WorldWideScience

Sample records for classifying caesarean sections

  1. Perimortem caesarean section.

    Science.gov (United States)

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

    2016-03-01

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

  2. Neonatology and the caesarean section.

    Science.gov (United States)

    Zanini, R; Minghetti, D

    2012-10-01

    The origins of the use of the Caesarean section date far back in human history. Traces of this procedure can be found in Greek mythology and in the history of Ancient Rome. Many documents about the history of religion make reference to a delivery from the abdomen. PMID:22958012

  3. Psychiatric illness in women requesting caesarean section

    OpenAIRE

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

    2014-01-01

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

  4. Effective education to decrease elective caesarean section

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Mahieu, Céline

    2016-01-01

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

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

    LENUS (Irish Health Repository)

    Robson, Michael

    2013-04-01

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

  7. Intervention for postpartum infections following caesarean section

    OpenAIRE

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sanjivani A. Wanjari

    2014-06-01

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

  9. Thromboprophylaxis for women undergoing caesarean section.

    LENUS (Irish Health Repository)

    Kennedy, C

    2012-02-01

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

  10. INDICATIONS FOR CAESAREAN SECTION IN NULLIPAROUS AND MULTIPAROUS WOMEN

    Directory of Open Access Journals (Sweden)

    Sheela

    2014-12-01

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

  11. Intervention for Postpartum Infections following Caesarean Section

    DEFF Research Database (Denmark)

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

    Purpose: To examine the effect on wound healing, using Negative Pressure Wound Therapy (NPWT) compared with standard wound dressings in women, who experience spontaneous dehiscence or reoperation due to infection or hematoma after caesarean section. In addition, an analysis of the health economic...... cost and consequences of NPWT is planned. Methods: A randomized controlled trial. The study will be performed at two large obstetrical units in Denmark. Data will be collected prospectively. We expect to include 50 women, of whom two-thirds will be randomized to NPWT. The primary endpoint is the...... treatment for one change with NPWT to be cost effective. Concussion: The preliminary results indicate that NPWT reduce the risk of re-rupture significantly. The benefit of the treatment is expected to be twofold: a) A reduction in health care costs (inpatient bed days and readmissions) b) An increase in the...

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  14. Caesarean section scar ectopic pregnancy following postcoital contraception.

    Science.gov (United States)

    Fabunmi, Laura; Perks, Nigel

    2002-07-01

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

  15. Techniques and materials for skin closure in caesarean section

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  16. Preference for Institutional Delivery and Caesarean Sections in Bangladesh

    OpenAIRE

    Kamal, S M Mostafa

    2013-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

    Manisha Sharma; Ruchira Nautiyal; Jaya Chaturvedi; Surbhi Bhargava

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

    Bolaji, I I; Meehan, F P

    1993-01-01

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

  1. Caesarean section in Ancient Greek mythology.

    Science.gov (United States)

    Lurie, Samuel

    2015-01-01

    The narrative of caesarean birth appears on several occasions in Greek mythology: in the birth of Dionysus is the God of the grape harvest and winemaking and wine; in the birth of Asclepius the God of medicine and healing; and in the birth of Adonis the God of beauty and desire. It is possible, however not obligatory, that it was not solely a fantasy but also reflected a contemporary medical practice. PMID:26203550

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

    LENUS (Irish Health Repository)

    Khalifeh, A

    2012-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Manisha Chhetry

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    International Journal of Paediatric Dentistry 2011 Background. Early in life, vaginally delivered infants exhibit a different composition of the gut flora compared with infants delivered by caesarean section (C-section); however, it is unclear whether this also applies to the oral cavity. Aim. To...

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

    Directory of Open Access Journals (Sweden)

    El-Khoury Marianne

    2012-08-01

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

  7. Caesarean Section and Hospitalization for Respiratory Syncytial Virus Infection

    DEFF Research Database (Denmark)

    Kristensen, Kim; Fisker, Niels; Haerskjold, Ann;

    2015-01-01

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

  8. Evidence-based surgical techniques for caesarean section

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rajarshi Aich, MBBS

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Piotr Niziurski

    2013-08-01

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

  11. Prolonged labour as indication for emergency caesarean section

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  12. Can classic metaphyseal lesions follow uncomplicated caesarean section?

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-05-15

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

  13. Anaesthetic Management of Caesarean Section in an Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Kirti N Saxena

    2008-01-01

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

  14. Third caesarean section in patient with myasthenia gravis

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  15. Emergency caesarean section in low risk nulliparous women

    DEFF Research Database (Denmark)

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

    2012-01-01

    The rising incidence of caesarean section (CS), including emergency caesarean section (ECS) in nulliparas is of concern. Previous CS may have implications for future pregnancies and deliveries. This article describes the prevalence and indications for ECS in a cohort of low risk nulliparas and...... association between risk factors and indications for ECS. Smoking during pregnancy (OR 2.33; CI 1.18-4.61) and BMI ≥ 30 (OR 2.87, CI 1.34-6.16) were associated with increased risk of ECS due to SFD. Birth weight (BW) ≥ 4,000 (OR 2.95; CI 1.92-4.53) and smoking cessation during pregnancy (OR 2.02; CI 1...

  16. Caesarean Section, Vaginal Delivery and Post Natal Depression

    OpenAIRE

    MH Baghianimoghadam; D Shodjaee zadeh; AH Aminian

    2009-01-01

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

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

    LENUS (Irish Health Repository)

    Sommerfield, D

    2010-01-01

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

  18. Fetal circulation during epidural analgesia for caesarean section.

    OpenAIRE

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

    1984-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Luana Buhagiar

    2011-01-01

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

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

    Science.gov (United States)

    van Reenen, Samantha; van Rensburg, Esmé

    2015-01-01

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

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

    OpenAIRE

    Rupal Samal; Pallavee Palai; Seetesh Ghose

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Rajita Jani; Devangi Munshi

    2013-01-01

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

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

    LENUS (Irish Health Repository)

    McMorrow, R C N

    2011-05-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Thulasi

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Gurpreet Kaur

    2015-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Sudhanshu Sekhara Nanda

    2014-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Adenike Funmilola Faremi

    2014-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-01-01

    Objectives: This study was undertaken to assess the degree of agreement amongst obstetricians regarding decisions to perform emergency Caesarean section (CS) procedures at a university hospital. Methods: This retrospective clinical audit was carried out on 50 consecutive emergency CS procedures performed between November 2012 and March 2013 on women with singleton pregnancies at the Sultan Qaboos University Hospital in Muscat, Oman. Data on each procedure were collected from electronic patient records and independently reviewed by six senior obstetricians to determine agreement with the decision. Results: Of the 50 women who underwent CS procedures, the mean age was 28.9 ± 5.1 years and 48% were primigravidae. A total of 65% of the CS procedures were category I. The most common indications for a CS was a non-reassuring fetal heart trace (40%) and dystocia (32%). There was complete agreement on the decision to perform 62% of the CS procedures. Five and four obstetricians agreed on 80% and 95% of the procedures, respectively. The range of disagreement was 4–20%. Disagreement occurred primarily with category II and III procedures compared to category I. Additionally, disagreement occurred in cases where the fetal heart trace pattern was interpreted as an indication for a category II CS. Conclusion: The majority of obstetricians agreed on the decisions to perform 94% of the emergency CS procedures. Obstetric decision-making could be improved with the implementation of fetal scalp pH testing facilities, fetal heart trace interpretation training and cardiotocography review meetings. PMID:26909212

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

    Science.gov (United States)

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

    2013-07-01

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

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

    OpenAIRE

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

    2014-01-01

    Background: Our aim was to determine the service quality of delivered care for people with Caesarean Section and Normal Delivery. Methods: A cross-sectional study was conducted among 200 people who had caesarean section and normal delivery in Al-Zahra Teaching Hospital in Tabriz, north western Iran. Service quality was calculated using: Service Quality = 10 – (Importance × Performance) based on importance and performance of service quality aspects from the postpartum women‟s...

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nandini M Dave

    2007-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    OBJECTIVE: To assess the association between fear of childbirth (FOC) and emergency caesarean section. DESIGN: A prospective cohort study of low-risk nulliparous women at term. SETTING: Nine obstetric departments in Denmark, May 2004-July 2005. POPULATION: A total of 2598 nulliparous women in...... recorded by the attending staff. Logistic regression analyses were used to estimate unadjusted and adjusted odds ratios (OR). MAIN OUTCOME MEASURES: Risk of emergency caesarean section in women who feared childbirth. RESULTS: FOC (W-DEQ sum score ≥ 85 and DFS sum score ≥ 70) was not associated with...... emergency caesarean section: adjusted OR = 0.81 (95% CI: 0.48-1.36) and OR = 0.97 (95% CI: 0.55-1.71), respectively. CONCLUSION: In this prospective observational study, women with FOC did not have an increased risk of emergency caesarean section compared to women with no such fear....

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

    Science.gov (United States)

    McGuinness, B J; Trivedi, A N

    1999-05-01

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

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

    OpenAIRE

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

    2000-01-01

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


Keywords: thromboprophylaxis; caesarean section; computerised assessment

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

    OpenAIRE

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

    2009-01-01

    BACKGROUND: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sensitisation at the age of 8 years, taking into account the allergic status of the parents. METHODS: 2917 children who participated in a birth cohort study were followed for 8 years. The definition of...

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

    OpenAIRE

    Aliya Islam; Ambreen Ehsan

    2011-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

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

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

    OpenAIRE

    Bamigboye, Anthony A; Hofmeyr, G Justus

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

    In England and Wales, 19% of live births in 2012 were at 37-38 weeks' gestation, equating to nearly 140 000 early-term births each year. Since caesarean sections (CS) are often performed at early-term gestations, this accounts for some of the increased proportion of the early-term births. Infants born early-term are at an increased risk of neonatal respiratory morbidity particularly if they are delivered by caesarean section. The long term lung function data are limited but available data suggest that early-term delivery is associated with respiratory morbidity in childhood. CS also appears to be associated with increased neonatal morbidity and future development of respiratory symptoms. However, future studies need to confirm the independent effects of caesarean sections and early-term deliveries particularly for long term outcomes as both are likely to affect the respiratory system differently. PMID:26810083

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

    Directory of Open Access Journals (Sweden)

    Bukar M

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    I. J. J. Dons-Sinke

    2014-01-01

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

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

    Czech Academy of Sciences Publication Activity Database

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

    2001-01-01

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

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

    OpenAIRE

    Rogelio González Pérez

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    AIM: The aim of this review was to assess the relationship between delivery by elective caesarean section and respiratory morbidity in the term and near-term neonate. METHODS: Searches were made in the MEDLINE database, EMBASE, Cochrane database and Web of Science to identify peer-reviewed studie...

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Zaman Shakila

    2010-01-01

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

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

    OpenAIRE

    Shubhra Goel; Cat Nguyen Burkat

    2011-01-01

    This is a rare case of persistent Horner's syndrome following epidural anesthesia and Caesarean section. A 33-year-old female presented with persistent ptosis and miosis following epidural anesthesia and Caesarian section several months prior. Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA) of head, neck, and chest were unremarkable. Medline search using terms Horner’s, epidural, spinal anesthesia, delivery, childbirth, Caesarian, and pregnancy identified 31 articles des...

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

    Directory of Open Access Journals (Sweden)

    Rajita Jani

    2013-07-01

    Full Text Available Objective: In today’s obstetric practice we encounter increasing number of post caesarean pregnancies because of rise in primary caesarean due to multi factorial reasons. There is increasing concern by obstetricians for managing these cases for medical and legal point of view. Present study was undertaken to decide appropriate mode of delivery and to conduct the proper management of patients with previous lower segment caesarean section.Study design: This is a prospective study carried out on 50 women with previous lower segment caesarean section. From December 2010 to December 2012 at private hospital Ahmedabad. Patient enrolled in study are with previous lower segment caesarean section (classical CS, Inverted T incision other medical complications (Hypertension, diabetes mellitus, anemia, heart disease, cardiac disease patients excluded. Patients were evaluated thoroughly by history and examination and mode of delivery was decided. Informed consent was taken of the patients who were fit for VBAC (Vaginal Birth after caesarean section. Women who were given trial ofVBAC, they progressed into labour spontaneously.Labour was constantly supervised by competent staff and meticulously monitored by cardiotocography.Results and discussion: Out of 50 cases, 40 (80% patients had history of previous 1 cesarean section, 8(16% patients had history of previous 2 cesarean section and 2 (4% had history of previous 3 cesarean section. Number of previous cesarean section has an important effect on outcome of labour as number of previous cesarean section increases, a repeat LSCS increases. Amongst 8 (16% patients with history of previous 2 LSCS and 2(4% patients with previous 3 LSCS, repeat LSCS was done in all 10 patients as there is no policy to give trial in patients of previous two or more caesarean sections. In present study, out of 40 patients with history of previous 1 cesarean section, in 20 patients repeat LSCS was done without giving trial

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

    Directory of Open Access Journals (Sweden)

    Shubhra Goel

    2011-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Rodrigo M. Carrillo-Larco

    2015-06-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sujay

    2014-05-01

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

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

    LENUS (Irish Health Repository)

    Agnew, G

    2012-02-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Kashif, Sanum; Saleem, Jodat

    2015-02-01

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

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

    OpenAIRE

    Larsson, Christina

    2010-01-01

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

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

    OpenAIRE

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

    1994-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rogelio González Pérez

    2012-04-01

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

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

    OpenAIRE

    Madhu Gupta; Shalini Subramanian; Preeti Adlakha

    2013-01-01

    A 31-year-antenatal lady with critical mitral stenosis presented for emergency caesarean section with fetal distress. She had acute onset atrial fibrillation. She was given a combined spinal epidural (CSE) anaesthesia and her arrhythmia was successfully managed after delivery of the baby with intravenous calcium channel blocker. Mitral stenosis is the most common valvular heart disease complicating pregnancy in developing countries. The physiological changes during pregnancy may exacerbate th...

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

    OpenAIRE

    Hughes, Laura Jane

    2016-01-01

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

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

    OpenAIRE

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

    2014-01-01

    Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a defi...

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

    Directory of Open Access Journals (Sweden)

    Madhu Gupta

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    2007-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Biswas

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Volkov O.O.

    2014-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sushma

    2015-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Prerana N Shah

    2011-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Aliya Islam

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2011-01-01

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

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

    OpenAIRE

    Marshall, Joyce; Spiby, Helen; McCormick, Felicia

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Milanez Helaine M

    2010-06-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2014-10-01

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

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

    LENUS (Irish Health Repository)

    McMorrow, R C N

    2012-02-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    LENUS (Irish Health Repository)

    Tadrous, R

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Tadrous, R

    2011-07-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    AIM: No information was available on how fast intravenous cefuroxime administered to pregnant women before a Caesarean section was cleared in newborn infants. This study investigated the drug's half-life and the exposure of healthy newborn infants after their mothers received the drug. METHODS......: Healthy mothers received a single dose of cefuroxime 15 to 60 minutes before skin incision. One blood sample was drawn from the umbilical cord and two blood samples were drawn from the infant after delivery. Total plasma cefuroxime (μg/ml) was measured using high-pressure liquid chromatography. RESULTS......: Cefuroxime was given to 22 mothers, including two who had twins. The concentration of cefuroxime varied significantly among infants (p<0.001), while the rate of decline did not (p=0.24). The median cefuroxime half-life was 3.5 hours (range 2.9-5.5), which was approximately three times longer than in normal...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-01-01

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

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

    Directory of Open Access Journals (Sweden)

    J. Heethal

    2010-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Latika

    2015-06-01

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

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

    OpenAIRE

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

    2011-01-01

    Introduction Approximately 25% of all babies in North America are delivered via Caesarean section (C-section). Though a common surgical procedure, C-section recovery can be painful. Opioids, specifically codeine, are commonly used to ease pain; however, its active metabolite, morphine, passes into breast milk, and may produce unwanted side effects in neonates; therefore, alternatives to opioids are being sought. Reiki is an ancient Japanese form of healing where practitioners transfer healing...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Balvinder Sagoo

    2015-01-01

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

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

    LENUS (Irish Health Repository)

    O'Dwyer, Vicky

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Sheehan, Sharon R

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Lundgren, Ingela

    2015-02-05

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

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

    Directory of Open Access Journals (Sweden)

    Gowri Vaidyanathan

    2016-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Tatiana Augustinho Rocha

    2006-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Seyedeh Masoumeh Hosseini Valami

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Oshodi Yussuf A

    2010-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Sunil

    2014-06-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hagen Terje P

    2011-10-01

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

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

    OpenAIRE

    Nanik Handayani

    2015-01-01

    Pain is the most common effects in patients after undergoing surgery of Caesarean section. Pain management using pharmacological and non pharmacological management, one of non-pharmacological management is using music therapy The purpose of this study was to analyze the effect of music therapy on pain level of postoperative patients' with Caesarean section. The type of study is analytic with True Experimental type with Pre Post Test Control Group Design done by Random Allocation. The study po...

