25.5%). The International Classification of Diseases,Tenth Revision code of P22.1, was used to identify the infants with TTN. Stratified multivariate analysis was undertaken on subgroups to assess the effect modification by factors known to influence the incidence of TTN: maternal age, maternal systolic-diastolic artery pressure, heart rate, Apgar score at 1 and 5 minutes, sex, time interval from spinal block to skin incision, and time interval from skin incision to umbilical cord clamping. Results. The rate of TTN diagnosis was found to be higher in parturients who had a cesarean section with combined epidural-spinal anesthesia, but no statistical differences were found. (P related to C/S but independent from the type of anesthesia. However, studies with a wider spectrum of patients and a lower quantitative difference between the groups are needed in order to draw firm this conclusions. PMID:23710366

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

    Directory of Open Access Journals (Sweden)

    K Mungrue

    2010-11-01

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

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

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    Al-Kadri HM

    2015-07-01

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

  3. 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

  4. 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

  5. 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.

  6. [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

  7. Anesthetic Management of a Parturient Undergoing Cesarean Section with a Tracheal Tumor and Hemoptysis

    Directory of Open Access Journals (Sweden)

    Yuet-Tong Ng

    2003-01-01

    Full Text Available Anesthetic management of a parturient with respiratory failure associated with hemoptysis,dyspnea, and orthopnea is difficult. An anesthesiologist should realize that the patient'smajor problem is not solved during the surgery. This circumstance is similar to a patientwith associated cardiac disease scheduled for non-cardiac surgery. General anesthesia withendotracheal intubation can provide safe oxygenation for both the parturient and the fetus,but with possible unexpected massive hemoptysis and tumor seeding. Prolonged intubationmay delay the patient's pulmonary treatment course. Laryngeal mask anesthesia can providean airway, but must not be secured due to the risk of aspiration. The need of high doses ofinhalation drugs may hinder uterine contractions. The addition of a muscle relaxant willchange the patient's respiratory patterns and physiology. Regional anesthesia alone mightnot be tolerated. A decrease in cough strength, as well as dyspnea, orthopnea, and hyperventilationmay be harmful to both the parturient and the fetus. However, we successfullymanaged this case using epidural anesthesia combined with assisted mask ventilation insteadof spontaneous breathing usually provided by a simple mask in almost all American Societyof Anesthesiology (ASA class I-II parturients during cesarean section. The anesthetic levelwas maintained at T8 with 18 ml of 2% Xylocaine mixed with 2 ml of 7% sodium bicarbonatewith 1:200,000 epinephrine epidurally and with the patient in a supine position with thehead up at 30o to prevent cephalic spreading and to ensure better pulmonary ventilation.

  8. Post Dural Puncture Headache after Cesarean Section, a Teaching Hospital Experience

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    Farhad Etezadi

    2012-03-01

    Full Text Available Objective: This prospective study examined the frequency of Post-Dural Puncture Headache (PDPH in361 parturient women undergoing spinal anesthesia for cesarean section in a teaching hospital ofTehran University of Medical Sciences.Materials and methods: Spinal anesthesia was performed using 25 gauge Quincke needles in allwomen. Patients were followed up to determine incidence of PDPH and then tried to compare those withor without PDPH using statistical methods to determine risk factors of PDPH.Results: The overall incidence of PDPH was 10.8 percent in this study. In terms of probable risk factorswhich were compared between the two groups of patients, no statistically significant differences werefound.Conclusion: The incidence of PDPH in our study was higher than studies which used pencil - tippedneedles and we determined that the occurrence of PDPH is not associated to some factors like theprevious history of nonspecific headache, Body Mass Index, age, type of local anesthetic, previoushistory of PDPH, experience of operator, history of habitual tea and coffee drinking.

  9. A Comparison of the Effects of Fentanyl and Remifentanil on Nausea, Vomiting, and Pain after Cesarean Section

    OpenAIRE

    Fatemeh Gourtanian; Safoura Rouholami; Mitra Jabalameli

    2011-01-01

    Background: The effects of different opioids on postoperative nausea and vomiting (PONV) and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial recruiting 96 parturients with American Society of Anesthesiologists (ASA) physical status I and II. They sch...