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

    Directory of Open Access Journals (Sweden)

    Salvatore Gizzo

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

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

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Clare Newton Dunn

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

  4. Caesarean Section: Could Different Transverse Abdominal Incision Techniques Influence Postpartum Pain and Subsequent Quality of Life? A Systematic Review

    Science.gov (United States)

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

    2015-01-01

    The choice of the type of abdominal incision performed in caesarean delivery is made chiefly on the basis of the individual surgeon’s experience and preference. A general consensus on the most appropriate surgical technique has not yet been reached. The aim of this systematic review of the literature is to compare the two most commonly used transverse abdominal incisions for caesarean delivery, the Pfannenstiel incision and the modified Joel-Cohen incision, in terms of acute and chronic post-surgical pain and their subsequent influence in terms of quality of life. Electronic database searches formed the basis of the literature search and the following databases were searched in the time frame between January 1997 and December 2013: MEDLINE, EMBASE Sciencedirect and the Cochrane Library. Key search terms included: “acute pain”, “chronic pain”, “Pfannenstiel incision”, “Misgav-Ladach”, “Joel Cohen incision”, in combination with “Caesarean Section”, “abdominal incision”, “numbness”, “neuropathic pain” and “nerve entrapment”. Data on 4771 patients who underwent caesarean section (CS) was collected with regards to the relation between surgical techniques and postoperative outcomes defined as acute or chronic pain and future pregnancy desire. The Misgav-Ladach incision was associated with a significant advantage in terms of reduction of post-surgical acute and chronic pain. It was indicated as the optimal technique in view of its characteristic of reducing lower pelvic discomfort and pain, thus improving quality of life and future fertility desire. Further studies which are not subject to important bias like pre-existing chronic pain, non-standardized analgesia administration, variable length of skin incision and previous abdominal surgery are required. PMID:25646621

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

    Directory of Open Access Journals (Sweden)

    Mahima Jain

    2016-06-01

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

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

    Science.gov (United States)

    Jihong, Lu; Siow, Anthony; Chern, Bernard

    2009-03-01

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

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

    Science.gov (United States)

    Drake, M J P; Hill, J S

    2013-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Wendy Chaboyer

    2014-09-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2013-04-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Chethanananda

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Tullika

    2014-03-01

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ali Sizlan

    2009-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    1989-05-01

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

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

    OpenAIRE

    Sancheeta Ghosh

    2010-01-01

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

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

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    AIM: To test whether intramuscular injection of 30 microg adrenaline decreased the incidence of respiratory distress and hypoglycaemia in term infants delivered by elective caesarean section before active labour. METHOD: The study was randomised and double-blinded. A total of 270 neonates were...... respiratory distress and hypoglycaemia was 14% among infants treated with adrenaline compared with 7% in those who received saline injection (p = 0.048). CONCLUSION: Intramuscular injection of 30 microg adrenaline does not reduce the incidence of respiratory distress or hypoglycaemia after elective caesarean...... assigned to intramuscular treatment with saline (0.30 ml) or 30 microg adrenaline (0.30 ml) immediately after birth. The primary endpoint was referral to the neonatal ward because of respiratory distress or a blood glucose level <1.8 mmol/l measured 2 h after birth. The first 50 infants were monitored with...

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    OpenAIRE

    Narayan

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rubio-Hoyos Sandra M

    2015-01-01

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

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

    Science.gov (United States)

    Parikh, Suchita; Tavri, Snehlata; Mohite, Shubha

    2016-01-01

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

  8. COMPARATIVE EVALUATION OF INTRATHECAL BUPIVACAINE-FENTANYL AND BUPIVACAINE - CLONIDINE FOR CAESAREAN SECTION IN PREGNANCY INDUCED HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Tripti

    2014-09-01

    Full Text Available BACKGROUND: Pain free postoperative period and early ambulation are the need of the day for mothers and their neonates for early initiation of breast feeding. It is moral responsibility of Anaesthesiologist to provide a safe and pain free postoperative period with use of various techniques and drug combinations. Spinal anaesthesia has been widely used for caesarean section in normalas well as preeclamptic parturients and has been found to be efficaciousand safe. The present study aimed to compare the analgesic efficacy and side effect profile of intrathecal Bupivacaine with Fentanyl and Bupivacaine with Clonidine in cesarean section of parturients with pregnancy induced hypertension (PIH. METHODS: 50 full term parturients with pregnancy induced hypertension scheduled for cesarean section were randomized into 2 groups of 25 each. GROUP BF (Bupivacaine with Fentanyl received 7.5mg of 0.5% hyperbaric Bupivacaine and 20µg Fentanyl intrathecally. GROUP BC (Bupivacaine with Clonidine received 7.5mg of 0.5% hyperbaric Bupivacaine and 60µg clonidine intrathecally. RESULTS: Patients in group BC showed long lasting analgesia compared to group BF (p value<0.05. Both the groups had satisfactory analgesia with hemodynamic stability, however the incidence of hypotension and vasopressor requirement was more in group BC compared to BF. Incidence of pruritus was exceptionally seen in group BF, however more patients were sedated and complained of dry mouth in group BC. Both the groups had comparable APGAR scores with no adverse neonatal effects. CONCLUSION: We conclude use of intrathecal clonidine 60µg and Fentanyl 20µg both provide excellent sensory and motor blockage with lower dose of bupivacaine. Both drugs improved intraoperative analgesia and prolonged the duration of effective analgesia without any adverse effect on neonate neurobehaviour. Fairly good analgesia with less sedation and better haemodynamic stability is observed with 20μg fentanyl

  9. A randomised controlled trial of opioid only versus combined opioid and non-steroidal anti inflammatory analgesics for pain relief in the first 48 hours after Caesarean section

    Directory of Open Access Journals (Sweden)

    Natalia Adamou

    2014-01-01

    Full Text Available Background: Post-Caesarean section pain is complex in nature, requiring a combination of pharmacological and non-pharmacological methods. Effective management of postoperative pain will reduce postoperative morbidity, hospital stay and cost. The objective of this study was to compare the clinical effectiveness and adverse effects of a combination of non-selective cyclooxygenase (COX inhibitor (Diclofenac sodium 50 mg and opioid (Pentazocine 60 mg to opiod only (Pentazocine 60 mg for pain management after Caesarean section (CS at Aminu Kano Teaching Hospital (AKTH. Materials and Methods: This was a randomised double-blind controlled study conducted at AKTH, Kano, Nigeria. A total of 166 patients scheduled to undergo either emergency or elective Caesarean section were studied. Group I received a combination of COX inhibitor and opiod while Group II received opiod only for pain management after CS. Results: The average age of the patients was 28.35 years (SD ± 6.426 in the group I and 26.9(SD ± 6.133 in group II. The mean parity was 3.27(SD ± 2.67 and 2.75(SD ± 2.14 while the mean gestational age at admission was 37.68(SD ± 2.69 and 38.18(SD ± 2.63 weeks in the first and second groups, respectively. Comparison of the level of pain experienced and patients satisfaction during the first 48 hours postoperatively revealed that the level of pain was statistically significantly less and patient′s satisfaction significantly better in group I compared to group II (P-value 0.00001. Conclusion: The use of combined compared to single agent analgesia is safe, significantly reduced pain and improved patient satisfaction after a caesarian section (CS.

  10. The pregnant woman and the good Samaritan: can a woman have a duty to undergo a caesarean section?

    Science.gov (United States)

    Scott, R

    2000-01-01

    Although a pregnant woman can now refuse any medical treatment needed by the fetus, the Court of Appeal has acknowledged that ethical dilemmas remain, adverting to the inappropriateness of legal compulsion of presumed moral duties in this context. This leaves the impression of an uncomfortable split between the ethics and the law. The notion of a pregnant woman refusing medical treatment needed by the fetus is troubling and it helps little simply to assert that she has a legal right to do so. At the same time, the idea that a pregnant woman fails in her moral duty unless she accepts any recommended treatment or surgery--however great the burden--is also not without difficulty. This article seeks to find a way between these two somewhat polarized positions by arguing that, instead of being a question primarily about whether legally to enforce moral obligations, the 'maternal-fetal conflict' begins with previously unrecognized difficulties in determining when a woman's prima facie moral rights invoked in the treatment context should 'give way' to the interests of the fetus. This difficulty is mirrored within the law. Thus, how can we tell when a pregnant woman has the moral or legal duty to submit to a caesarean section? Seen in this way, the conflict is a problem which lies at the interface between moral and legal rights and duties, showing that there are important conceptual links between the ethics and the law. Against this background, this article explores the limits of a pregnant woman's right to bodily integrity by focusing upon the idea of her moral duty to aid the fetus through her body. Here we find difficulties in determining the existence and extent of this somewhat extraordinary duty. Such a duty is contrasted with both negative and positive duties toward others in the course of 'general conduct.' Attention to the social context of pregnancy and the refusal of treatment within this is also instructive. Overall, the purpose is to foster understanding and

  11. A decade of inequality in maternity care: antenatal care, professional attendance at delivery, and caesarean section in Bangladesh (1991–2004

    Directory of Open Access Journals (Sweden)

    Ronsmans Carine

    2007-08-01

    Full Text Available Abstract Background Bangladesh is committed to the fifth Millennium Development Goal (MDG-5 target of reducing its maternal mortality ratio by three-quarters between 1990 and 2015. Since the early 1990s, Bangladesh has followed a strategy of improving access to facilities equipped and staffed to provide emergency obstetric care (EmOC. Methods We used data from four Demographic and Health Surveys conducted between 1993 and 2004 to examine trends in the proportions of live births preceded by antenatal consultation, attended by a health professional, and delivered by caesarean section, according to key socio-demographic characteristics. Results Utilization of antenatal care increased substantially, from 24% in 1991 to 60% in 2004. Despite a relatively greater increase in rural than urban areas, utilization remained much lower among the poorest rural women without formal education (18% compared with the richest urban women with secondary or higher education (99%. Professional attendance at delivery increased by 50% (from 9% to 14%, more rapidly in rural than urban areas, and caesarean sections trebled (from 2% to 6%, but these indicators remained low even by developing country standards. Within these trends there were huge inequalities; 86% of live births among the richest urban women with secondary or higher education were attended by a health professional, and 35% were delivered by caesarean section, compared with 2% and 0.1% respectively of live births among the poorest rural women without formal education. The trend in professional attendance was entirely confounded by socioeconomic and demographic changes, but education of the woman and her husband remained important determinants of utilization of obstetric services. Conclusion Despite commendable progress in improving uptake of antenatal care, and in equipping health facilities to provide emergency obstetric care, the very low utilization of these facilities, especially by poor women, is a

  12. A RANDOMIZED CLINICAL STUDY TO EVALUATE THE EFFECT OF INTRAVENOUS MAGNESIUM SULPHATE FOR POSTOPERATIVE PAIN RELIEF IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Jitendra

    2015-09-01

    Full Text Available BACKGROUND : In this randomized, double - blind, prospective study, we have evaluated the effect of i.v. infusion of magnesium sulphate during spinal anaesthesia, for postoperative pain relief in patients undergoing lower segment caesarean section. AIM : A comparative evaluation of intravenous magnesium sulphate for prevention of postoperative pain relief in lower segment caesarean section under spinal anaesthesia” . METHODS AND MATERIAL S : 60 female patients of ASA grade I and II of the age group 20 - 40 yrs., posted for lower segment caesarean section under spinal anaesthesia were selected after pre anaesthetic fitness. Randomly patient were divided into two groups (n=30 patients each group NS, and group MS to receive 100ml of 0.9% Normal saline and Magnesium sulphate 50mg kg - 1 in 100ml of 0.9% Normal saline respectively to be given over 15 min, 60min after performing spinal anaesthesia. After surgery, rescue analgesia in form of inj. tramadol 100 mg i.v was provided for the patients. The Postoperative pain scores, Rescue analgesic consumption, and incidences of sedation, shivering, dysrhythmia, bradycardia, and hypotension evaluated immediately after surgery, and at 30 min, 1, 2, 3, hrs. After surgery. STATISTICAL ANALYSIS: Results were expressed as mean and standard deviation. P value of <0.05 was considered statistically significant. RESULTS: IV Magnesium sulphate 50 mg kg - 1 bolus significantly prolonged duration of analgesia, superior quality of analgesia ( L ower VAS and significant reduction in postoperative analgesic requirement than normal saline under spinal anaesthesia. No significant hemodynamic and respiratory instability occurred with Magnesium Sulphate use. CONCLUSION: I.V. magnesium sulphate administration during spinal anaesthesia improves postoperative analge sia without any notable complications.

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

    OpenAIRE

    Litorp, Helena

    2015-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Nanik Handayani

    2015-11-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:"Times New Roman";} Pain is the most common effects in patients after undergoing surgery of Caesarean section. Pain management using pharmacological and non pharmacological management, one of non-pharmacological management is using music therapy The purpose of this study was to analyze the effect of music therapy on pain level of postoperative patients' with Caesarean section. The type of study is analytic with True Experimental type with Pre Post Test Control Group Design done by Random Allocation. The study population is post-operative Caesarean section mothers who are hospitalized in Surabaya Islamic Hospital Surabaya Jl. A Yani since May 2011. The Sample are some populations above mentioned with amount of 24 respondents, 12 respondents as a control and 12 respondents were given music therapy. The Sampling technique uses Consecutive Sampling. Independent variable is music therapy and dependent variable is pain level. The instrument used to measure the independent variables is a check sheet lists while the dependent variable is Descriptive Pain Intensity Scale. To analyze the changes of pain level in the control group and the treatment used Paired T Test, the result showed that values of ρ is 0.166 or (ρ > 0.05, so there is no significant change of pain level on a pre test and post test control group, whereas in treatment group obtained value of ρ is 0.000 or (ρ < 0.05, so there is a significant change of pain level on a pre test and post test. To analyze differences of pain

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

    Directory of Open Access Journals (Sweden)

    Kolokotroni Ourania

    2012-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Esteban Puentes-Rosas

    2004-02-01

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

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

    Science.gov (United States)

    O'Regan, M

    2003-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Yasmine El-Masry

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

    AIM: To test whether intramuscular injection of 30 microg adrenaline decreased the incidence of respiratory distress and hypoglycaemia in term infants delivered by elective caesarean section before active labour. METHOD: The study was randomised and double-blinded. A total of 270 neonates were...... assigned to intramuscular treatment with saline (0.30 ml) or 30 microg adrenaline (0.30 ml) immediately after birth. The primary endpoint was referral to the neonatal ward because of respiratory distress or a blood glucose level ... with pulse oximetry to disclose potential side effects. RESULTS: Pulse-oximetry recordings revealed a modest systemic effect by intramuscular adrenaline as the heart rate and the haemoglobin oxygen saturation were significantly higher in infants who received adrenaline. In contrast, the incidence...

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

    LENUS (Irish Health Repository)

    Tan, T

    2012-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Shelley

    2013-04-01

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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    赵松兰; 刘晓健; 李飞; 于红凤

    2011-01-01

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

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

    Science.gov (United States)

    Arpino, Bruno; Cannas, Massimo

    2016-05-30

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

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

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

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

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

    OpenAIRE

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ana Pilar Betrán

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

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

    Directory of Open Access Journals (Sweden)

    Vasantha Kumar J

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Jacob, Louis

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Sonja Melman

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

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

    Institute of Scientific and Technical Information of China (English)

    李湛

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Michael Affolter

    2016-08-01

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

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

    Institute of Scientific and Technical Information of China (English)

    查建梅; 褚光萍

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  17. Semi-automated porosity identification from thin section images using image analysis and intelligent discriminant classifiers

    Science.gov (United States)

    Ghiasi-Freez, Javad; Soleimanpour, Iman; Kadkhodaie-Ilkhchi, Ali; Ziaii, Mansur; Sedighi, Mahdi; Hatampour, Amir

    2012-08-01

    Identification of different types of porosity within a reservoir rock is a functional parameter for reservoir characterization since various pore types play different roles in fluid transport and also, the pore spaces determine the fluid storage capacity of the reservoir. The present paper introduces a model for semi-automatic identification of porosity types within thin section images. To get this goal, a pattern recognition algorithm is followed. Firstly, six geometrical shape parameters of sixteen largest pores of each image are extracted using image analysis techniques. The extracted parameters and their corresponding pore types of 294 pores are used for training two intelligent discriminant classifiers, namely linear and quadratic discriminant analysis. The trained classifiers take the geometrical features of the pores to identify the type and percentage of five types of porosity, including interparticle, intraparticle, oomoldic, biomoldic, and vuggy in each image. The accuracy of classifiers is determined from two standpoints. Firstly, the predicted and measured percentages of each type of porosity are compared with each other. The results indicate reliable performance for predicting percentage of each type of porosity. In the second step, the precisions of classifiers for categorizing the pore spaces are analyzed. The classifiers also took a high acceptance score when used for individual recognition of pore spaces. The proposed methodology is a further promising application for petroleum geologists allowing statistical study of pore types in a rapid and accurate way.

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

    Directory of Open Access Journals (Sweden)

    Melman Sonja

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Douwe A Verkuyl

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

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

    Directory of Open Access Journals (Sweden)

    Montgomery Alan A

    2004-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈少娟; 郭雅梅; 赖梅; 黄素娟; 张莹

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈启蓉

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    曹冬如; 张小燕; 包狄

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    潘桂芳

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    沈少云

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kidanto Hussein L

    2009-07-01

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

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

    LENUS (Irish Health Repository)

    Unterscheider, J

    2011-08-01

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

  8. Numerical Investigation of Sheath and Aerosol Flows in the Flow Combination Section of a Baron Fiber Classifier

    OpenAIRE

    Dubey, Prahit; Ghia, Urmila; Turkevich, Leonid A.

    2014-01-01

    The Baron fiber classifier is an instrument used to separate fibers by length. The flow combination section (FCS) of this instrument is an upstream annular region, where an aerosol of uncharged fibers is introduced along with two sheath flows; length separation occurs by dielectrophoresis downstream in the flow classification section. In its current implementation at NIOSH, the instrument is capable of processing only very small quantities of fibers. In order to prepare large quantities of le...

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

    Institute of Scientific and Technical Information of China (English)

    谭菁瑜; 董庆龙; 欧阳葆怡

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Joychandra Singh Oinam

    2016-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王新妃

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Madhuri Alwani

    2014-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张惠珍; 于振峰

    2014-01-01

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

  14. Intervention for postpartum infections following caesarean section

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    OpenAIRE

    Isabel Mª García Sánchez

    2004-01-01

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

  16. Cross-Sectional Relatedness Between Sentences in Breast Radiology Reports: Development of an SVM Classifier and Evaluation Against Annotations of Five Breast Radiologists

    OpenAIRE

    Sevenster, Merlijn; Qian, Yuechen; Abe, Hiroyuki; Buurman, Johannes

    2013-01-01

    Introduce the notion of cross-sectional relatedness as an informational dependence relation between sentences in the conclusion section of a breast radiology report and sentences in the findings section of the same report. Assess inter-rater agreement of breast radiologists. Develop and evaluate a support vector machine (SVM) classifier for automatically detecting cross-sectional relatedness. A standard reference is manually created from 444 breast radiology reports by the first author. A sub...

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

    LENUS (Irish Health Repository)

    Hayes, N E

    2012-02-01

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

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

    LENUS (Irish Health Repository)

    Hayes, N E

    2011-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Sneha S. Rao

    2016-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  1. First trimester caesarean scar ectopic pregnancy evaluation using MRI

    International Nuclear Information System (INIS)

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

  2. 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 ...

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

    Institute of Scientific and Technical Information of China (English)

    罗新萍; 尹新武; 罗芳; 周生智

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Amrutha Ramachandran

    2013-08-01

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

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

    DEFF Research Database (Denmark)

    Berlac, P A; Rasmussen, Yvonne Hovmann

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hong Zhou

    2012-01-01

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

  7. Classifying Microorganisms

    DEFF Research Database (Denmark)

    Sommerlund, Julie

    2006-01-01

    This paper describes the coexistence of two systems for classifying organisms and species: a dominant genetic system and an older naturalist system. The former classifies species and traces their evolution on the basis of genetic characteristics, while the latter employs physiological characteris...

  8. Pyoderma Gangrenosum in Two Successive Pregnancies Complicating Caesarean Wound

    Directory of Open Access Journals (Sweden)

    Sapna Vinit Amin

    2014-01-01

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

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

    OpenAIRE

    Zhu, Jie; Shen, Yue-Ying; ZHAO, YU-QING; Lin, Ru; Fang, Fang

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    谢伟

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    V R Hemanth Kumar

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    段庆芳; 肖玮; 张希峣; 王天龙

    2015-01-01

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

  13. Classifying Microorganisms.

    Science.gov (United States)

    Baker, William P.; Leyva, Kathryn J.; Lang, Michael; Goodmanis, Ben

    2002-01-01

    Focuses on an activity in which students sample air at school and generate ideas about how to classify the microorganisms they observe. The results are used to compare air quality among schools via the Internet. Supports the development of scientific inquiry and technology skills. (DDR)

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

    Directory of Open Access Journals (Sweden)

    Jyoti V. Dube

    2014-01-01

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

  15. 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.

  16. Carbon classified?

    DEFF Research Database (Denmark)

    Lippert, Ingmar

    2012-01-01

    . Using an actor- network theory (ANT) framework, the aim is to investigate the actors who bring together the elements needed to classify their carbon emission sources and unpack the heterogeneous relations drawn on. Based on an ethnographic study of corporate agents of ecological modernisation over a...... corporations construing themselves as able and suitable to manage their emissions, and, additionally, given that the construction of carbon emissions has performative consequences, the underlying practices need to be declassified, i.e. opened for public scrutiny. Hence the paper concludes by arguing for a...

  17. Caesarean section in a case of systemic lupus erythematosus

    OpenAIRE

    Varsha Vyas; Deepika Shukla; Surekha Patil; Shubha Mohite

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sinéad M O'Neill

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

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

    Directory of Open Access Journals (Sweden)

    Mostafizur Rahman

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    黄东林; 韩娜娜

    2012-01-01

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

  1. 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 ...

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

    Science.gov (United States)

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

    2007-09-01

    This article draws on qualitative data to explore the beliefs through which decisions about caesarean birth are made and to consider how these might contribute to the increasing rate of caesarean birth. A total of 36 interviews were conducted in Australia, including 12 hospital-based midwives, 6 obstetricians, and 18 women who had experienced caesarean birth within the 2 years prior to the research interview. Data reveal a belief derived from the pervasive discourse of neo-liberalism that women are self-governing autonomous subjects in their birth experience, with entitlement to the consumption of birthing information and services, as guided by obstetricians. Feeding into this belief are coexisting discourses that serve to organise 'free choice' in terms of safe/unsafe, order/disorder, life/death; and with ontological meanings, by structuring women's mothering identities as good/bad. The neo-liberal obligation to manage risk and pursue success for both mothers and babies means that women (and others) are obliged to choose what is set up as the most obvious and sensible option: safe, ordered caesareans. The structuring of discourses in this way shows how caesareans can be positioned as a preferential means of birth. PMID:17590252

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

    Directory of Open Access Journals (Sweden)

    Khajehei M

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

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

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

    LENUS (Irish Health Repository)

    Fawsitt, Christopher G

    2013-01-01

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

  6. Preoperative administration of cephalosporins for elective caesarean delivery

    Directory of Open Access Journals (Sweden)

    Bogavac Mirjana

    2010-01-01

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

  7. Clinical Analysis of 45 Cases of Caesarean Scar Pregnancy

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Upendra Singh

    2015-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Michel Chandon

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

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

    Directory of Open Access Journals (Sweden)

    Daniela de Abreu Barra

    2008-03-01

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

  11. A Classifier Ensemble of Binary Classifier Ensembles

    Directory of Open Access Journals (Sweden)

    Sajad Parvin

    2011-09-01

    Full Text Available This paper proposes an innovative combinational algorithm to improve the performance in multiclass classification domains. Because the more accurate classifier the better performance of classification, the researchers in computer communities have been tended to improve the accuracies of classifiers. Although a better performance for classifier is defined the more accurate classifier, but turning to the best classifier is not always the best option to obtain the best quality in classification. It means to reach the best classification there is another alternative to use many inaccurate or weak classifiers each of them is specialized for a sub-space in the problem space and using their consensus vote as the final classifier. So this paper proposes a heuristic classifier ensemble to improve the performance of classification learning. It is specially deal with multiclass problems which their aim is to learn the boundaries of each class from many other classes. Based on the concept of multiclass problems classifiers are divided into two different categories: pairwise classifiers and multiclass classifiers. The aim of a pairwise classifier is to separate one class from another one. Because of pairwise classifiers just train for discrimination between two classes, decision boundaries of them are simpler and more effective than those of multiclass classifiers.The main idea behind the proposed method is to focus classifier in the erroneous spaces of problem and use of pairwise classification concept instead of multiclass classification concept. Indeed although usage of pairwise classification concept instead of multiclass classification concept is not new, we propose a new pairwise classifier ensemble with a very lower order. In this paper, first the most confused classes are determined and then some ensembles of classifiers are created. The classifiers of each of these ensembles jointly work using majority weighting votes. The results of these ensembles

  12. CLASSIFIER IN BODO

    OpenAIRE

    Pratima Brahma

    2014-01-01

    The present paper investigates the classifiers in Bodo. In Bodo classifiers have function as specific determiner of the physical shape or size, quantity and quality of the noun. Classifiers in Bodo are predominantly of monosyllabic structure. It occurs with numeral and the classifiers precede numeral. The monosyllabic structure may be single verb or simple verb and noun; it functions as classifiers by suffixing numerals. In Bodo, classifier can occur before and after in no...

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

    Directory of Open Access Journals (Sweden)

    YM Zhang

    2016-02-01

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

  14. 15 CFR 4.8 - Classified Information.

    Science.gov (United States)

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kim Young-Mi

    2012-03-01

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

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

    OpenAIRE

    Gaurav Tomar; Neeraj Narang; TC Kriplani; Ashish Sethi

    2010-01-01

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

  17. 32 CFR 775.5 - Classified actions.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Classified actions. 775.5 Section 775.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY MISCELLANEOUS RULES PROCEDURES FOR IMPLEMENTING THE NATIONAL ENVIRONMENTAL POLICY ACT § 775.5 Classified actions. (a) The fact that a...

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

    Directory of Open Access Journals (Sweden)

    Malene M Andersen

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

  19. 10 CFR 110.126 - Protection of classified information.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Protection of classified information. 110.126 Section 110... MATERIAL Special Procedures for Classified Information in Hearings § 110.126 Protection of classified information. Nothing in this subpart shall relieve any person from safeguarding classified information...

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

    LENUS (Irish Health Repository)

    Ismail, Khadijah I

    2012-01-31

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

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

    Science.gov (United States)

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

    2015-01-01

    Caesarean section (CS) results in the occurrence of the phenomenon ‘niche’. A ‘niche’ describes the presence of a hypoechoic area within the myometrium of the lower uterine segment, reflecting a discontinuation of the myometrium at the site of a previous CS. Using gel or saline instillation sonohysterography, a niche is identified in the scar in more than half of the women who had had a CS, most with the uterus closed in one single layer, without closure of the peritoneum. An incompletely healed scar is a long-term complication of the CS and is associated with more gynaecological symptoms than is commonly acknowledged. Approximately 30% of women with a niche report spotting at 6–12 months after their CS. Other reported symptoms in women with a niche are dysmenorrhoea, chronic pelvic pain and dyspareunia. Given the association between a niche and gynaecological symptoms, obstetric complications and potentially with subfertility, it is important to elucidate the aetiology of niche development after CS in order to develop preventive strategies. Based on current published data and our observations during sonographic, hysteroscopic and laparoscopic evaluations of niches we postulate some hypotheses on niche development. Possible factors that could play a role in niche development include a very low incision through cervical tissue, inadequate suturing technique during closure of the uterine scar, surgical interventions that increase adhesion formation or patient-related factors that impair wound healing or increase inflammation or adhesion formation. PMID:26409016

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

    Directory of Open Access Journals (Sweden)

    Sandeep P. Kumar

    2015-06-01

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

  3. Recognition Using Hybrid Classifiers.

    Science.gov (United States)

    Osadchy, Margarita; Keren, Daniel; Raviv, Dolev

    2016-04-01

    A canonical problem in computer vision is category recognition (e.g., find all instances of human faces, cars etc., in an image). Typically, the input for training a binary classifier is a relatively small sample of positive examples, and a huge sample of negative examples, which can be very diverse, consisting of images from a large number of categories. The difficulty of the problem sharply increases with the dimension and size of the negative example set. We propose to alleviate this problem by applying a "hybrid" classifier, which replaces the negative samples by a prior, and then finds a hyperplane which separates the positive samples from this prior. The method is extended to kernel space and to an ensemble-based approach. The resulting binary classifiers achieve an identical or better classification rate than SVM, while requiring far smaller memory and lower computational complexity to train and apply. PMID:26959677

  4. Dynamic system classifier

    CERN Document Server

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

    2016-01-01

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

  5. Classifying Returns as Extreme

    DEFF Research Database (Denmark)

    Christiansen, Charlotte

    2014-01-01

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

  6. Classifying Cereal Data

    Science.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Fayaz Ahmad

    2016-04-01

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

  8. Intelligent Garbage Classifier

    Directory of Open Access Journals (Sweden)

    Ignacio Rodríguez Novelle

    2008-12-01

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

  9. Intelligent Garbage Classifier

    OpenAIRE

    Ignacio Rodríguez Novelle; Javier Pérez Cid; Alvaro Salmador

    2008-01-01

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

  10. Classifier in Age classification

    OpenAIRE

    B. Santhi; R.Seethalakshmi

    2012-01-01

    Face is the important feature of the human beings. We can derive various properties of a human by analyzing the face. The objective of the study is to design a classifier for age using facial images. Age classification is essential in many applications like crime detection, employment and face detection. The proposed algorithm contains four phases: preprocessing, feature extraction, feature selection and classification. The classification employs two class labels namely child and Old. This st...

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

    Institute of Scientific and Technical Information of China (English)

    曾鸿; 李晓曦; 赵文秋; 冯新恒; 郭向阳

    2012-01-01

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

  12. Classified Stable Matching

    CERN Document Server

    Huang, Chien-Chung

    2009-01-01

    We introduce the {\\sc classified stable matching} problem, a problem motivated by academic hiring. Suppose that a number of institutes are hiring faculty members from a pool of applicants. Both institutes and applicants have preferences over the other side. An institute classifies the applicants based on their research areas (or any other criterion), and, for each class, it sets a lower bound and an upper bound on the number of applicants it would hire in that class. The objective is to find a stable matching from which no group of participants has reason to deviate. Moreover, the matching should respect the upper/lower bounds of the classes. In the first part of the paper, we study classified stable matching problems whose classifications belong to a fixed set of ``order types.'' We show that if the set consists entirely of downward forests, there is a polynomial-time algorithm; otherwise, it is NP-complete to decide the existence of a stable matching. In the second part, we investigate the problem using a p...

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

    Directory of Open Access Journals (Sweden)

    Nilesh C. Mhaske

    2015-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Fyfe Elaine M

    2012-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Lourdes Campero

    2007-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Aida Kulo

    2012-01-01

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

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

    DEFF Research Database (Denmark)

    Basso, Olga; Baird, Donna D.

    2003-01-01

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

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

    OpenAIRE

    Biswas,, S.; Rout; Mukhopadhyay,

    2014-01-01

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

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

    Science.gov (United States)

    Hillermann, Thomas; Breitenstein, Chantal; Soll, Cristina

    2015-06-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

  2. Comparative Analysis of Classifier Fusers

    Directory of Open Access Journals (Sweden)

    Marcin Zmyslony

    2012-06-01

    Full Text Available There are many methods of decision making by an ensemble of classifiers. The most popular are methods that have their origin in voting method, where the decision of the common classifier is a combination of individual classifiers’ outputs. This work presents comparative analysis of some classifier fusion methods based on weighted voting of classifiers’ responses and combination of classifiers’ discriminant functions. We discus different methods of producing combined classifiers based on weights. We show that it is notpossible to obtain classifier better than an abstract model of committee known as an Oracle if it is based only on weighted voting but models based on discriminant function or classifier using feature values and class numbers could outperform the Oracle as well. Delivered conclusions are confirmed by the results of computer experiments carried out on benchmark and computer generated data.

  3. Comparative Analysis of Classifier Fusers

    Directory of Open Access Journals (Sweden)

    Marcin Zmyslony

    2012-05-01

    Full Text Available There are many methods of decision making by an ensemble of classifiers. The most popular are methods that have their origin in voting method, where the decision of the common classifier is a combination of individual classifiers’ outputs. This work presents comparative analysis of some classifier fusion methods based on weighted voting of classifiers’ responses and combination of classifiers’ discriminant functions. We discus different methods of producing combined classifiers based on weights. We show that it is not possible to obtain classifier better than an abstract model of committee known as an Oracle if it is based only on weighted voting but models based on discriminant function or classifier using feature values and class numbers could outperform the Oracle as well. Delivered conclusions are confirmed by the results of computer experiments carried out on benchmark and computer generated data.

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

    OpenAIRE

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

    2010-01-01

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

  5. Feature Selection and Effective Classifiers.

    Science.gov (United States)

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

    1998-01-01

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

  6. 22 CFR 125.3 - Exports of classified technical data and classified defense articles.

    Science.gov (United States)

    2010-04-01

    ... classified defense articles. 125.3 Section 125.3 Foreign Relations DEPARTMENT OF STATE INTERNATIONAL TRAFFIC... commodity for shipment. A nontransfer and use certificate (Form DSP-83) executed by the applicant, foreign... reexport after a temporary import will be transferred or disclosed only in accordance with the...

  7. Classified

    CERN Multimedia

    Computer Security Team

    2011-01-01

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

  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. Al-Hadith Text Classifier

    OpenAIRE

    Mohammed Naji Al-Kabi; Ghassan Kanaan; Riyad Al-Shalabi; Saja I. Al- Sinjilawi; Ronza S. Al- Mustafa

    2005-01-01

    This study explore the implementation of a text classification method to classify the prophet Mohammed (PBUH) hadiths (sayings) using Sahih Al-Bukhari classification. The sayings explain the Holy Qur`an, which considered by Muslims to be the direct word of Allah. Present method adopts TF/IDF (Term Frequency-Inverse Document Frequency) which is used usually for text search. TF/IDF was used for term weighting, in which document weights for the selected terms are computed, to classify non-vocali...

  10. 3D Bayesian contextual classifiers

    DEFF Research Database (Denmark)

    Larsen, Rasmus

    2000-01-01

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

  11. Knowledge Uncertainty and Composed Classifier

    Czech Academy of Sciences Publication Activity Database

    Klimešová, Dana; Ocelíková, E.

    2007-01-01

    Roč. 1, č. 2 (2007), s. 101-105. ISSN 1998-0140 Institutional research plan: CEZ:AV0Z10750506 Keywords : Boosting architecture * contextual modelling * composed classifier * knowledge management , * knowledge * uncertainty Subject RIV: IN - Informatics, Computer Science

  12. Correlation Dimension-Based Classifier

    Czech Academy of Sciences Publication Activity Database

    Jiřina, Marcel; Jiřina jr., M.

    2014-01-01

    Roč. 44, č. 12 (2014), s. 2253-2263. ISSN 2168-2267 R&D Projects: GA MŠk(CZ) LG12020 Institutional support: RVO:67985807 Keywords : classifier * multidimensional data * correlation dimension * scaling exponent * polynomial expansion Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 3.469, year: 2014

  13. Classifying unstructured text using structured training instances and ensemble classifiers

    OpenAIRE

    Lianos, Andreas; Yang, Yanyan

    2015-01-01

    Typical supervised classification techniques require training instances similar to the values that need to be classified. This research proposes a methodology that can utilize training instances found in a different format. The benefit of this approach is that it allows the use of traditional classification techniques, without the need to hand-tag training instances if the information exists in other data sources. The proposed approach is presented through a practical classification applicati...

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

    Directory of Open Access Journals (Sweden)

    María Antonia Cabezas Poblet

    2003-12-01

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

  15. Aggregation Operator Based Fuzzy Pattern Classifier Design

    DEFF Research Database (Denmark)

    Mönks, Uwe; Larsen, Henrik Legind; Lohweg, Volker

    2009-01-01

    This paper presents a novel modular fuzzy pattern classifier design framework for intelligent automation systems, developed on the base of the established Modified Fuzzy Pattern Classifier (MFPC) and allows designing novel classifier models which are hardware-efficiently implementable. The...

  16. 75 FR 705 - Classified National Security Information

    Science.gov (United States)

    2010-01-05

    ... Executive Order 13526--Classified National Security Information Memorandum of December 29, 2009--Implementation of the Executive Order ``Classified National Security Information'' Order of December 29, 2009... ] Executive Order 13526 of December 29, 2009 Classified National Security Information This order prescribes...

  17. 76 FR 34761 - Classified National Security Information

    Science.gov (United States)

    2011-06-14

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

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

    International Nuclear Information System (INIS)

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

  19. 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

  20. Al-Hadith Text Classifier

    Directory of Open Access Journals (Sweden)

    Mohammed Naji Al-Kabi

    2005-01-01

    Full Text Available This study explore the implementation of a text classification method to classify the prophet Mohammed (PBUH hadiths (sayings using Sahih Al-Bukhari classification. The sayings explain the Holy Qur`an, which considered by Muslims to be the direct word of Allah. Present method adopts TF/IDF (Term Frequency-Inverse Document Frequency which is used usually for text search. TF/IDF was used for term weighting, in which document weights for the selected terms are computed, to classify non-vocalized sayings, after their terms (keywords have been transformed to the corresponding canonical form (i.e., roots, to one of eight Books (classes, according to Al-Bukhari classification. A term would have a higher weight if it were a good descriptor for a particular book, i.e., it appears frequently in the book but is infrequent in the entire corpus.