  10. 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...

  11. Limb-girdle muscular dystrophy with obesity for elective cesarean section: Anesthetic management and brief review of the literature

    OpenAIRE

    R V Ranjan; Ramachandran, T. R.; S Manikandan; John, Roshan

    2015-01-01

    Limb-girdle muscular dystrophy (LGMD) is an autosomal recessive disorder in which the pelvic or shoulder girdle musculature is predominantly or primarily involved. We report the management of a 27-year-old primigravida with LGMD associated with obesity posted for elective cesarean section. She was successfully managed with epidural anesthesia assisted with noninvasive positive pressure ventilation. She had an uncomplicated intra- and post-operative course.

  12. 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

  13. 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.

  14. Bilateral megalocystic ovaries following in vitro fertilization detected during cesarean section: a case presentation.

    Science.gov (United States)

    Alptekin, Hüsnü; Gezginç, Kazım; Yılmaz, Fatma Yazıcı

    2012-01-01

    We present a patient with persistent bilateral megalocystic ovaries following in vitro fertilization which was detected during cesarean section. A 24 year-old primigravida presented to our clinic at the 36(th) week of a twin pregnancy with labour pain and cervical dilatation. On ultrasound examination, 2 masses of 90×60 and 60×70 mm were seen in the right and left adnexal regions respectively. Her history showed that she had unexplained infertility for 4 years and had undergone IVF with gonadotropin releasing hormone (GnRH)-agonist stimulation. Two embryos were transferred. Twin pregnancy was detected on ultrasound examination. The patient was delivered by emergency caesarean section due to transverse presentations at 36(th) weeks of gestation. During the operation, both adnexae were markedly enlarged, the right ovary measuring about 15×18 cm and the left about 16×18 cm. There was minimal ascites in the abdominal cavity. Ovarian biopsy was performed and the final pathology report showed bilateral follicle cysts. The patient was discharged on the postoperative 4(th) day. The patient was seen 4 weeks later. She had no complaints and ultrasound follow-up revealed a normal size uterus and ovaries. We should keep in mind that hyperstimulated, enlarged ovaries and its complication may be seen in the late weeks of pregnancy, even at term, in cases of in vitro fertilization cases. Therefore, close follow-up of pregnant IVF patints is recommended whether they had OHSS or not, because ovarian torsion caused by hyperstimulated ovaries may be difficult to diagnose during pregnancy. PMID:24592025

  15. 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

  16. The history of cesarean technique.

    Science.gov (United States)

    Lurie, Samuel; Glezerman, Marek

    2003-12-01

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

  17. Intrathecal Administration of Morphine Decreases Persistent Pain after Cesarean Section: A Prospective Observational Study

    Science.gov (United States)

    Moriyama, Kumi; Ohashi, Yuki; Motoyasu, Akira; Ando, Tadao; Moriyama, Kiyoshi; Yorozu, Tomoko

    2016-01-01

    Purpose Chronic pain after cesarean section (CS) is a serious concern, as it can result in functional disability. We evaluated the prevalence of chronic pain after CS prospectively at a single institution in Japan. We also analyzed perioperative risk factors associated with chronic pain using logistic regression analyses with a backward-stepwise procedure. Materials and Methods Patients who underwent elective or emergency CS between May 2012 and May 2014 were recruited. Maternal demographics as well as details of surgery and anesthesia were recorded. An anesthesiologist visited the patients on postoperative day (POD) 1 and 2, and assessed their pain with the Prince Henry Pain Scale. To evaluate the prevalence of chronic pain, we contacted patients by sending a questionnaire 3 months post-CS. Results Among 225 patients who questionnaires, 69 (30.7%) of patients complained of persistent pain, although no patient required pain medication. Multivariate analyses identified lighter weight (p = 0.011) and non-intrathecal administration of morphine (p = 0.023) as determinant factors associated with persistent pain at 3 months. The adjusted odds ratio of intrathecal administration of morphine to reduce persistent pain was 0.424, suggesting that intrathecal administration of morphine could decrease chronic pain by 50%. In addition, 51.6% of patients had abnormal wound sensation, suggesting the development of neuropathic pain. Also, 6% of patients with abnormal wound sensation required medication, yet no patients with persistent pain required medication. Conclusion Although no effect on acute pain was observed, intrathecal administration of morphine significantly decreased chronic pain after CS. PMID:27163790

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

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    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.