  1. Classifying self-gravitating radiations

    CERN Document Server

    Kim, Hyeong-Chan

    2016-01-01

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

  2. Clustering signatures classify directed networks

    Science.gov (United States)

    Ahnert, S. E.; Fink, T. M. A.

    2008-09-01

    We use a clustering signature, based on a recently introduced generalization of the clustering coefficient to directed networks, to analyze 16 directed real-world networks of five different types: social networks, genetic transcription networks, word adjacency networks, food webs, and electric circuits. We show that these five classes of networks are cleanly separated in the space of clustering signatures due to the statistical properties of their local neighborhoods, demonstrating the usefulness of clustering signatures as a classifier of directed networks.

  3. Classifying Southern Hemisphere extratropical cyclones

    Science.gov (United States)

    Catto, Jennifer

    2015-04-01

    There is a wide variety of flavours of extratropical cyclones in the Southern Hemisphere, with differing structures and lifecycles. Previous studies have classified these manually using upper level flow features or satellite data. In order to be able to evaluate climate models and understand how extratropical cyclones might change in the future, we need to be able to use an automated method to classify cyclones. Extratropical cyclones have been identified in the Southern Hemisphere from the ERA-Interim reanalysis dataset with a commonly used identification and tracking algorithm that employs 850hPa relative vorticity. A clustering method applied to large-scale fields from ERA-Interim at the time of cyclone genesis (when the cyclone is first identified), has been used to objectively classify these cyclones in the Southern Hemisphere. This simple method is able to separate the cyclones into classes with quite different development mechanisms and lifecycle characteristics. Some of the classes seem to coincide with previous manual classifications on shorter timescales, showing their utility for climate model evaluation and climate change studies.

  4. ANALYSIS OF BAYESIAN CLASSIFIER ACCURACY

    Directory of Open Access Journals (Sweden)

    Felipe Schneider Costa

    2013-01-01

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

  5. [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

  6. 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

  7. 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

  8. 41 CFR 102-34.45 - How are passenger automobiles classified?

    Science.gov (United States)

    2010-07-01

    ... automobiles classified? 102-34.45 Section 102-34.45 Public Contracts and Property Management Federal Property... MANAGEMENT Obtaining Fuel Efficient Motor Vehicles § 102-34.45 How are passenger automobiles classified? Passenger automobiles are classified in the following table: Sedan class Station wagon class...

  9. Waste classifying and separation device

    International Nuclear Information System (INIS)

    A flexible plastic bags containing solid wastes of indefinite shape is broken and the wastes are classified. The bag cutting-portion of the device has an ultrasonic-type or a heater-type cutting means, and the cutting means moves in parallel with the transferring direction of the plastic bags. A classification portion separates and discriminates the plastic bag from the contents and conducts classification while rotating a classification table. Accordingly, the plastic bag containing solids of indefinite shape can be broken and classification can be conducted efficiently and reliably. The device of the present invention has a simple structure which requires small installation space and enables easy maintenance. (T.M.)

  10. Defining and Classifying Interest Groups

    DEFF Research Database (Denmark)

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

    2014-01-01

    The interest group concept is defined in many different ways in the existing literature and a range of different classification schemes are employed. This complicates comparisons between different studies and their findings. One of the important tasks faced by interest group scholars engaged in...... large-N studies is therefore to define the concept of an interest group and to determine which classification scheme to use for different group types. After reviewing the existing literature, this article sets out to compare different approaches to defining and classifying interest groups with a sample...... cluster actors according to a number of key background characteristics and second assess how the categories of the different interest group typologies relate to these clusters. We demonstrate that background characteristics do align to a certain extent with certain interest group types but also find...

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

    LENUS (Irish Health Repository)

    Sheehan, S

    2011-02-01

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

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

    OpenAIRE

    Essén, Birgitta; Binder, Pauline; Johnsdotter, Sara

    2011-01-01

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

  13. 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.

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

    OpenAIRE

    Van Reenen, Samantha Lynne

    2012-01-01

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

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

    OpenAIRE

    Naima Fathima

    2016-01-01

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

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

    DEFF Research Database (Denmark)

    Leth, Rita Andersen

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

  17. Hybrid k -Nearest Neighbor Classifier.

    Science.gov (United States)

    Yu, Zhiwen; Chen, Hantao; Liuxs, Jiming; You, Jane; Leung, Hareton; Han, Guoqiang

    2016-06-01

    Conventional k -nearest neighbor (KNN) classification approaches have several limitations when dealing with some problems caused by the special datasets, such as the sparse problem, the imbalance problem, and the noise problem. In this paper, we first perform a brief survey on the recent progress of the KNN classification approaches. Then, the hybrid KNN (HBKNN) classification approach, which takes into account the local and global information of the query sample, is designed to address the problems raised from the special datasets. In the following, the random subspace ensemble framework based on HBKNN (RS-HBKNN) classifier is proposed to perform classification on the datasets with noisy attributes in the high-dimensional space. Finally, the nonparametric tests are proposed to be adopted to compare the proposed method with other classification approaches over multiple datasets. The experiments on the real-world datasets from the Knowledge Extraction based on Evolutionary Learning dataset repository demonstrate that RS-HBKNN works well on real datasets, and outperforms most of the state-of-the-art classification approaches. PMID:26126291

  18. 18 CFR 367.18 - Criteria for classifying leases.

    Science.gov (United States)

    2010-04-01

    ... classification of the lease under the criteria in paragraph (a) of this section had the changed terms been in... the lessee) must not give rise to a new classification of a lease for accounting purposes. ... ACT General Instructions § 367.18 Criteria for classifying leases. (a) If, at its inception, a...

  19. Entropic One-Class Classifiers.

    Science.gov (United States)

    Livi, Lorenzo; Sadeghian, Alireza; Pedrycz, Witold

    2015-12-01

    The one-class classification problem is a well-known research endeavor in pattern recognition. The problem is also known under different names, such as outlier and novelty/anomaly detection. The core of the problem consists in modeling and recognizing patterns belonging only to a so-called target class. All other patterns are termed nontarget, and therefore, they should be recognized as such. In this paper, we propose a novel one-class classification system that is based on an interplay of different techniques. Primarily, we follow a dissimilarity representation-based approach; we embed the input data into the dissimilarity space (DS) by means of an appropriate parametric dissimilarity measure. This step allows us to process virtually any type of data. The dissimilarity vectors are then represented by weighted Euclidean graphs, which we use to determine the entropy of the data distribution in the DS and at the same time to derive effective decision regions that are modeled as clusters of vertices. Since the dissimilarity measure for the input data is parametric, we optimize its parameters by means of a global optimization scheme, which considers both mesoscopic and structural characteristics of the data represented through the graphs. The proposed one-class classifier is designed to provide both hard (Boolean) and soft decisions about the recognition of test patterns, allowing an accurate description of the classification process. We evaluate the performance of the system on different benchmarking data sets, containing either feature-based or structured patterns. Experimental results demonstrate the effectiveness of the proposed technique. PMID:25879977

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

    Directory of Open Access Journals (Sweden)

    Poornima

    2013-05-01

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

  1. Rotary fluidized dryer classifier for coal

    Energy Technology Data Exchange (ETDEWEB)

    Sakaba, M.; Ueki, S.; Matsumoto, T.

    1985-01-01

    The development of equipment is reproted which uses a heat transfer medium and hot air to dry metallurgical coal to a predetermined moisture level, and which simultaneously classifies the dust-producing fine coal content. The integral construction of the drying and classifying zones results in a very compact configuration, with an installation area of 1/2 to 1/3 of that required for systems in which a separate dryer and classifier are combined. 6 references.

  2. Serefind: A Social Networking Website for Classifieds

    OpenAIRE

    Verma, Pramod

    2014-01-01

    This paper presents the design and implementation of a social networking website for classifieds, called Serefind. We designed search interfaces with focus on security, privacy, usability, design, ranking, and communications. We deployed this site at the Johns Hopkins University, and the results show it can be used as a self-sustaining classifieds site for public or private communities.

  3. A review of learning vector quantization classifiers

    CERN Document Server

    Nova, David

    2015-01-01

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

  4. A fuzzy classifier system for process control

    Science.gov (United States)

    Karr, C. L.; Phillips, J. C.

    1994-01-01

    A fuzzy classifier system that discovers rules for controlling a mathematical model of a pH titration system was developed by researchers at the U.S. Bureau of Mines (USBM). Fuzzy classifier systems successfully combine the strengths of learning classifier systems and fuzzy logic controllers. Learning classifier systems resemble familiar production rule-based systems, but they represent their IF-THEN rules by strings of characters rather than in the traditional linguistic terms. Fuzzy logic is a tool that allows for the incorporation of abstract concepts into rule based-systems, thereby allowing the rules to resemble the familiar 'rules-of-thumb' commonly used by humans when solving difficult process control and reasoning problems. Like learning classifier systems, fuzzy classifier systems employ a genetic algorithm to explore and sample new rules for manipulating the problem environment. Like fuzzy logic controllers, fuzzy classifier systems encapsulate knowledge in the form of production rules. The results presented in this paper demonstrate the ability of fuzzy classifier systems to generate a fuzzy logic-based process control system.

  5. Adaboost Ensemble Classifiers for Corporate Default Prediction

    Directory of Open Access Journals (Sweden)

    Suresh Ramakrishnan

    2015-01-01

    Full Text Available This study aims to show a substitute technique to corporate default prediction. Data mining techniques have been extensively applied for this task, due to its ability to notice non-linear relationships and show a good performance in presence of noisy information, as it usually happens in corporate default prediction problems. In spite of several progressive methods that have widely been proposed, this area of research is not out dated and still needs further examination. In this study, the performance of multiple classifier systems is assessed in terms of their capability to appropriately classify default and non-default Malaysian firms listed in Bursa Malaysia. Multi-stage combination classifiers provided significant improvements over the single classifiers. In addition, Adaboost shows improvement in performance over the single classifiers.

  6. Deconvolution When Classifying Noisy Data Involving Transformations

    KAUST Repository

    Carroll, Raymond

    2012-09-01

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

  7. Designing Kernel Scheme for Classifiers Fusion

    CERN Document Server

    Haghighi, Mehdi Salkhordeh; Vahedian, Abedin; Modaghegh, Hamed

    2009-01-01

    In this paper, we propose a special fusion method for combining ensembles of base classifiers utilizing new neural networks in order to improve overall efficiency of classification. While ensembles are designed such that each classifier is trained independently while the decision fusion is performed as a final procedure, in this method, we would be interested in making the fusion process more adaptive and efficient. This new combiner, called Neural Network Kernel Least Mean Square1, attempts to fuse outputs of the ensembles of classifiers. The proposed Neural Network has some special properties such as Kernel abilities,Least Mean Square features, easy learning over variants of patterns and traditional neuron capabilities. Neural Network Kernel Least Mean Square is a special neuron which is trained with Kernel Least Mean Square properties. This new neuron is used as a classifiers combiner to fuse outputs of base neural network classifiers. Performance of this method is analyzed and compared with other fusion m...

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

    Science.gov (United States)

    Musk, G C; Kemp, M W

    2016-06-01

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

  9. Parallelism and programming in classifier systems

    CERN Document Server

    Forrest, Stephanie

    1990-01-01

    Parallelism and Programming in Classifier Systems deals with the computational properties of the underlying parallel machine, including computational completeness, programming and representation techniques, and efficiency of algorithms. In particular, efficient classifier system implementations of symbolic data structures and reasoning procedures are presented and analyzed in detail. The book shows how classifier systems can be used to implement a set of useful operations for the classification of knowledge in semantic networks. A subset of the KL-ONE language was chosen to demonstrate these o

  10. Classifier Risk Estimation under Limited Labeling Resources

    OpenAIRE

    Kumar, Anurag; Raj, Bhiksha

    2016-01-01

    In this paper we propose strategies for estimating performance of a classifier when labels cannot be obtained for the whole test set. The number of test instances which can be labeled is very small compared to the whole test data size. The goal then is to obtain a precise estimate of classifier performance using as little labeling resource as possible. Specifically, we try to answer, how to select a subset of the large test set for labeling such that the performance of a classifier estimated ...

  11. 32 CFR 2004.21 - Protection of Classified Information [201(e)].

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Protection of Classified Information . 2004.21 Section 2004.21 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY... DIRECTIVE NO. 1 Operations § 2004.21 Protection of Classified Information . Procedures for the...

  12. 48 CFR 8.608 - Protection of classified and sensitive information.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Protection of classified and sensitive information. 8.608 Section 8.608 Federal Acquisition Regulations System FEDERAL... Prison Industries, Inc. 8.608 Protection of classified and sensitive information. Agencies shall...

  13. 14 CFR 1213.106 - Preventing release of classified information to the media.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Preventing release of classified... ADMINISTRATION RELEASE OF INFORMATION TO NEWS AND INFORMATION MEDIA § 1213.106 Preventing release of classified... employee from responsibility for preventing any unauthorized release. See NPR 1600.1, Chapter 5, Section...

  14. 40 CFR 260.32 - Variances to be classified as a boiler.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Variances to be classified as a boiler. 260.32 Section 260.32 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) HAZARDOUS WASTE MANAGEMENT SYSTEM: GENERAL Rulemaking Petitions § 260.32 Variances to be classified as a boiler. In accordance...

  15. Dengue—How Best to Classify It

    OpenAIRE

    Srikiatkhachorn, Anon; Rothman, Alan L.; Robert V Gibbons; Sittisombut, Nopporn; Malasit, Prida; Ennis, Francis A.; Nimmannitya, Suchitra; Kalayanarooj, Siripen

    2011-01-01

    Since the 1970s, dengue has been classified as dengue fever and dengue hemorrhagic fever. In 2009, the World Health Organization issued a new, severity-based clinical classification which differs greatly from the previous classification.

  16. Local Component Analysis for Nonparametric Bayes Classifier

    CERN Document Server

    Khademi, Mahmoud; safayani, Meharn

    2010-01-01

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

  17. Classifiers based on optimal decision rules

    KAUST Repository

    Amin, Talha

    2013-11-25

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

  18. Classifying Genomic Sequences by Sequence Feature Analysis

    Institute of Scientific and Technical Information of China (English)

    Zhi-Hua Liu; Dian Jiao; Xiao Sun

    2005-01-01

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

  19. Quality Classifiers for Open Source Software Repositories

    OpenAIRE

    Tsatsaronis, George; Halkidi, Maria; Giakoumakis, Emmanouel A.

    2009-01-01

    Open Source Software (OSS) often relies on large repositories, like SourceForge, for initial incubation. The OSS repositories offer a large variety of meta-data providing interesting information about projects and their success. In this paper we propose a data mining approach for training classifiers on the OSS meta-data provided by such data repositories. The classifiers learn to predict the successful continuation of an OSS project. The `successfulness' of projects is defined in terms of th...

  20. Searching and Classifying non-textual information

    OpenAIRE

    Arentz, Will Archer

    2004-01-01

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

  1. Nomograms for Visualization of Naive Bayesian Classifier

    OpenAIRE

    Možina, Martin; Demšar, Janez; Michael W Kattan; Zupan, Blaz

    2004-01-01

    Besides good predictive performance, the naive Bayesian classifier can also offer a valuable insight into the structure of the training data and effects of the attributes on the class probabilities. This structure may be effectively revealed through visualization of the classifier. We propose a new way to visualize the naive Bayesian model in the form of a nomogram. The advantages of the proposed method are simplicity of presentation, clear display of the effects of individual attribute value...

  2. Probabilistic classifiers with high-dimensional data

    OpenAIRE

    Kim, Kyung In; Simon, Richard

    2010-01-01

    For medical classification problems, it is often desirable to have a probability associated with each class. Probabilistic classifiers have received relatively little attention for small n large p classification problems despite of their importance in medical decision making. In this paper, we introduce 2 criteria for assessment of probabilistic classifiers: well-calibratedness and refinement and develop corresponding evaluation measures. We evaluated several published high-dimensional probab...

  3. Classifier Aggregation Using Local Classification Confidence

    Czech Academy of Sciences Publication Activity Database

    Štefka, David; Holeňa, Martin

    Setúbal: INSTICC, 2009, s. 173-178. ISBN 978-989-8111-66-1. [ICAART 2009. International Conference on Agents and Artificial Intelligence /1./. Porto (PT), 19.01.2009-21.01.2009] R&D Projects: GA AV ČR 1ET100300517 Institutional research plan: CEZ:AV0Z10300504 Keywords : classifier aggregation * classifier combining * classification confidence Subject RIV: IN - Informatics, Computer Science

  4. Evolving Classifiers: Methods for Incremental Learning

    OpenAIRE

    Hulley, Greg; Marwala, Tshilidzi

    2007-01-01

    The ability of a classifier to take on new information and classes by evolving the classifier without it having to be fully retrained is known as incremental learning. Incremental learning has been successfully applied to many classification problems, where the data is changing and is not all available at once. In this paper there is a comparison between Learn++, which is one of the most recent incremental learning algorithms, and the new proposed method of Incremental Learning Using Genetic ...

  5. Binary Classifier Calibration: Non-parametric approach

    OpenAIRE

    Naeini, Mahdi Pakdaman; Cooper, Gregory F.; Hauskrecht, Milos

    2014-01-01

    Accurate calibration of probabilistic predictive models learned is critical for many practical prediction and decision-making tasks. There are two main categories of methods for building calibrated classifiers. One approach is to develop methods for learning probabilistic models that are well-calibrated, ab initio. The other approach is to use some post-processing methods for transforming the output of a classifier to be well calibrated, as for example histogram binning, Platt scaling, and is...

  6. 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.

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

    CERN Document Server

    Hu, Bao-Gang

    2011-01-01

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

  8. COMBINING CLASSIFIERS FOR CREDIT RISK PREDICTION

    Institute of Scientific and Technical Information of China (English)

    Bhekisipho TWALA

    2009-01-01

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

  9. The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study

    OpenAIRE

    Nazareth Irwin; King Michael

    2006-01-01

    Abstract Background The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual. Methods We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that...

  10. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    Science.gov (United States)

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

    2012-01-01

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

  11. What are the differences between Bayesian classifiers and mutual-information classifiers?

    Science.gov (United States)

    Hu, Bao-Gang

    2014-02-01

    In this paper, both Bayesian and mutual-information classifiers are examined for binary classifications with or without a reject option. The general decision rules are derived for Bayesian classifiers with distinctions on error types and reject types. A formal analysis is conducted to reveal the parameter redundancy of cost terms when abstaining classifications are enforced. The redundancy implies an intrinsic problem of nonconsistency for interpreting cost terms. If no data are given to the cost terms, we demonstrate the weakness of Bayesian classifiers in class-imbalanced classifications. On the contrary, mutual-information classifiers are able to provide an objective solution from the given data, which shows a reasonable balance among error types and reject types. Numerical examples of using two types of classifiers are given for confirming the differences, including the extremely class-imbalanced cases. Finally, we briefly summarize the Bayesian and mutual-information classifiers in terms of their application advantages and disadvantages, respectively. PMID:24807026

  12. Dynamic Bayesian Combination of Multiple Imperfect Classifiers

    CERN Document Server

    Simpson, Edwin; Psorakis, Ioannis; Smith, Arfon

    2012-01-01

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

  13. Adapt Bagging to Nearest Neighbor Classifiers

    Institute of Scientific and Technical Information of China (English)

    Zhi-Hua Zhou; Yang Yu

    2005-01-01

    It is well-known that in order to build a strong ensemble, the component learners should be with high diversity as well as high accuracy. If perturbing the training set can cause significant changes in the component learners constructed, then Bagging can effectively improve accuracy. However, for stable learners such as nearest neighbor classifiers, perturbing the training set can hardly produce diverse component learners, therefore Bagging does not work well. This paper adapts Bagging to nearest neighbor classifiers through injecting randomness to distance metrics. In constructing the component learners, both the training set and the distance metric employed for identifying the neighbors are perturbed. A large scale empirical study reported in this paper shows that the proposed BagInRand algorithm can effectively improve the accuracy of nearest neighbor classifiers.

  14. Evolving Classifiers: Methods for Incremental Learning

    CERN Document Server

    Hulley, Greg

    2007-01-01

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

  15. Design of Robust Neural Network Classifiers

    DEFF Research Database (Denmark)

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

    1998-01-01

    This paper addresses a new framework for designing robust neural network classifiers. The network is optimized using the maximum a posteriori technique, i.e., the cost function is the sum of the log-likelihood and a regularization term (prior). In order to perform robust classification, we present...... a modified likelihood function which incorporates the potential risk of outliers in the data. This leads to the introduction of a new parameter, the outlier probability. Designing the neural classifier involves optimization of network weights as well as outlier probability and regularization...

  16. CLASSIFYING NODULAR LESIONS OF ORAL CAVITY

    OpenAIRE

    Sumit Bhateja

    2013-01-01

    Diagnosis of many lesions of the oral cavity is challenging to most cliniciansbecause of their uncommon prevalence. A number of cystic, osteodystrophic,microbial, tumor and tumor like lesions of the oral cavity are present withcharacteristic exophytic/raised surface; which makes their diagnosis and studysimpler. The present article is attempted at classifying the common nodular lesions ofthe oral cavity.

  17. The classifying topos of a topological bicategory

    CERN Document Server

    Bakovic, Igor

    2009-01-01

    For any topological bicategory 2C, the Duskin nerve N2C of 2C is a simplicial space. We introduce the classifying topos B2C of 2C as the Deligne topos of sheaves Sh(N2C) on the simplicial space 2NC. It is shown that the category of topos morphisms from the topos of sheaves Sh(X) on a topological space X to the Deligne classifying topos Sh(N2C) is naturally equivalent to the category of principal 2C-bundles. As a simple consequence, the geometric realization of the nerve N2C of a locally contractible topological bicategory 2C is the classifying space of principal 2C-bundles (on CW complexes), giving a variant of the result of Baas, Bokstedt and Kro derived in the context of bicategorical K-theory. We also define classifying topoi of a topological bicategory 2C using sheaves on other types of nerves of a bicategory given by Lack and Paoli, Simpson and Tamsamani by means of bisimplicial spaces, and we examine their properties.

  18. Automated mobility-classified-aerosol detector

    OpenAIRE

    Russell, Lynn M.; Flagan, Richard C.; Zhang, Shou-Hua

    2001-01-01

    An aerosol detection system for measuring particle number distribution with respect to particle dimension in an aerosol sample. The system includes an alternating dual-bag sampler, a radially classified differential mobility analyzer, and a condensation nucleus counter. Pressure variations in sampling are compensated by feedback control of volumetric flow rates using a plurality of flow control elements.

  19. Embedded feature ranking for ensemble MLP classifiers

    OpenAIRE

    Windeatt, T; Duangsoithong, R; Smith, R

    2011-01-01

    A feature ranking scheme for multilayer perceptron (MLP) ensembles is proposed, along with a stopping criterion based upon the out-of-bootstrap estimate. To solve multi-class problems feature ranking is combined with modified error-correcting output coding. Experimental results on benchmark data demonstrate the versatility of the MLP base classifier in removing irrelevant features.

  20. Adaptively robust filtering with classified adaptive factors

    Institute of Scientific and Technical Information of China (English)

    CUI Xianqiang; YANG Yuanxi

    2006-01-01

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

  1. 75 FR 37253 - Classified National Security Information

    Science.gov (United States)

    2010-06-28

    ... and Records Administration Information Security Oversight Office 32 CFR Parts 2001 and 2003 Classified National Security Information; Final Rule #0;#0;Federal Register / Vol. 75, No. 123 / Monday, June 28, 2010 / Rules and Regulations#0;#0; ] NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Information...

  2. Disassembly and Sanitization of Classified Matter

    International Nuclear Information System (INIS)

    The Disassembly Sanitization Operation (DSO) process was implemented to support weapon disassembly and disposition by using recycling and waste minimization measures. This process was initiated by treaty agreements and reconfigurations within both the DOD and DOE Complexes. The DOE is faced with disassembling and disposing of a huge inventory of retired weapons, components, training equipment, spare parts, weapon maintenance equipment, and associated material. In addition, regulations have caused a dramatic increase in the need for information required to support the handling and disposition of these parts and materials. In the past, huge inventories of classified weapon components were required to have long-term storage at Sandia and at many other locations throughout the DoE Complex. These materials are placed in onsite storage unit due to classification issues and they may also contain radiological and/or hazardous components. Since no disposal options exist for this material, the only choice was long-term storage. Long-term storage is costly and somewhat problematic, requiring a secured storage area, monitoring, auditing, and presenting the potential for loss or theft of the material. Overall recycling rates for materials sent through the DSO process have enabled 70 to 80% of these components to be recycled. These components are made of high quality materials and once this material has been sanitized, the demand for the component metals for recycling efforts is very high. The DSO process for NGPF, classified components established the credibility of this technique for addressing the long-term storage requirements of the classified weapons component inventory. The success of this application has generated interest from other Sandia organizations and other locations throughout the complex. Other organizations are requesting the help of the DSO team and the DSO is responding to these requests by expanding its scope to include Work-for- Other projects. For example

  3. Classification Studies in an Advanced Air Classifier

    Science.gov (United States)

    Routray, Sunita; Bhima Rao, R.

    2016-01-01

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

  4. NETWORK FAULT DIAGNOSIS USING DATA MINING CLASSIFIERS

    Directory of Open Access Journals (Sweden)

    Eleni Rozaki

    2015-04-01

    Full Text Available Mobile networks are under more pressure than ever before because of the increasing number of smartphone users and the number of people relying on mobile data networks. With larger numbers of users, the issue of service quality has become more important for network operators. Identifying faults in mobile networks that reduce the quality of service must be found within minutes so that problems can be addressed and networks returned to optimised performance. In this paper, a method of automated fault diagnosis is presented using decision trees, rules and Bayesian classifiers for visualization of network faults. Using data mining techniques the model classifies optimisation criteria based on the key performance indicators metrics to identify network faults supporting the most efficient optimisation decisions. The goal is to help wireless providers to localize the key performance indicator alarms and determine which Quality of Service factors should be addressed first and at which locations.

  5. Comparing cosmic web classifiers using information theory

    CERN Document Server

    Leclercq, Florent; Jasche, Jens; Wandelt, Benjamin

    2016-01-01

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

  6. Semantic Features for Classifying Referring Search Terms

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-11

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

  7. Comparing cosmic web classifiers using information theory

    Science.gov (United States)

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

    2016-08-01

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

  8. Design and evaluation of neural classifiers

    DEFF Research Database (Denmark)

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

    In this paper we propose a method for the design of feedforward neural classifiers based on regularization and adaptive architectures. Using a penalized maximum likelihood scheme we derive a modified form of the entropy error measure and an algebraic estimate of the test error. In conjunction wit...... optimal brain damage pruning the test error estimate is used to optimize the network architecture. The scheme is evaluated on an artificial and a real world problem......In this paper we propose a method for the design of feedforward neural classifiers based on regularization and adaptive architectures. Using a penalized maximum likelihood scheme we derive a modified form of the entropy error measure and an algebraic estimate of the test error. In conjunction with...

  9. Robot Learning Using Learning Classifier Systems Approach

    OpenAIRE

    Jabin, Suraiya

    2010-01-01

    In this chapter, I have presented Learning Classifier Systems, which add to the classical Reinforcement Learning framework the possibility of representing the state as a vector of attributes and finding a compact expression of the representation so induced. Their formalism conveys a nice interaction between learning and evolution, which makes them a class of particularly rich systems, at the intersection of several research domains. As a result, they profit from the accumulated extensions of ...

  10. Classifiers Based on Inverted Distances. Chapter 19

    Czech Academy of Sciences Publication Activity Database

    Jiřina, Marcel; Jiřina jr., M.

    Rijeka: InTech, 2011 - (Funatsu, K.; Hasegawa, K.), s. 369-386 ISBN 978-953-307-547-1 R&D Projects: GA MŠk(CZ) 1M0567 Institutional research plan: CEZ:AV0Z10300504 Keywords : classification * neighbor distances * correlation dimension * Zipfian distribution Subject RIV: BB - Applied Statistics, Operational Research http://www.intechopen.com/books/new-fundamental-technologies-in-data-mining/classifiers-based-on-inverted-distances

  11. Use Restricted - Classified information sharing, case NESA

    OpenAIRE

    El-Bash, Amira

    2015-01-01

    This Thesis is written for the Laurea University of Applied Sciences under the Bachelor’s Degree in Security Management. The empirical research of the thesis was supported by the National Emergency Supply Agency as a CASE study, in classified information sharing in the organization. The National Emergency Supply Agency was chosen for the research because of its social significance and distinctively wide operation field. Being one of the country’s administrator’s actors, its range of tasks in ...

  12. Comparing cosmic web classifiers using information theory

    OpenAIRE

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

    2016-01-01

    We introduce a decision scheme for optimally choosing a classifier, which segments the cosmic web into different structure types (voids, sheets, filaments, and clusters). Our framework, based on information theory, accounts for the design aims of different classes of possible applications: (i) parameter inference, (ii) model selection, and (iii) prediction of new observations. As an illustration, we use cosmographic maps of web-types in the Sloan Digital Sky Survey to assess the relative perf...

  13. Using Singularity Exponent in Distance based Classifier

    Czech Academy of Sciences Publication Activity Database

    Jiřina, Marcel; Jiřina jr., M.

    Los Alamitos : IEEE, 2010, s. 220-224 ISBN 978-1-4244-8135-4. [ISDA 2010. International Conference on Intelligent Systems Design and Applications /10./. Cairo (EG), 29.11.2010-01.12.2010] R&D Projects: GA MŠk 1M0567 Institutional research plan: CEZ:AV0Z10300504 Keywords : singularity exponent * nearest neighbor * classifier Subject RIV: IN - Informatics, Computer Science

  14. Classifying and evaluating architecture design methods

    OpenAIRE

    Aksit, Mehmet; Tekinerdogan, Bedir

    1999-01-01

    The concept of software architecture has gained a wide popularity and is generally considered to play a fundamental role in coping with the inherent difficulties of the development of large-scale and complex software systems. This document first gives a definition of architectures. Second, a meta-model for architecture design methods is presented. This model is used for classifying and evaluating various architecture design approaches. The document concludes with the description of the identi...

  15. Neural Network Classifier Based on Growing Hyperspheres

    Czech Academy of Sciences Publication Activity Database

    Jiřina Jr., Marcel; Jiřina, Marcel

    2000-01-01

    Roč. 10, č. 3 (2000), s. 417-428. ISSN 1210-0552. [Neural Network World 2000. Prague, 09.07.2000-12.07.2000] Grant ostatní: MŠMT ČR(CZ) VS96047; MPO(CZ) RP-4210 Institutional research plan: AV0Z1030915 Keywords : neural network * classifier * hyperspheres * big -dimensional data Subject RIV: BA - General Mathematics

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

    Institute of Scientific and Technical Information of China (English)

    蔡宇

    2009-01-01

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

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

    OpenAIRE

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-07-01

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

  19. Quality of life in urban-classified and rural-classified English local authority areas

    OpenAIRE

    Josep M. Campanera; Paul Higgins

    2011-01-01

    This paper presents the results of an analysis of the Audit Commission’s local quality-of-life indicators dataset to compare reported outcomes amongst 208 urban-classified and 144 rural-classified English local authority areas. We contextualise the demarcation of the urban and rural by reference to the transformational politics of the previous Labour government and its establishment of the sustainable communities initiative, whose controversial ‘place-based’ revitalisation essence continues t...

  20. A classifier neural network for rotordynamic systems

    Science.gov (United States)

    Ganesan, R.; Jionghua, Jin; Sankar, T. S.

    1995-07-01

    A feedforward backpropagation neural network is formed to identify the stability characteristic of a high speed rotordynamic system. The principal focus resides in accounting for the instability due to the bearing clearance effects. The abnormal operating condition of 'normal-loose' Coulomb rub, that arises in units supported by hydrodynamic bearings or rolling element bearings, is analysed in detail. The multiple-parameter stability problem is formulated and converted to a set of three-parameter algebraic inequality equations. These three parameters map the wider range of physical parameters of commonly-used rotordynamic systems into a narrow closed region, that is used in the supervised learning of the neural network. A binary-type state of the system is expressed through these inequalities that are deduced from the analytical simulation of the rotor system. Both the hidden layer as well as functional-link networks are formed and the superiority of the functional-link network is established. Considering the real time interpretation and control of the rotordynamic system, the network reliability and the learning time are used as the evaluation criteria to assess the superiority of the functional-link network. This functional-link network is further trained using the parameter values of selected rotor systems, and the classifier network is formed. The success rate of stability status identification is obtained to assess the potentials of this classifier network. The classifier network is shown that it can also be used, for control purposes, as an 'advisory' system that suggests the optimum way of parameter adjustment.

  1. 46 CFR 503.59 - Safeguarding classified information.

    Science.gov (United States)

    2010-10-01

    ... maintain: (1) A classified document register or log containing a listing of all classified holdings, and (2) A classified document destruction register or log containing the title and date of all classified... documents. (m) Combinations to dial-type locks shall be changed only by persons having an...

  2. Support Vector classifiers for Land Cover Classification

    CERN Document Server

    Pal, Mahesh

    2008-01-01

    Support vector machines represent a promising development in machine learning research that is not widely used within the remote sensing community. This paper reports the results of Multispectral(Landsat-7 ETM+) and Hyperspectral DAIS)data in which multi-class SVMs are compared with maximum likelihood and artificial neural network methods in terms of classification accuracy. Our results show that the SVM achieves a higher level of classification accuracy than either the maximum likelihood or the neural classifier, and that the support vector machine can be used with small training datasets and high-dimensional data.

  3. Gearbox Condition Monitoring Using Advanced Classifiers

    Directory of Open Access Journals (Sweden)

    P. Večeř

    2010-01-01

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

  4. Learnability of min-max pattern classifiers

    Science.gov (United States)

    Yang, Ping-Fai; Maragos, Petros

    1991-11-01

    This paper introduces the class of thresholded min-max functions and studies their learning under the probably approximately correct (PAC) model introduced by Valiant. These functions can be used as pattern classifiers of both real-valued and binary-valued feature vectors. They are a lattice-theoretic generalization of Boolean functions and are also related to three-layer perceptrons and morphological signal operators. Several subclasses of the thresholded min- max functions are shown to be learnable under the PAC model.

  5. Classifying LEP Data with Support Vector Algorithms

    CERN Document Server

    Vannerem, P; Schölkopf, B; Smola, A J; Söldner-Rembold, S

    1999-01-01

    We have studied the application of different classification algorithms in the analysis of simulated high energy physics data. Whereas Neural Network algorithms have become a standard tool for data analysis, the performance of other classifiers such as Support Vector Machines has not yet been tested in this environment. We chose two different problems to compare the performance of a Support Vector Machine and a Neural Net trained with back-propagation: tagging events of the type e+e- -> ccbar and the identification of muons produced in multihadronic e+e- annihilation events.

  6. Comparison of Current Frame-Based Phoneme Classifiers

    Directory of Open Access Journals (Sweden)

    Vaclav Pfeifer

    2011-01-01

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

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

    Science.gov (United States)

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

    2012-12-01

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

  8. Cross-classified occupational exposure data.

    Science.gov (United States)

    Jones, Rachael M; Burstyn, Igor

    2016-09-01

    We demonstrate the regression analysis of exposure determinants using cross-classified random effects in the context of lead exposures resulting from blasting surfaces in advance of painting. We had three specific objectives for analysis of the lead data, and observed: (1) high within-worker variability in personal lead exposures, explaining 79% of variability; (2) that the lead concentration outside of half-mask respirators was 2.4-fold higher than inside supplied-air blasting helmets, suggesting that the exposure reduction by blasting helmets may be lower than expected by the Assigned Protection Factor; and (3) that lead concentrations at fixed area locations in containment were not associated with personal lead exposures. In addition, we found that, on average, lead exposures among workers performing blasting and other activities was 40% lower than among workers performing only blasting. In the process of obtaining these analyses objectives, we determined that the data were non-hierarchical: repeated exposure measurements were collected for a worker while the worker was a member of several groups, or cross-classified among groups. Since the worker is a member of multiple groups, the exposure data do not adhere to the traditionally assumed hierarchical structure. Forcing a hierarchical structure on these data led to similar within-group and between-group variability, but decreased precision in the estimate of effect of work activity on lead exposure. We hope hygienists and exposure assessors will consider non-hierarchical models in the design and analysis of exposure assessments. PMID:27029937

  9. A systematic comparison of supervised classifiers.

    Directory of Open Access Journals (Sweden)

    Diego Raphael Amancio

    Full Text Available Pattern recognition has been employed in a myriad of industrial, commercial and academic applications. Many techniques have been devised to tackle such a diversity of applications. Despite the long tradition of pattern recognition research, there is no technique that yields the best classification in all scenarios. Therefore, as many techniques as possible should be considered in high accuracy applications. Typical related works either focus on the performance of a given algorithm or compare various classification methods. In many occasions, however, researchers who are not experts in the field of machine learning have to deal with practical classification tasks without an in-depth knowledge about the underlying parameters. Actually, the adequate choice of classifiers and parameters in such practical circumstances constitutes a long-standing problem and is one of the subjects of the current paper. We carried out a performance study of nine well-known classifiers implemented in the Weka framework and compared the influence of the parameter configurations on the accuracy. The default configuration of parameters in Weka was found to provide near optimal performance for most cases, not including methods such as the support vector machine (SVM. In addition, the k-nearest neighbor method frequently allowed the best accuracy. In certain conditions, it was possible to improve the quality of SVM by more than 20% with respect to their default parameter configuration.