  19. 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.

  20. 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

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

    OpenAIRE

    Nurul Mutmainah; Puri Setyati; Niken Handasari

    2014-01-01

    The use of antibiotics for prophylactic in sectio cesarean can reduce the risk of infection-related complications and postoperative infections. This study aims to describe and evaluate the usage and the effectiveness of prophylactic antibiotics in cesarean section patients in two hospitals in Surakarta in year 2010. The study used retrospective data from medical records. The analysis was then conducted on the use of antibiotic including the appropriateness of antibiotic (compare...

  2. 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.

  3. 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.

  4. 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。

  5. Comparison of metaraminol, phenylephrine and ephedrine in prophylaxis and treatment of hypotension in cesarean section under spinal anesthesia

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    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.

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

    OpenAIRE

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

    2016-01-01

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

  7. 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

  8. 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.

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

    Science.gov (United States)

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

    2014-05-01

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

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. 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

  15. Prevention of Postoperative Nausea and Vomiting by Administration of Sub Hypnotic Doses of Propofol and Midazolam during Spinal Anesthesia for Cesarean Section

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    Saghar Samimi Sade

    2010-12-01

    Conclusion: Sub hypnotic dose of midazolam was as effective as the sub hypnotic dose of propofol for preventing of nausea and vomiting in parturients undergoing cesarean section under spinal anesthesia. We undertook this study in regard to examine a simple, safe and non-expensive antiemetic method.

  16. A Comparison of the Effects of Fentanyl and Remifentanil on Nausea, Vomiting, and Pain after Cesarean Section

    Directory of Open Access Journals (Sweden)

    Fatemeh Gourtanian

    2011-09-01

    Full Text Available Background: The effects of different opioids on postoperative nausea and vomiting (PONV and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial recruiting 96 parturients with American Society of Anesthesiologists (ASA physical status I and II. They scheduled for cesarean section under general anesthesia using sodium thiopental, succynylcholine, and isoflurane O2/N2O 50/50 mixture. After clamping the umbilical cord, the patients were given fentanyl (2 µg/kg/h, remifentanil (0.05 µg/kg/h, or fentanyl (2 µg/kg pulse morphine (0.1 mg/kg intravenously. Visual analog scale for pain and nausea, frequency of PONV, meperidine and metoclopramide consumption were evaluated at recovery, and 4, 8, 12 and 24 hours after the surgery. Results: There was no significant difference between the three groups in terms of frequency of nausea, vomiting, and mean nausea and pain scores at any time points. None of the patients required the administration of metoclopramide. However, the mean VAS for pain in remifentanil-treated group was insignificantly more than that in fentanyl- or fentanyl plus morphine-treated group at recovery or 4 hours after the surgery. The mean mepridine consumption in remifentanil-treated group was significantly (P=0.001 more than that in fentanyl- or fentanyl plus morphine-treated group in 24 hours after the surgery respectively. There was no significant difference in hemodynamic parameters of the three groups in all measurements after the surgery. Conclusion: The findings of this study showed that early postoperative analgesia was better with fentanyl, and postoperative meperidine consumption was significantly less with fentanyl than with remifentanil or combined fentayl and morphine. Trial

  17. 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.

  18. 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。

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

    Institute of Scientific and Technical Information of China (English)

    李湛

    2014-01-01

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

  20. 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

  1. [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

  2. Hemodynamic Changes Following Endotracheal Intubation in Patients Undergoing Cesarean Section With General Anesthesia: Application of Glidescope® Videolaryngoscope Versus Direct Laryngoscope

    OpenAIRE

    Amini, Shahram; Shakib, Majid

    2015-01-01

    Background Endotracheal intubation is usually associated with hemodynamic changes, especially in patients undergoing cesarean section by general anesthesia. GlideScope® videolaryngoscope (GVL) is a novel video laryngoscope, which does not need direct exposure of vocal cords and produces lesser hemodynamic changes due to lower degrees of trauma and stimuli to oropharynx than the Macintosh direct laryngoscope (MDL). Objectives The aim of this study was to compare hemodynamic changes following e...

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

    Directory of Open Access Journals (Sweden)

    Sapana Shah

    2014-07-01

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

  4. [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

  5. 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.

  6. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  8. [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

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    Nurul Mutmainah

    2014-06-01

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

  11. 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.

  12. Acute lower limb compartment syndrome after Cesarean section: a case report

    Directory of Open Access Journals (Sweden)

    Sütterlin Marc

    2011-04-01

    Full Text Available Abstract Introduction Acute compartment syndrome of the lower limb is a rare but severe intra- and post-partum complication. Prompt diagnosis is essential to avoid permanent functional restriction or even the loss of the affected limb. Clinical signs and symptoms might be nonspecific, especially in the early stages; therefore, knowledge of predisposing risk factors can be helpful. Case presentation We present the case of a 32-year-old Caucasian woman with acute post-partum compartment syndrome. Conclusion Acute compartment syndrome is an important differential diagnosis for the sudden onset of intra- or post-partum lower-limb pain. Predisposing factors for the manifestation of acute compartment syndrome in an obstetric environment are augmented intra-partum blood loss, prolonged hypotensive episodes and the use of oxytocin to support or induce labor because of its vasoconstrictive properties. Treatment is prompt surgical decompression by performing fasciotomy in any affected muscular compartments.

  13. 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

    目的:探讨Stark式刮宫产术后腹膜及膀胱腹膜反折愈合及粘连发生情况.方法:采用回顾性分析的方法,对剖宫产术后2次开腹手术患者腹膜及膀胱腹膜反折粘连发生情况进行观察.其中,Stark式剖宫产术后2次开腹手术69例(A组),下腹纵切口式剖宫产术后2次开腹手术128例(B组),Pfannenstiel切口式剖宫产术后2次开腹手术41例(C组).比较3组患者剖宫产术后腹壁切口愈合情况以及腹直肌、腹膜、大网膜、膀胱腹膜反折愈合粘连发生情况;比较3组患者剖宫产手术时间.结果:①腹壁切口愈合好,瘢痕纤细:A组85.5% (59/69),B组32.0% (41/128),C组75.6%(31/41);②腹直肌粘连:A组23.2% (16/69),B组52.3%(67/128),C组12,2%(5/41);③大网膜粘连:A组11.6(8/69),B组55.5%(71/128),C组24,4% (10/41);④腹膜粘连:A组15.9% (11/69),B组46.1% (59/128),C组12.2% (5/41);⑤膀胱腹膜反折粘连:A组15.9% (11/69),B组54.7% (70/128),C组12.2% (5/41).腹壁切口愈合及腹直肌、大网膜、腹膜、膀胱腹膜反折粘连情况,A组明显优于B组,两组比较,差异有统计学意义(P0.05);B组手术时间长于A、C组,经比较差异有统计学意义(P0.05).结论:Stark式剖宫产腹壁切口愈合及减少腹直肌、大网膜、腹膜、膀胱腹膜反折粘连方面明显优于下腹纵切口式剖宫产术;虽然与Pfannenstiel切口式剖宫产术相比差异无统计学意义,但Stark式剖宫产具有诸多公认的优点,值得推广.%Objective: To explore the recovery and adhesion of peritoneum and vesical peritoneal reflection after Stark cesarean section. Methods: A retrospective analysis method was used to observe the occurrence of peritoneum adhesion and vesical peritoneal reflection adhesion during the second cesarean section after cesarean section. The study objects were composed of 69 cases after Stark cesarean section (A group), 128 cases after vertical lower segment cesarean section (B group) and 41 eases after

  14. 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.