  10. Classifying Coding DNA with Nucleotide Statistics

    Directory of Open Access Journals (Sweden)

    Nicolas Carels

    2009-10-01

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

  11. The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study

    Directory of Open Access Journals (Sweden)

    Nazareth Irwin

    2006-05-01

    Full Text Available Abstract Background The morbidity of gay, lesbian or bisexual people attending family practice has not been previously assessed. We compared health measures of family practice attendees classified as lesbian, gay and bisexual. Methods We conducted a cross-sectional, controlled study conducted in 13 London family practices and compared the responses of 26 lesbian and 85 bisexual classified women, with that of 934 heterosexual classified women and 38 gay and 23 bisexual classified men with that of 373 heterosexual classified men. Our outcomes of interest were: General health questionnaire; CAGE questionnaire; short form12; smoking status; sexual experiences during childhood; number of sexual partners and sexual function and satisfaction. Results In comparison to people classified as heterosexuals: men classified as gay reported higher levels of psychological symptoms (OR 2.48, CI 1.05–5.90; women classified as bisexual were more likely to misuse alcohol (OR 2.73, 1.70–4.40; women classified as bisexual (OR 2.53, 1.60–4.00 and lesbian (OR 3.13, 1.41–6.97 and men classified as bisexual (OR 2.48, 1,04, 5.86 were more likely to be smokers and women classified as bisexual (OR 3.27, 1.97–5.43 and men classified as gay (OR 4.86, 2.28–10.34 were much more likely to report childhood sexual experiences in childhood. Psychological distress was associated with reporting sexual experiences in childhood in men classified as gay and bisexual and women classified as heterosexual. Men classified as bisexual (OR 5.00, 1.73–14.51 and women classified as bisexual (OR 2.88, 1.24- 6.56 were more likely than heterosexuals to report more than one sexual partner in the preceding four weeks. Lesbian, gay and bisexual classified people encountered no more sexual function problems than heterosexuals but men classified as bisexual (OR 2.74, 1.12–6.70 were more dissatisfied with their sex lives. Conclusion Bisexual and lesbian classified people attending London

  12. 5 CFR 532.283 - Special wage schedules for nonappropriated fund tipped employees classified as waiter/waitress.

    Science.gov (United States)

    2010-01-01

    ... nonappropriated fund tipped employees classified as waiter/waitress. 532.283 Section 532.283 Administrative... Determinations § 532.283 Special wage schedules for nonappropriated fund tipped employees classified as waiter/waitress. (a) Tipped employees shall be paid from the regular nonappropriated fund (NAF)...

  13. A Spiking Neural Learning Classifier System

    CERN Document Server

    Howard, Gerard; Lanzi, Pier-Luca

    2012-01-01

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

  14. Learning Vector Quantization for Classifying Astronomical Objects

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

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

  15. Automatic Fracture Detection Using Classifiers- A Review

    Directory of Open Access Journals (Sweden)

    S.K.Mahendran

    2011-11-01

    Full Text Available X-Ray is one the oldest and frequently used devices, that makes images of any bone in the body, including the hand, wrist, arm, elbow, shoulder, foot, ankle, leg (shin, knee, thigh, hip, pelvis or spine. A typical bone ailment is the fracture, which occurs when bone cannot withstand outside force like direct blows, twisting injuries and falls. Fractures are cracks in bones and are defined as a medical condition in which there is a break in the continuity of the bone. Detection and correct treatment of fractures are considered important, as a wrong diagnosis often lead to ineffective patient management, increased dissatisfaction and expensive litigation. The main focus of this paper is a review study that discusses about various classification algorithms that can be used to classify x-ray images as normal or fractured.

  16. Combining Heterogeneous Classifiers for Relational Databases

    CERN Document Server

    Manjunatha, Geetha; Sitaram, Dinkar

    2012-01-01

    Most enterprise data is distributed in multiple relational databases with expert-designed schema. Using traditional single-table machine learning techniques over such data not only incur a computational penalty for converting to a 'flat' form (mega-join), even the human-specified semantic information present in the relations is lost. In this paper, we present a practical, two-phase hierarchical meta-classification algorithm for relational databases with a semantic divide and conquer approach. We propose a recursive, prediction aggregation technique over heterogeneous classifiers applied on individual database tables. The proposed algorithm was evaluated on three diverse datasets, namely TPCH, PKDD and UCI benchmarks and showed considerable reduction in classification time without any loss of prediction accuracy.

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

    OpenAIRE

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

    2013-01-01

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

  18. Classifying gauge anomalies through SPT orders and classifying anomalies through topological orders

    CERN Document Server

    Wen, Xiao-Gang

    2013-01-01

    In this paper, we systematically study gauge anomalies in bosonic and fermionic weak-coupling gauge theories with gauge group G (which can be continuous or discrete). We argue that, in d space-time dimensions, the gauge anomalies are described by the elements in Free[H^{d+1}(G,R/Z)]\\oplus H_\\pi^{d+1}(BG,R/Z). The well known Adler-Bell-Jackiw anomalies are classified by the free part of the group cohomology class H^{d+1}(G,R/Z) of the gauge group G (denoted as Free[H^{d+1}(G,\\R/\\Z)]). We refer other kinds of gauge anomalies beyond Adler-Bell-Jackiw anomalies as nonABJ gauge anomalies, which include Witten SU(2) global gauge anomaly. We introduce a notion of \\pi-cohomology group, H_\\pi^{d+1}(BG,R/Z), for the classifying space BG, which is an Abelian group and include Tor[H^{d+1}(G,R/Z)] and topological cohomology group H^{d+1}(BG,\\R/\\Z) as subgroups. We argue that H_\\pi^{d+1}(BG,R/Z) classifies the bosonic nonABJ gauge anomalies, and partially classifies fermionic nonABJ anomalies. We also show a very close rel...

  19. Gene-expression Classifier in Papillary Thyroid Carcinoma: Validation and Application of a Classifier for Prognostication

    DEFF Research Database (Denmark)

    Londero, Stefano Christian; Jespersen, Marie Louise; Krogdahl, Annelise;

    2016-01-01

    frozen tissue from 38 patients was collected between the years 1986 and 2009. Validation cohort: formalin-fixed paraffin-embedded tissues were collected from 183 consecutively treated patients. RESULTS: A 17-gene classifier was identified based on the expression values in patients with and without...

  20. Classifying gauge anomalies through symmetry-protected trivial orders and classifying gravitational anomalies through topological orders

    Science.gov (United States)

    Wen, Xiao-Gang

    2013-08-01

    In this paper, we systematically study gauge anomalies in bosonic and fermionic weak-coupling gauge theories with gauge group G (which can be continuous or discrete) in d space-time dimensions. We show a very close relation between gauge anomalies for gauge group G and symmetry-protected trivial (SPT) orders (also known as symmetry-protected topological (SPT) orders) with symmetry group G in one-higher dimension. The SPT phases are classified by group cohomology class Hd+1(G,R/Z). Through a more careful consideration, we argue that the gauge anomalies are described by the elements in Free[Hd+1(G,R/Z)]⊕Hπ˙d+1(BG,R/Z). The well known Adler-Bell-Jackiw anomalies are classified by the free part of Hd+1(G,R/Z) (denoted as Free[Hd+1(G,R/Z)]). We refer to other kinds of gauge anomalies beyond Adler-Bell-Jackiw anomalies as non-ABJ gauge anomalies, which include Witten SU(2) global gauge anomalies. We introduce a notion of π-cohomology group, Hπ˙d+1(BG,R/Z), for the classifying space BG, which is an Abelian group and include Tor[Hd+1(G,R/Z)] and topological cohomology group Hd+1(BG,R/Z) as subgroups. We argue that Hπ˙d+1(BG,R/Z) classifies the bosonic non-ABJ gauge anomalies and partially classifies fermionic non-ABJ anomalies. Using the same approach that shows gauge anomalies to be connected to SPT phases, we can also show that gravitational anomalies are connected to topological orders (i.e., patterns of long-range entanglement) in one-higher dimension.

  1. MISR Level 2 TOA/Cloud Classifier parameters V003

    Data.gov (United States)

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

  2. Optimized Radial Basis Function Classifier for Multi Modal Biometrics

    Directory of Open Access Journals (Sweden)

    Anand Viswanathan

    2014-07-01

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

  3. Classifying Unidentified Gamma-ray Sources

    CERN Document Server

    Salvetti, David

    2016-01-01

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

  4. Is it important to classify ischaemic stroke?

    LENUS (Irish Health Repository)

    Iqbal, M

    2012-02-01

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

  5. Stress fracture development classified by bone scintigraphy

    International Nuclear Information System (INIS)

    There is no consensus on classifying stress fractures (SF) appearing on bone scans. The authors present a system of classification based on grading the severity and development of bone lesions by visual inspection, according to three main scintigraphic criteria: focality and size, intensity of uptake compare to adjacent bone, and local medular extension. Four grades of development (I-IV) were ranked, ranging from ill defined slightly increased cortical uptake to well defined regions with markedly increased uptake extending transversely bicortically. 310 male subjects aged 19-2, suffering several weeks from leg pains occurring during intensive physical training underwent bone scans of the pelvis and lower extremities using Tc-99-m-MDP. 76% of the scans were positive with 354 lesions, of which 88% were in th4e mild (I-II) grades and 12% in the moderate (III) and severe (IV) grades. Post-treatment scans were obtained in 65 cases having 78 lesions during 1- to 6-month intervals. Complete resolution was found after 1-2 months in 36% of the mild lesions but in only 12% of the moderate and severe ones, and after 3-6 months in 55% of the mild lesions and 15% of the severe ones. 75% of the moderate and severe lesions showed residual uptake in various stages throughout the follow-up period. Early recognition and treatment of mild SF lesions in this study prevented protracted disability and progression of the lesions and facilitated complete healing

  6. Classifying auroras using artificial neural networks

    Science.gov (United States)

    Rydesater, Peter; Brandstrom, Urban; Steen, Ake; Gustavsson, Bjorn

    1999-03-01

    In Auroral Large Imaging System (ALIS) there is need of stable methods for analysis and classification of auroral images and images with for example mother of pearl clouds. This part of ALIS is called Selective Imaging Techniques (SIT) and is intended to sort out images of scientific interest. It's also used to find out what and where in the images there is for example different auroral phenomena's. We will discuss some about the SIT units main functionality but this work is mainly concentrated on how to find auroral arcs and how they are placed in images. Special case have been taken to make the algorithm robust since it's going to be implemented in a SIT unit which will work automatic and often unsupervised and some extends control the data taking of ALIS. The method for finding auroral arcs is based on a local operator that detects intensity differens. This gives arc orientation values as a preprocessing which is fed to a neural network classifier. We will show some preliminary results and possibilities to use and improve this algorithm for use in the future SIT unit.

  7. A Neural Network Classifier of Volume Datasets

    CERN Document Server

    Zukić, Dženan; Kolb, Andreas

    2009-01-01

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

  8. Colorization by classifying the prior knowledge

    Institute of Scientific and Technical Information of China (English)

    DU Weiwei

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. 28 CFR 17.47 - Denial or revocation of eligibility for access to classified information.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Denial or revocation of eligibility for access to classified information. 17.47 Section 17.47 Judicial Administration DEPARTMENT OF JUSTICE..., the identity of the deciding authority, and written notice of the right to appeal. (d) Within 30...

  11. 3 CFR 13526 - Executive Order 13526 of December 29, 2009. Classified National Security Information

    Science.gov (United States)

    2010-01-01

    ... documents in the physical and legal custody of the National Archives and Records Administration (National... classification standards and routine, secure, and effective declassification are equally important priorities... CLASSIFICATION Section 1.1. Classification Standards. (a) Information may be originally classified under...

  12. Classifying rock lithofacies using petrophysical data

    Science.gov (United States)

    Al-Omair, Osamah; Garrouch, Ali A.

    2010-09-01

    This study automates a type-curve technique for estimating the rock pore-geometric factor (λ) from capillary pressure measurements. The pore-geometric factor is determined by matching the actual rock capillary pressure versus wetting-phase saturation (Pc-Sw) profile with that obtained from the Brooks and Corey model (1966 J. Irrigation Drainage Proc. Am. Soc. Civ. Eng. 61-88). The pore-geometric factor values are validated by comparing the actual measured rock permeability to the permeability values estimated using the Wyllie and Gardner model (1958 World Oil (April issue) 210-28). Petrophysical data for both carbonate and sandstone rocks, along with the pore-geometric factor derived from the type-curve matching, are used in a discriminant analysis for the purpose of developing a model for rock typing. The petrophysical parameters include rock porosity (phi), irreducible water saturation (Swi), permeability (k), the threshold capillary-entry-pressure (Pd), a pore-shape factor (β), and a flow-impedance parameter (n) which is a property that reflects the flow impedance caused by the irreducible wetting-phase saturation. The results of the discriminant analysis indicate that five of the parameters (phi, k, Pd, λ and n) are sufficient for classifying rocks according to two broad lithology classes: sandstones and carbonates. The analysis reveals the existence of a significant discriminant function that is mostly sensitive to the pore-geometric factor values (λ). A discriminant-analysis classification model that honours both static and dynamic petrophysical rock properties is, therefore, introduced. When tested on two distinct data sets, the discriminant-analysis model was able to predict the correct lithofacies for approximately 95% of the tested samples. A comprehensive database of the experimentally collected petrophysical properties of 215 carbonate and sandstone rocks is provided with this study.

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

    Institute of Scientific and Technical Information of China (English)

    倪正强

    2008-01-01

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

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

    Science.gov (United States)

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

    2014-05-01

    Fusing a number of classifiers can generally improve the performance of individual classifiers, and the fuzzy integral, which can clearly express the interaction among the individual classifiers, has been acknowledged as an effective tool of fusion. In order to make the best use of the individual classifiers and their combinations, we propose in this paper a new scheme of classifier fusion based on upper integrals, which differs from all the existing models. Instead of being a fusion operator, the upper integral is used to reasonably arrange the finite resources, and thus to maximize the classification efficiency. By solving an optimization problem of upper integrals, we obtain a scheme for assigning proportions of examples to different individual classifiers and their combinations. According to these proportions, new examples could be classified by different individual classifiers and their combinations, and the combination of classifiers that specific examples should be submitted to depends on their performance. The definition of upper integral guarantees such a conclusion that the classification efficiency of the fused classifier is not less than that of any individual classifier theoretically. Furthermore, numerical simulations demonstrate that most existing fusion methodologies, such as bagging and boosting, can be improved by our upper integral model. PMID:23782843

  15. Face Detection Using a First-Order RCE Classifier

    Directory of Open Access Journals (Sweden)

    Byeong Hwan Jeon

    2003-08-01

    Full Text Available We present a new face detection algorithm based on a first-order reduced Coulomb energy (RCE classifier. The algorithm locates frontal views of human faces at any degree of rotation and scale in complex scenes. The face candidates and their orientations are first determined by computing the Hausdorff distance between simple face abstraction models and binary test windows in an image pyramid. Then, after normalizing the energy, each face candidate is verified by two subsequent classifiers: a binary image classifier and the first-order RCE classifier. While the binary image classifier is employed as a preclassifier to discard nonfaces with minimum computational complexity, the first-order RCE classifier is used as the main face classifier for final verification. An optimal training method to construct the representative face model database is also presented. Experimental results show that the proposed algorithm yields a high detection ratio while yielding no false alarm.

  16. Peat classified as slowly renewable biomass fuel

    International Nuclear Information System (INIS)

    thousands of years. The report states also that peat should be classified as biomass fuel instead of biofuels, such as wood, or fossil fuels such as coal. According to the report peat is a renewable biomass fuel like biofuels, but due to slow accumulation it should be considered as slowly renewable fuel. The report estimates that bonding of carbon in both virgin and forest drained peatlands are so high that it can compensate the emissions formed in combustion of energy peat

  17. INFLUENCE OF PROLONGED SITTING POSITION ON EFFECTS OF SPINAL ANAESTHESIA ON CAESAREAN DELIVERY: A RANDOMIZED CONTROLLED TRIAL

    Directory of Open Access Journals (Sweden)

    Priti

    2014-08-01

    postoperative analgesia was prolonged in both the fentanyl Groups. CONCLUSION: prolonged sitting position after spinal anesthesia not only limit the spread of LA, producing lower sensory block height but also reduces the incidence of hypotension and Intraoperative ephedrine requirement in caesarean delivery.

  18. Rule Based Ensembles Using Pair Wise Neural Network Classifiers

    Directory of Open Access Journals (Sweden)

    Moslem Mohammadi Jenghara

    2015-03-01

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

  19. Image Classifying Registration and Dynamic Region Merging

    Directory of Open Access Journals (Sweden)

    Himadri Nath Moulick

    2013-07-01

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

  20. 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 ...

  1. To fuse or not to fuse: Fuser versus best classifier

    Energy Technology Data Exchange (ETDEWEB)

    Rao, N.S.

    1998-04-01

    A sample from a class defined on a finite-dimensional Euclidean space and distributed according to an unknown distribution is given. The authors are given a set of classifiers each of which chooses a hypothesis with least misclassification error from a family of hypotheses. They address the question of choosing the classifier with the best performance guarantee versus combining the classifiers using a fuser. They first describe a fusion method based on isolation property such that the performance guarantee of the fused system is at least as good as the best of the classifiers. For a more restricted case of deterministic classes, they present a method based on error set estimation such that the performance guarantee of fusing all classifiers is at least as good as that of fusing any subset of classifiers.