  15. 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)

  16. 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。

  17. Cesarean Section Birth

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  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Rafid Fayadh Al-Aqeedi

    2011-01-01

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

  12. Chewing Gum in Promoting Bowel Recovery after Cesarean Section: A Systematic Review%剖宫产术后咀嚼口香糖促进肠道功能恢复的系统评价

    Institute of Scientific and Technical Information of China (English)

    袁远霞; 赵红利; 何佳; 龚钿

    2011-01-01

    .01) and possibly shortened the length of hospital stay (MD= -0.21, 95%CI -0.39 to -0.03, P=0.02)compared with blank control. Currently, no adequate data supported the safety of chewing gum after cesarean section.Conclusion Chewing gum after cesarean section can promote the postoperative bowel recovery, and reduce the odds of postoperative ileus. However, more high quality RCTs are required for lack of included studies and poor quality of methodology.

  13. 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。

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    José Otavio Costa Auler Junior

    2010-06-01

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

  16. 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.

  17. Comparative study of bupivacaine 0.25% vs 0.375% Levobupivacaine spinal anesthesia for cesarean Section

    Directory of Open Access Journals (Sweden)

    Pérez-Guzmán Carlos Andrés

    2011-06-01

    Full Text Available During recent decades, it has been seen development of regional anesthesia as thebest method for cesarean section, thereby, there is constant research interestforoptimal dose that can abolish inherent complications of spinal technique. In pregnantwomen undergoing cesarean delivery under spinal anesthesia with conventionaldoses, hemodynamic changes occur abruptly, leading to clinical manifestations andcomplications related to maternal and fetal hypotension and hypoxemia, fetal acidosisand poor neonatal adaptation; considering this implications, they acquire a specialmedical interest in early diagnosis and prompttreatment.Objectives: To compare effectiveness of a dilution technique of heavy bupivacaine0.25% with a heavy dilution to 0.375% levobupivacaine in terms of quality of anesthesiaand clinical conditions of patient within 15 minutes after application.Methods: Intervention, non-blinded study in which two anesthetic techniques wereapplied, bupivacaine 0.25% and heavy heavy levobupivacaine to 0.375%, in patientsrequiring elective or emergency caesarean section in a health institution in Cartagena,Colombia, between June 2009 and June 2010. The technique was randomly assigned toeach patient; prior to its implementation, demographic and clinical variables of patientswere identified and blood pressure and heart rate baseline were obtained, the latter hadthree additional measurements at 5, 10 and15 minutes. Level of motor block also had three assessments; at 15 minutes of theprocedure, we verify the existence or absence of complications. Differences betweenvalues of both techniques for quantitative variables was performed with the U testof Mann-Whitney, for qualitative variables, we used the Pearson Chi-square or Fisherexact test when there were expected frequencies under 5.Results: In this research, decreased local anesthetic doses were used, which reboundin cost-benefit balance and length of stay of patients in post-anesthesia care unit

  18. 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。

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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)

  4. 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.

  5. 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.

  6. 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。

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

    Science.gov (United States)

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

    2002-11-01

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

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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。

  17. CAD support section: tasks and projects

    CERN Document Server

    Friman, Per Olof; CERN. Geneva. TS Department

    2004-01-01

    The CAE section is well known for its daily support of CAD usage at CERN but, in fact, a large part of the section’s activity is dedicated to anticipating future needs and dealing with operating systems issues and evolution of CAD software. The section supports more than 200 professional CAD users located all around the site, and it helps many other users at CERN and outside with CAD data exchange. The section is in charge of developing tools to fulfil the specific needs of the design offices and adapting these tools to the changing hardware and software environment. As an example, the section, in collaboration with the MME design office and the survey group, has developed the DMU application, which is used extensively for the LHC integration studies. In the coming years, the big challenge for the section as well as for the design offices will be the introduction of Catia. This project, started last year, is going on to adapt Catia and its data manager SmarTeam to the tools and practices in use today. Ca...