  2. Evidential multinomial logistic regression for multiclass classifier calibration

    OpenAIRE

    Xu, Philippe; Davoine, Franck; Denoeux, Thierry

    2015-01-01

    The calibration of classifiers is an important task in information fusion. To compare or combine the outputs of several classifiers, they need to be represented in a common space. Probabilistic calibration methods transform the output of a classifier into a posterior probability distribution. In this paper, we introduce an evidential calibration method for multiclass classification problems. Our approach uses an extension of multinomial logistic regression to the theory of belief functions. W...

  3. Taxonomy grounded aggregation of classifiers with different label sets

    OpenAIRE

    SAHA, AMRITA; Indurthi, Sathish; Godbole, Shantanu; Rongali, Subendhu; Raykar, Vikas C.

    2015-01-01

    We describe the problem of aggregating the label predictions of diverse classifiers using a class taxonomy. Such a taxonomy may not have been available or referenced when the individual classifiers were designed and trained, yet mapping the output labels into the taxonomy is desirable to integrate the effort spent in training the constituent classifiers. A hierarchical taxonomy representing some domain knowledge may be different from, but partially mappable to, the label sets of the individua...

  4. Investigating The Fusion of Classifiers Designed Under Different Bayes Errors

    Directory of Open Access Journals (Sweden)

    Fuad M. Alkoot

    2004-12-01

    Full Text Available We investigate a number of parameters commonly affecting the design of a multiple classifier system in order to find when fusing is most beneficial. We extend our previous investigation to the case where unequal classifiers are combined. Results indicate that Sum is not affected by this parameter, however, Vote degrades when a weaker classifier is introduced in the combining system. This is more obvious when estimation error with uniform distribution exists.

  5. The SVM Classifier Based on the Modified Particle Swarm Optimization

    OpenAIRE

    Liliya Demidova; Evgeny Nikulchev; Yulia Sokolova

    2016-01-01

    The problem of development of the SVM classifier based on the modified particle swarm optimization has been considered. This algorithm carries out the simultaneous search of the kernel function type, values of the kernel function parameters and value of the regularization parameter for the SVM classifier. Such SVM classifier provides the high quality of data classification. The idea of particles' {\\guillemotleft}regeneration{\\guillemotright} is put on the basis of the modified particle swarm ...

  6. The analysis of cross-classified categorical data

    CERN Document Server

    Fienberg, Stephen E

    2007-01-01

    A variety of biological and social science data come in the form of cross-classified tables of counts, commonly referred to as contingency tables. Until recent years the statistical and computational techniques available for the analysis of cross-classified data were quite limited. This book presents some of the recent work on the statistical analysis of cross-classified data using longlinear models, especially in the multidimensional situation.

  7. Near-Optimal Evasion of Convex-Inducing Classifiers

    CERN Document Server

    Nelson, Blaine; Huang, Ling; Joseph, Anthony D; Lau, Shing-hon; Lee, Steven J; Rao, Satish; Tran, Anthony; Tygar, J D

    2010-01-01

    Classifiers are often used to detect miscreant activities. We study how an adversary can efficiently query a classifier to elicit information that allows the adversary to evade detection at near-minimal cost. We generalize results of Lowd and Meek (2005) to convex-inducing classifiers. We present algorithms that construct undetected instances of near-minimal cost using only polynomially many queries in the dimension of the space and without reverse engineering the decision boundary.

  8. 6 CFR 7.23 - Emergency release of classified information.

    Science.gov (United States)

    2010-01-01

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

  9. Unsupervised Supervised Learning II: Training Margin Based Classifiers without Labels

    CERN Document Server

    Donmez, Pinar; Lebanon, Guy

    2010-01-01

    Many popular linear classifiers, such as logistic regression, boosting, or SVM, are trained by optimizing a margin-based risk function. Traditionally, these risk functions are computed based on a labeled dataset. We develop a novel technique for estimating such risks using only unlabeled data and p(y). We prove that the technique is consistent for high-dimensional linear classifiers and demonstrate it on synthetic and real-world data. In particular, we show how the estimate is used for evaluating classifiers in transfer learning, and for training classifiers with no labeled data whatsoever.

  10. Construction of unsupervised sentiment classifier on idioms resources

    Institute of Scientific and Technical Information of China (English)

    谢松县; 王挺

    2014-01-01

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

  11. Facial expression recognition with facial parts based sparse representation classifier

    Science.gov (United States)

    Zhi, Ruicong; Ruan, Qiuqi

    2009-10-01

    Facial expressions play important role in human communication. The understanding of facial expression is a basic requirement in the development of next generation human computer interaction systems. Researches show that the intrinsic facial features always hide in low dimensional facial subspaces. This paper presents facial parts based facial expression recognition system with sparse representation classifier. Sparse representation classifier exploits sparse representation to select face features and classify facial expressions. The sparse solution is obtained by solving l1 -norm minimization problem with constraint of linear combination equation. Experimental results show that sparse representation is efficient for facial expression recognition and sparse representation classifier obtain much higher recognition accuracies than other compared methods.

  12. Using Classifiers to Identify Binge Drinkers Based on Drinking Motives.

    Science.gov (United States)

    Crutzen, Rik; Giabbanelli, Philippe

    2013-08-21

    A representative sample of 2,844 Dutch adult drinkers completed a questionnaire on drinking motives and drinking behavior in January 2011. Results were classified using regressions, decision trees, and support vector machines (SVMs). Using SVMs, the mean absolute error was minimal, whereas performance on identifying binge drinkers was high. Moreover, when comparing the structure of classifiers, there were differences in which drinking motives contribute to the performance of classifiers. Thus, classifiers are worthwhile to be used in research regarding (addictive) behaviors, because they contribute to explaining behavior and they can give different insights from more traditional data analytical approaches. PMID:23964957

  13. 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

  14. Performance of classification confidence measures in dynamic classifier systems

    Czech Academy of Sciences Publication Activity Database

    Štefka, D.; Holeňa, Martin

    2013-01-01

    Roč. 23, č. 4 (2013), s. 299-319. ISSN 1210-0552 R&D Projects: GA ČR GA13-17187S Institutional support: RVO:67985807 Keywords : classifier combining * dynamic classifier systems * classification confidence Subject RIV: IN - Informatics, Computer Science Impact factor: 0.412, year: 2013

  15. 3 CFR - Classified Information and Controlled Unclassified Information

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Classified Information and Controlled Unclassified Information Presidential Documents Other Presidential Documents Memorandum of May 27, 2009 Classified... and perceived technological obstacles to moving toward an information sharing culture, continue...

  16. 32 CFR 2400.30 - Reproduction of classified information.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Reproduction of classified information. 2400.30... SECURITY PROGRAM Safeguarding § 2400.30 Reproduction of classified information. Documents or portions of... the originator or higher authority. Any stated prohibition against reproduction shall be...

  17. Self-recalibrating classifiers for intracortical brain-computer interfaces

    Science.gov (United States)

    Bishop, William; Chestek, Cynthia C.; Gilja, Vikash; Nuyujukian, Paul; Foster, Justin D.; Ryu, Stephen I.; Shenoy, Krishna V.; Yu, Byron M.

    2014-04-01

    Objective. Intracortical brain-computer interface (BCI) decoders are typically retrained daily to maintain stable performance. Self-recalibrating decoders aim to remove the burden this may present in the clinic by training themselves autonomously during normal use but have only been developed for continuous control. Here we address the problem for discrete decoding (classifiers). Approach. We recorded threshold crossings from 96-electrode arrays implanted in the motor cortex of two rhesus macaques performing center-out reaches in 7 directions over 41 and 36 separate days spanning 48 and 58 days in total for offline analysis. Main results. We show that for the purposes of developing a self-recalibrating classifier, tuning parameters can be considered as fixed within days and that parameters on the same electrode move up and down together between days. Further, drift is constrained across time, which is reflected in the performance of a standard classifier which does not progressively worsen if it is not retrained daily, though overall performance is reduced by more than 10% compared to a daily retrained classifier. Two novel self-recalibrating classifiers produce a \\mathord {\\sim }15% increase in classification accuracy over that achieved by the non-retrained classifier to nearly recover the performance of the daily retrained classifier. Significance. We believe that the development of classifiers that require no daily retraining will accelerate the clinical translation of BCI systems. Future work should test these results in a closed-loop setting.

  18. Classifying spaces with virtually cyclic stabilizers for linear groups

    DEFF Research Database (Denmark)

    Degrijse, Dieter Dries; Köhl, Ralf; Petrosyan, Nansen

    2015-01-01

    We show that every discrete subgroup of GL(n, ℝ) admits a finite-dimensional classifying space with virtually cyclic stabilizers. Applying our methods to SL(3, ℤ), we obtain a four-dimensional classifying space with virtually cyclic stabilizers and a decomposition of the algebraic K-theory of its...

  19. 40 CFR 152.175 - Pesticides classified for restricted use.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Pesticides classified for restricted...) PESTICIDE PROGRAMS PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Classification of Pesticides § 152.175 Pesticides classified for restricted use. The following uses of pesticide products containing...

  20. Analysis of Sequence Based Classifier Prediction for HIV Subtypes

    Directory of Open Access Journals (Sweden)

    S. Santhosh Kumar

    2012-10-01

    Full Text Available Human immunodeficiency virus (HIV is a lent virus that causes acquired immunodeficiency syndrome (AIDS. The main drawback in HIV treatment process is its sub type prediction. The sub type and group classification of HIV is based on its genetic variability and location. HIV can be divided into two major types, HIV type 1 (HIV-1 and HIV type 2 (HIV-2. Many classifier approaches have been used to classify HIV subtypes based on their group, but some of cases are having two groups in one; in such cases the classification becomes more complex. The methodology used is this paper based on the HIV sequences. For this work several classifier approaches are used to classify the HIV1 and HIV2. For implementation of the work a real time patient database is taken and the patient records are experimented and the final best classifier is identified with quick response time and least error rate.

  1. Algorithm for classifying multiple targets using acoustic signatures

    Science.gov (United States)

    Damarla, Thyagaraju; Pham, Tien; Lake, Douglas

    2004-08-01

    In this paper we discuss an algorithm for classification and identification of multiple targets using acoustic signatures. We use a Multi-Variate Gaussian (MVG) classifier for classifying individual targets based on the relative amplitudes of the extracted harmonic set of frequencies. The classifier is trained on high signal-to-noise ratio data for individual targets. In order to classify and further identify each target in a multi-target environment (e.g., a convoy), we first perform bearing tracking and data association. Once the bearings of the targets present are established, we next beamform in the direction of each individual target to spatially isolate it from the other targets (or interferers). Then, we further process and extract a harmonic feature set from each beamformed output. Finally, we apply the MVG classifier on each harmonic feature set for vehicle classification and identification. We present classification/identification results for convoys of three to five ground vehicles.

  2. An ensemble of dissimilarity based classifiers for Mackerel gender determination

    International Nuclear Information System (INIS)

    Mackerel is an infravalored fish captured by European fishing vessels. A manner to add value to this specie can be achieved by trying to classify it attending to its sex. Colour measurements were performed on Mackerel females and males (fresh and defrozen) extracted gonads to obtain differences between sexes. Several linear and non linear classifiers such as Support Vector Machines (SVM), k Nearest Neighbors (k-NN) or Diagonal Linear Discriminant Analysis (DLDA) can been applied to this problem. However, theyare usually based on Euclidean distances that fail to reflect accurately the sample proximities. Classifiers based on non-Euclidean dissimilarities misclassify a different set of patterns. We combine different kind of dissimilarity based classifiers. The diversity is induced considering a set of complementary dissimilarities for each model. The experimental results suggest that our algorithm helps to improve classifiers based on a single dissimilarity

  3. An ensemble of SVM classifiers based on gene pairs.

    Science.gov (United States)

    Tong, Muchenxuan; Liu, Kun-Hong; Xu, Chungui; Ju, Wenbin

    2013-07-01

    In this paper, a genetic algorithm (GA) based ensemble support vector machine (SVM) classifier built on gene pairs (GA-ESP) is proposed. The SVMs (base classifiers of the ensemble system) are trained on different informative gene pairs. These gene pairs are selected by the top scoring pair (TSP) criterion. Each of these pairs projects the original microarray expression onto a 2-D space. Extensive permutation of gene pairs may reveal more useful information and potentially lead to an ensemble classifier with satisfactory accuracy and interpretability. GA is further applied to select an optimized combination of base classifiers. The effectiveness of the GA-ESP classifier is evaluated on both binary-class and multi-class datasets. PMID:23668348

  4. An ensemble of dissimilarity based classifiers for Mackerel gender determination

    Science.gov (United States)

    Blanco, A.; Rodriguez, R.; Martinez-Maranon, I.

    2014-03-01

    Mackerel is an infravalored fish captured by European fishing vessels. A manner to add value to this specie can be achieved by trying to classify it attending to its sex. Colour measurements were performed on Mackerel females and males (fresh and defrozen) extracted gonads to obtain differences between sexes. Several linear and non linear classifiers such as Support Vector Machines (SVM), k Nearest Neighbors (k-NN) or Diagonal Linear Discriminant Analysis (DLDA) can been applied to this problem. However, theyare usually based on Euclidean distances that fail to reflect accurately the sample proximities. Classifiers based on non-Euclidean dissimilarities misclassify a different set of patterns. We combine different kind of dissimilarity based classifiers. The diversity is induced considering a set of complementary dissimilarities for each model. The experimental results suggest that our algorithm helps to improve classifiers based on a single dissimilarity.

  5. Query Strategies for Evading Convex-Inducing Classifiers

    CERN Document Server

    Nelson, Blaine; Huang, Ling; Joseph, Anthony D; Lee, Steven J; Rao, Satish; Tygar, J D

    2010-01-01

    Classifiers are often used to detect miscreant activities. We study how an adversary can systematically query a classifier to elicit information that allows the adversary to evade detection while incurring a near-minimal cost of modifying their intended malfeasance. We generalize the theory of Lowd and Meek (2005) to the family of convex-inducing classifiers that partition input space into two sets one of which is convex. We present query algorithms for this family that construct undetected instances of approximately minimal cost using only polynomially-many queries in the dimension of the space and in the level of approximation. Our results demonstrate that near-optimal evasion can be accomplished without reverse-engineering the classifier's decision boundary. We also consider general lp costs and show that near-optimal evasion on the family of convex-inducing classifiers is generally efficient for both positive and negative convexity for all levels of approximation if p=1.

  6. Construction of High-accuracy Ensemble of Classifiers

    Directory of Open Access Journals (Sweden)

    Hedieh Sajedi

    2014-04-01

    Full Text Available There have been several methods developed to construct ensembles. Some of these methods, such as Bagging and Boosting are meta-learners, i.e. they can be applied to any base classifier. The combination of methods should be selected in order that classifiers cover each other weaknesses. In ensemble, the output of several classifiers is used only when they disagree on some inputs. The degree of disagreement is called diversity of the ensemble. Another factor that plays a significant role in performing an ensemble is accuracy of the basic classifiers. It can be said that all the procedures of constructing ensembles seek to achieve a balance between these two parameters, and successful methods can reach a better balance. The diversity of the members of an ensemble is known as an important factor in determining its generalization error. In this paper, we present a new approach for generating ensembles. The proposed approach uses Bagging and Boosting as the generators of base classifiers. Subsequently, the classifiers are partitioned by means of a clustering algorithm. We introduce a selection phase for construction the final ensemble and three different selection methods are proposed for applying in this phase. In the first proposed selection method, a classifier is selected randomly from each cluster. The second method selects the most accurate classifier from each cluster and the third one selects the nearest classifier to the center of each cluster to construct the final ensemble. The results of the experiments on well-known datasets demonstrate the strength of our proposed approach, especially applying the selection of the most accurate classifiers from clusters and employing Bagging generator.

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

    Directory of Open Access Journals (Sweden)

    Hyejin Jeong

    2011-01-01

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

  8. Class-specific Error Bounds for Ensemble Classifiers

    Energy Technology Data Exchange (ETDEWEB)

    Prenger, R; Lemmond, T; Varshney, K; Chen, B; Hanley, W

    2009-10-06

    The generalization error, or probability of misclassification, of ensemble classifiers has been shown to be bounded above by a function of the mean correlation between the constituent (i.e., base) classifiers and their average strength. This bound suggests that increasing the strength and/or decreasing the correlation of an ensemble's base classifiers may yield improved performance under the assumption of equal error costs. However, this and other existing bounds do not directly address application spaces in which error costs are inherently unequal. For applications involving binary classification, Receiver Operating Characteristic (ROC) curves, performance curves that explicitly trade off false alarms and missed detections, are often utilized to support decision making. To address performance optimization in this context, we have developed a lower bound for the entire ROC curve that can be expressed in terms of the class-specific strength and correlation of the base classifiers. We present empirical analyses demonstrating the efficacy of these bounds in predicting relative classifier performance. In addition, we specify performance regions of the ROC curve that are naturally delineated by the class-specific strengths of the base classifiers and show that each of these regions can be associated with a unique set of guidelines for performance optimization of binary classifiers within unequal error cost regimes.

  9. Glycosylation site prediction using ensembles of Support Vector Machine classifiers

    Directory of Open Access Journals (Sweden)

    Silvescu Adrian

    2007-11-01

    Full Text Available Abstract Background Glycosylation is one of the most complex post-translational modifications (PTMs of proteins in eukaryotic cells. Glycosylation plays an important role in biological processes ranging from protein folding and subcellular localization, to ligand recognition and cell-cell interactions. Experimental identification of glycosylation sites is expensive and laborious. Hence, there is significant interest in the development of computational methods for reliable prediction of glycosylation sites from amino acid sequences. Results We explore machine learning methods for training classifiers to predict the amino acid residues that are likely to be glycosylated using information derived from the target amino acid residue and its sequence neighbors. We compare the performance of Support Vector Machine classifiers and ensembles of Support Vector Machine classifiers trained on a dataset of experimentally determined N-linked, O-linked, and C-linked glycosylation sites extracted from O-GlycBase version 6.00, a database of 242 proteins from several different species. The results of our experiments show that the ensembles of Support Vector Machine classifiers outperform single Support Vector Machine classifiers on the problem of predicting glycosylation sites in terms of a range of standard measures for comparing the performance of classifiers. The resulting methods have been implemented in EnsembleGly, a web server for glycosylation site prediction. Conclusion Ensembles of Support Vector Machine classifiers offer an accurate and reliable approach to automated identification of putative glycosylation sites in glycoprotein sequences.