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

    Institute of Scientific and Technical Information of China (English)

    黄凯清

    2015-01-01

    目的:分析育龄妇女选择剖宫产的影响因素,以利于实施针对性的健康教育,提高育龄妇女对分娩方式的认知水平。方法采用调查问卷对2013年1月至2013年12月于我区8家镇医院分娩的1580位育龄妇女的分娩方式进行调查,统计剖宫产率及产妇选择剖宫产的原因。结果1048例剖宫产,520例阴道分娩,12例阴道助产,剖宫产率达66.33%;选择剖宫产分娩的产妇中,高等教育者显著多于低等教育者,职业劳动量较少者显著多于劳动量较多者,超过35岁的产妇显著多于35岁以下产妇,经产妇与初产妇之间的差异较少。剖宫产及阴道分娩母婴结局的比较无统计学意义(P ﹥0.05)。结论职业文化、年龄、助产技术及社会因素是造成育龄期妇女选择剖宫产的重要原因,提高医护人员的专业水平,对手术指征进行合理控制,有利于降低剖宫产率。%Objective To analyze factors affected women of childbearing age choose cesarean section,in order to facilitate the implementation of targeted health education,improved the cognitive level of women of childbearing age on mode of delivery. Methods The mode of delivery by questionnaire in 2013 January to 2013 December in the district 8 home town hospital childbirth 1580 women of childbearing age were investigated,statistics of cesarean section rate and maternal selection causes of cesarean section. Results 1048 cases of cesarean section,520 cases of vaginal delivery,12 cases of vaginal delivery,cesarean section rate was 66. 33% ;the choice of caesarean birth mothers,higher education were significantly more than low education,occupation labor less significantly more than the amount of labor is more and more,more than 35 years old is significantly more than the following maternal maternal at the age of 35,the difference between maternal and early maternal less. Cesarean section and vaginal delivery on maternal and neonatal

  19. 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。

  20. 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。

  1. 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.

  2. 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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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。

  4. 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.

  5. 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。

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

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2012-01-01

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

  7. 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.

  8. 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).

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

    Directory of Open Access Journals (Sweden)

    Madhuri

    2014-01-01

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

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Fábio Roberto Cabar

    2004-10-01

    relationship between previous cesarean section and abruptio placentae. METHODS: a retrospective study reviewed 6495 deliveries between April 2001 and January 2004. The adopted inclusion criteria were: clinical diagnosis of abruptio placentae confirmed by placental examination after delivery, single pregnancy, birth weight >500 g, gestational age >22 weeks and no history of abdominal trauma. Five controls were selected for each abruptio placentae case and were matched for the following parameters: parity, gestational age ( 30 weeks, maternal arterial hypertension during pregnancy, presence of nonobstetrical uterine scar, premature rupture of membranes and polyhydramnios. Statistical analysis of continuous variables was perfomed by Student's t test. Statistical significance of the comparisons of categorical variables was evaluated by the chi2 test or by the Fisher exact test. p values <0.05 were considered to be significant. RESULTS: thirty-four cases of abruptio placentae were included (incidence 0.52%. The control group included 170 cases that fulfilled the matching criteria. The incidence of previous cesarean section in the abruptio placentae group was 26.5% (9 cases and in the control group it was 21.2% (36 cases. No significant difference was found between the groups (p=0.65, OR=1.34, CI 95%=0.53-3.34. CONCLUSION: the present study was not able to demonstrate association between abruptio placentae and previous cesarean section.

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

    Directory of Open Access Journals (Sweden)

    Jyoti Ramesh

    2013-02-01

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

  13. 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.

  14. 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

  15. 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.

  16. 上海市闸北区高剖宫产率供方因素定性研究%Qualitative study of the effect of health service providers and health care system on high cesarean section rate in Zhabei District of Shanghai

    Institute of Scientific and Technical Information of China (English)

    杨莉敏; 纪红蕾; 杨岭岭; 叶茜

    2013-01-01

    Objective To explore the effect of knowledge , belief and behavior of health service providers and health care system on high cesarean section rate by in-depth individual interview among medical and nursing staff .Methods Semi-structured interview in qualitative study was applied to conduct in-depth interview among 12 doctors and nurses with different professional titles and positions in two comprehensive hospitals in Zhabei District of Shanghai .The interview was recorded on spot .NVIVO 8.0 was used for analysis .Results Altogether 12 doctors and nurses (6 in hospital A and 6 in hospital B) were interviewed.The longest working age was 30 years (midwife and head nurse ) and the shortest was 2 years ( resident physician ) .All interviewees were fully aware of the impact of different delivery modes on health of mothers and their babies .In case of cesarean section asked for by pregnant women , all interviewees could try to persuade them to have natural delivery .Eleven of 12 subjects believed that they could follow the provision of Shanghai Health Bureau and master cesarean section indications strictly .All interviewees denied that doctors would widen indications of cesarean section because of profit.Most interviewees believed that doctors would not apply cesarean section because of manpower deficiency , but insufficiency of human resources was the main reason for “continuous support during labor” and“pain relief services during labor” not available in both hospitals . All interviewees believed that avoiding medical risks due to strained doctor-patient relationship led to loosening indications of cesarean section were loosened .Conclusion Insufficiency of human resources and intense doctor-patient relationship are two impact factors of cesarean section rate .Human resource should be strengthened in obstetrical department to promote the development of “continuous support during labor” and“pain relief services during labor”.Doctor-patient relationship

  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. Cesarean Section: Recovering After Surgery

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  16. 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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  18. 剖宫产术后咀嚼口香糖对促进胃肠功能恢复的效果%Effect of chewing gum afar cesarean section on restoration of gastrointestinal function

    Institute of Scientific and Technical Information of China (English)

    罗仕琴; 伍春兰; 杨小梅; 雷厉秀; 邓皓茹; 李豪

    2010-01-01

    目的 探讨咀嚼无糖口香糖与剖宫产术后患者胃肠功能恢复的作用.方法 将在我院行子宫下段剖宫产的产妇300例,随机分为咀嚼口香糖组(观察组)和对照组,每组150例.咀嚼口香糖组于术后2 h开始咀嚼尤糖13香糖2~4片,每日4次,连续3 d;对照组予常规护理,不咀嚼口香糖;比较两组术后恢复情况.结果 咀嚼口香糖组术后的腹胀缓解时间、肠鸣音恢复、肛门排气及排便时间均少于对照组(P<0.05).结论 咀嚼无糖口香糖可促进剖宫产术后患者胃肠功能的恢复,对于剖口产产妇的产后恢复有一定的益处.%Objective To investigate the effect of chewing gum after cesarean section on restoration of gastrointestinal function.Methods 300 patients who had undergone low cesarean section in our hosplta|were randomlv divided into observation group(150 cases)and control group(150 eases).The former received sugarfree chewing gum 4 times per day(2~4 pieces each time)from 2h to 3d after cesarean section and the latter received routine nursing care. Gastrointestinal function of the two groups Was observed.Results Earlier alleviation of abdominal distension.as well as resume of bowelsound,anal exhaust and defecation was found in the observation group compared to the control group(P<0.05).Conclusions Chewing gum can promote restoration of gastrointestinal function and thus benefits rehabilitation of patients after cesarean section.

  19. 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...

  20. Clinical Efficacy of Hysteroscopy Combined Vasopressin in Treatment of Cesarean Section Pregnancy%宫腔镜联合垂体后叶素治疗剖宫产切口妊娠的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    庞悦平; 赵亚冰

    2015-01-01

    Objective Explore hysteroscopic observation and vasopressin combination therapy cesarean section pregnancy outcome. Methods A retrospective analysis of March 2014 - March 2015 treated in our hospital cesarean incision 64 cases of pregnancy, according to different programs into control group and study groups with 32 cases in the control group were treated with the B-curettage joint methotrexate, the study group to hysteroscopy and posterior pituitary hormone joint analysis of two groups. Results Serum β-HCG recovery time, recovery time of menstruation, hospital stay, compared with a statistically significant difference (P < 0.05). Conclusion Cesarean section incision pregnancy to after hysteroscopy and vasopressin combined with significant treatment effect.%目的 探究宫腔镜与垂体后叶素联合治疗剖宫产切口妊娠的疗效观察.方法 回顾性分析2014年3月~2015年3月本院诊治的剖宫产的切口妊娠者64例,按照不同方案分成对照组与研究组,每组32例,对照组予B超下清宫术联合甲氨蝶呤,研究组予宫腔镜与垂体后叶素联合,分析两组疗效.结果血β-HCG恢复时间、月经恢复时间、住院时间,比差异具统计意义(P<0.05).结论 对剖宫产的切口妊娠,予宫腔镜与垂体后叶素联合治疗效果显著.