  10. Malignancy and Abnormality Detection of Mammograms using Classifier Ensembling

    Directory of Open Access Journals (Sweden)

    Nawazish Naveed

    2011-07-01

    Full Text Available The breast cancer detection and diagnosis is a critical and complex procedure that demands high degree of accuracy. In computer aided diagnostic systems, the breast cancer detection is a two stage procedure. First, to classify the malignant and benign mammograms, while in second stage, the type of abnormality is detected. In this paper, we have developed a novel architecture to enhance the classification of malignant and benign mammograms using multi-classification of malignant mammograms into six abnormality classes. DWT (Discrete Wavelet Transformation features are extracted from preprocessed images and passed through different classifiers. To improve accuracy, results generated by various classifiers are ensembled. The genetic algorithm is used to find optimal weights rather than assigning weights to the results of classifiers on the basis of heuristics. The mammograms declared as malignant by ensemble classifiers are divided into six classes. The ensemble classifiers are further used for multiclassification using one-against-all technique for classification. The output of all ensemble classifiers is combined by product, median and mean rule. It has been observed that the accuracy of classification of abnormalities is more than 97% in case of mean rule. The Mammographic Image Analysis Society dataset is used for experimentation.

  11. A Comparison of Unsupervised Classifiers on BATSE Catalog Data

    Science.gov (United States)

    Hakkila, Jon; Roiger, Richard J.; Haglin, David J.; Giblin, Timothy W.; Paciesas, William S.

    2003-04-01

    We classify BATSE gamma-ray bursts using unsupervised clustering algorithms in order to compare classification with statistical clustering techniques. BATSE bursts detected with homogeneous trigger criteria and measured with a limited attribute set (duration, hardness, and fluence) are classified using four unsupervised algorithms (the concept hierarchy classifier ESX, the EM algorithm, the Kmeans algorithm, and a kohonen neural network). The classifiers prefer three-class solutions to two-class and four-class solutions. When forced to find two classes, the classifiers do not find the traditional long and short classes; many short soft events are placed in a class with the short hard bursts. When three classes are found, the classifiers clearly identify the short bursts, but place far more members in an intermediate duration soft class than have been found using statistical clustering techniques. It appears that the boundary between short faint and long bright bursts is more important to the classifiers than is the boundary between short hard and long soft bursts. We conclude that the boundary between short faint and long hard bursts is the result of data bias and poor attribute selection. We recommend that future gamma-ray burst classification avoid using extrinsic parameters such as fluence, and should instead concentrate on intrinsic properties such as spectral, temporal, and (when available) luminosity characteristics. Future classification should also be wary of correlated attributes (such as fluence and duration), as these bias classification results.

  12. Use of Mamdani-Assilian Fuzzy Controller for Combining Classifiers

    Czech Academy of Sciences Publication Activity Database

    Štefka, David; Holeňa, Martin

    Praha : Matfyzpress, 2007 - (Obdržálek, D.; Štanclová, J.; Plátek, M.), s. 88-97 ISBN 978-80-7378-033-3. [ MIS 2007. Malý informatický seminář /24./. Josefův důl (CZ), 13.01.2007-20.01.2007] R&D Projects: GA AV ČR 1ET100300517; GA ČR GA201/05/0325 Institutional research plan: CEZ:AV0Z10300504 Keywords : fuzzy control * classifier fusion * classifier aggregation * classifier combining Subject RIV: IN - Informatics, Computer Science

  13. Classifying Regularized Sensor Covariance Matrices: An Alternative to CSP.

    Science.gov (United States)

    Roijendijk, Linsey; Gielen, Stan; Farquhar, Jason

    2016-08-01

    Common spatial patterns (CSP) is a commonly used technique for classifying imagined movement type brain-computer interface (BCI) datasets. It has been very successful with many extensions and improvements on the basic technique. However, a drawback of CSP is that the signal processing pipeline contains two supervised learning stages: the first in which class- relevant spatial filters are learned and a second in which a classifier is used to classify the filtered variances. This may lead to potential overfitting issues, which are generally avoided by limiting CSP to only a few filters. PMID:26372428

  14. Remote Sensing Data Binary Classification Using Boosting with Simple Classifiers

    Directory of Open Access Journals (Sweden)

    Nowakowski Artur

    2015-10-01

    Full Text Available Boosting is a classification method which has been proven useful in non-satellite image processing while it is still new to satellite remote sensing. It is a meta-algorithm, which builds a strong classifier from many weak ones in iterative way. We adapt the AdaBoost.M1 boosting algorithm in a new land cover classification scenario based on utilization of very simple threshold classifiers employing spectral and contextual information. Thresholds for the classifiers are automatically calculated adaptively to data statistics.

  15. Classifier performance estimation under the constraint of a finite sample size: resampling schemes applied to neural network classifiers.

    Science.gov (United States)

    Sahiner, Berkman; Chan, Heang-Ping; Hadjiiski, Lubomir

    2008-01-01

    In a practical classifier design problem the sample size is limited, and the available finite sample needs to be used both to design a classifier and to predict the classifier's performance for the true population. Since a larger sample is more representative of the population, it is advantageous to design the classifier with all the available cases, and to use a resampling technique for performance prediction. We conducted a Monte Carlo simulation study to compare the ability of different resampling techniques in predicting the performance of a neural network (NN) classifier designed with the available sample. We used the area under the receiver operating characteristic curve as the performance index for the NN classifier. We investigated resampling techniques based on the cross-validation, the leave-one-out method, and three different types of bootstrapping, namely, the ordinary, .632, and .632+ bootstrap. Our results indicated that, under the study conditions, there can be a large difference in the accuracy of the prediction obtained from different resampling methods, especially when the feature space dimensionality is relatively large and the sample size is small. Although this investigation is performed under some specific conditions, it reveals important trends for the problem of classifier performance prediction under the constraint of a limited data set. PMID:18234468

  16. A NON-PARAMETER BAYESIAN CLASSIFIER FOR FACE RECOGNITION

    Institute of Scientific and Technical Information of China (English)

    Liu Qingshan; Lu Hanqing; Ma Songde

    2003-01-01

    A non-parameter Bayesian classifier based on Kernel Density Estimation (KDE)is presented for face recognition, which can be regarded as a weighted Nearest Neighbor (NN)classifier in formation. The class conditional density is estimated by KDE and the bandwidthof the kernel function is estimated by Expectation Maximum (EM) algorithm. Two subspaceanalysis methods-linear Principal Component Analysis (PCA) and Kernel-based PCA (KPCA)are respectively used to extract features, and the proposed method is compared with ProbabilisticReasoning Models (PRM), Nearest Center (NC) and NN classifiers which are widely used in facerecognition systems. The experiments are performed on two benchmarks and the experimentalresults show that the KDE outperforms PRM, NC and NN classifiers.

  17. Remote Sensing Data Binary Classification Using Boosting with Simple Classifiers

    Science.gov (United States)

    Nowakowski, Artur

    2015-10-01

    Boosting is a classification method which has been proven useful in non-satellite image processing while it is still new to satellite remote sensing. It is a meta-algorithm, which builds a strong classifier from many weak ones in iterative way. We adapt the AdaBoost.M1 boosting algorithm in a new land cover classification scenario based on utilization of very simple threshold classifiers employing spectral and contextual information. Thresholds for the classifiers are automatically calculated adaptively to data statistics. The proposed method is employed for the exemplary problem of artificial area identification. Classification of IKONOS multispectral data results in short computational time and overall accuracy of 94.4% comparing to 94.0% obtained by using AdaBoost.M1 with trees and 93.8% achieved using Random Forest. The influence of a manipulation of the final threshold of the strong classifier on classification results is reported.

  18. A semi-automated approach to building text summarisation classifiers

    Directory of Open Access Journals (Sweden)

    Matias Garcia-Constantino

    2012-12-01

    Full Text Available An investigation into the extraction of useful information from the free text element of questionnaires, using a semi-automated summarisation extraction technique, is described. The summarisation technique utilises the concept of classification but with the support of domain/human experts during classifier construction. A realisation of the proposed technique, SARSET (Semi-Automated Rule Summarisation Extraction Tool, is presented and evaluated using real questionnaire data. The results of this evaluation are compared against the results obtained using two alternative techniques to build text summarisation classifiers. The first of these uses standard rule-based classifier generators, and the second is founded on the concept of building classifiers using secondary data. The results demonstrate that the proposed semi-automated approach outperforms the other two approaches considered.

  19. Classifying hot water chemistry: Application of MULTIVARIATE STATISTICS - R code

    OpenAIRE

    Irawan, Dasapta Erwin; Gio, Prana Ugiana

    2016-01-01

    The following R code was used in this paper "Classifying hot water chemistry: Application of MULTIVARIATE STATISTICS" authors: Prihadi Sumintadireja1, Dasapta Erwin Irawan1, Yuano Rezky2, Prana Ugiana Gio3, Anggita Agustin1

  20. Classifying hot water chemistry: Application of MULTIVARIATE STATISTICS

    OpenAIRE

    Sumintadireja, Prihadi; Irawan, Dasapta Erwin; Rezky, Yuanno; Gio, Prana Ugiana; Agustin, Anggita

    2016-01-01

    This file is the dataset for the following paper "Classifying hot water chemistry: Application of MULTIVARIATE STATISTICS". Authors: Prihadi Sumintadireja1, Dasapta Erwin Irawan1, Yuano Rezky2, Prana Ugiana Gio3, Anggita Agustin1

  1. Which Is Better: Holdout or Full-Sample Classifier Design?

    Directory of Open Access Journals (Sweden)

    Edward R. Dougherty

    2008-04-01

    Full Text Available Is it better to design a classifier and estimate its error on the full sample or to design a classifier on a training subset and estimate its error on the holdout test subset? Full-sample design provides the better classifier; nevertheless, one might choose holdout with the hope of better error estimation. A conservative criterion to decide the best course is to aim at a classifier whose error is less than a given bound. Then the choice between full-sample and holdout designs depends on which possesses the smaller expected bound. Using this criterion, we examine the choice between holdout and several full-sample error estimators using covariance models and a patient-data model. Full-sample design consistently outperforms holdout design. The relation between the two designs is revealed via a decomposition of the expected bound into the sum of the expected true error and the expected conditional standard deviation of the true error.

  2. AUTO CLAIM FRAUD DETECTION USING MULTI CLASSIFIER SYSTEM

    Directory of Open Access Journals (Sweden)

    Luis Alexandre Rodrigues

    2014-06-01

    Full Text Available Through a cost matrix and a combination of classifiers, this work identifies the most economical model to perform the detection of suspected cases of fraud in a dataset of automobile claims. The experiments performed by this work show that working more deeply in sampled data in the training phase and test phase of each classifier is possible obtain a more economic model than other model presented in the literature.

  3. Automatic Genre Classification of Latin Music Using Ensemble of Classifiers

    OpenAIRE

    Silla Jr, Carlos N.; Kaestner, Celso A.A.; Koerich, Alessandro L.

    2006-01-01

    This paper presents a novel approach to the task of automatic music genre classification which is based on ensemble learning. Feature vectors are extracted from three 30-second music segments from the beginning, middle and end of each music piece. Individual classifiers are trained to account for each music segment. During classification, the output provided by each classifier is combined with the aim of improving music genre classification accuracy. Experiments carried out on a dataset conta...

  4. One pass learning for generalized classifier neural network.

    Science.gov (United States)

    Ozyildirim, Buse Melis; Avci, Mutlu

    2016-01-01

    Generalized classifier neural network introduced as a kind of radial basis function neural network, uses gradient descent based optimized smoothing parameter value to provide efficient classification. However, optimization consumes quite a long time and may cause a drawback. In this work, one pass learning for generalized classifier neural network is proposed to overcome this disadvantage. Proposed method utilizes standard deviation of each class to calculate corresponding smoothing parameter. Since different datasets may have different standard deviations and data distributions, proposed method tries to handle these differences by defining two functions for smoothing parameter calculation. Thresholding is applied to determine which function will be used. One of these functions is defined for datasets having different range of values. It provides balanced smoothing parameters for these datasets through logarithmic function and changing the operation range to lower boundary. On the other hand, the other function calculates smoothing parameter value for classes having standard deviation smaller than the threshold value. Proposed method is tested on 14 datasets and performance of one pass learning generalized classifier neural network is compared with that of probabilistic neural network, radial basis function neural network, extreme learning machines, and standard and logarithmic learning generalized classifier neural network in MATLAB environment. One pass learning generalized classifier neural network provides more than a thousand times faster classification than standard and logarithmic generalized classifier neural network. Due to its classification accuracy and speed, one pass generalized classifier neural network can be considered as an efficient alternative to probabilistic neural network. Test results show that proposed method overcomes computational drawback of generalized classifier neural network and may increase the classification performance. PMID

  5. Subtractive Fuzzy Classifier Based Driver Distraction Levels Classification Using EEG

    OpenAIRE

    Wali, Mousa Kadhim; Murugappan, Murugappan; Ahmad, Badlishah

    2013-01-01

    [Purpose] In earlier studies of driver distraction, researchers classified distraction into two levels (not distracted, and distracted). This study classified four levels of distraction (neutral, low, medium, high). [Subjects and Methods] Fifty Asian subjects (n=50, 43 males, 7 females), age range 20–35 years, who were free from any disease, participated in this study. Wireless EEG signals were recorded by 14 electrodes during four types of distraction stimuli (Global Position Systems (GPS), ...

  6. Classification of Breast Cancer Using SVM Classifier Technique

    OpenAIRE

    B.Senthil Murugan; S.Srirambabu; Santhosh Kumar. V

    2010-01-01

    This paper proposes a technique for classifying the breast cancer from mammogram. The proposed system aims at developing the visualization tool for detecting the breast cancer and minimizing the scheme of detection. The detection method is organized as follows: (a) Image Enhancement (b) Segmentation (c) Feature extraction (d) Classification using SVM classifier Technique. Image enhancement step concentrates on converting an image to more and better understandable level thereby applying Median...

  7. Classifying pedestrian shopping behaviour according to implied heuristic choice rules

    OpenAIRE

    Shigeyuki Kurose; Aloys W J Borgers; Timmermans, Harry J. P.

    2001-01-01

    Our aim in this paper is to build and test a model which classifies and identifies pedestrian shopping behaviour in a shopping centre by using temporal and spatial choice heuristics. In particular, the temporal local-distance-minimising, total-distance-minimising, and global-distance-minimising heuristic choice rules and spatial nearest-destination-oriented, farthest-destination-oriented, and intermediate-destination-oriented choice rules are combined to classify and identify the stop sequenc...

  8. Classifying Tweet Level Judgements of Rumours in Social Media

    OpenAIRE

    Lukasik, Michal; Cohn, Trevor; Bontcheva, Kalina

    2015-01-01

    Social media is a rich source of rumours and corresponding community reactions. Rumours reflect different characteristics, some shared and some individual. We formulate the problem of classifying tweet level judgements of rumours as a supervised learning task. Both supervised and unsupervised domain adaptation are considered, in which tweets from a rumour are classified on the basis of other annotated rumours. We demonstrate how multi-task learning helps achieve good results on rumours from t...

  9. MASTER REGULATORS USED AS BREAST CANCER METASTASIS CLASSIFIER*

    OpenAIRE

    Lim, Wei Keat; Lyashenko, Eugenia; Califano, Andrea

    2009-01-01

    Computational identification of prognostic biomarkers capable of withstanding follow-up validation efforts is still an open challenge in cancer research. For instance, several gene expression profiles analysis methods have been developed to identify gene signatures that can classify cancer sub-phenotypes associated with poor prognosis. However, signatures originating from independent studies show only minimal overlap and perform poorly when classifying datasets other than the ones they were g...

  10. Mining housekeeping genes with a Naive Bayes classifier

    OpenAIRE

    Aitken Stuart; De Ferrari Luna

    2006-01-01

    Abstract Background Traditionally, housekeeping and tissue specific genes have been classified using direct assay of mRNA presence across different tissues, but these experiments are costly and the results not easy to compare and reproduce. Results In this work, a Naive Bayes classifier based only on physical and functional characteristics of genes already available in databases, like exon length and measures of chromatin compactness, has achieved a 97% success rate in classification of human...

  11. Mining housekeeping genes with a Naive Bayes classifier

    OpenAIRE

    Ferrari, Luna De; Aitken, Stuart

    2006-01-01

    BACKGROUND: Traditionally, housekeeping and tissue specific genes have been classified using direct assay of mRNA presence across different tissues, but these experiments are costly and the results not easy to compare and reproduce.RESULTS: In this work, a Naive Bayes classifier based only on physical and functional characteristics of genes already available in databases, like exon length and measures of chromatin compactness, has achieved a 97% success rate in classification of human houseke...

  12. Dealing with contaminated datasets: An approach to classifier training

    Science.gov (United States)

    Homenda, Wladyslaw; Jastrzebska, Agnieszka; Rybnik, Mariusz

    2016-06-01

    The paper presents a novel approach to classification reinforced with rejection mechanism. The method is based on a two-tier set of classifiers. First layer classifies elements, second layer separates native elements from foreign ones in each distinguished class. The key novelty presented here is rejection mechanism training scheme according to the philosophy "one-against-all-other-classes". Proposed method was tested in an empirical study of handwritten digits recognition.

  13. The Virtually Cyclic Classifying Space of the Heisenberg Group

    OpenAIRE

    Manion, Andrew; Pham, Lisa; Poelhuis, Jonathan

    2008-01-01

    We are interested in the relationship between the virtual cohomological dimension (or vcd) of a discrete group Gamma and the smallest possible dimension of a model for the classifying space of Gamma relative to its family of virtually cyclic subgroups. In this paper we construct a model for the virtually cyclic classifying space of the Heisenberg group. This model has dimension 3, which equals the vcd of the Heisenberg group. We also prove that there exists no model of dimension less than 3.

  14. Protein and lipid MALDI profiles classify breast cancers according to the intrinsic subtype

    International Nuclear Information System (INIS)

    Matrix-assisted laser desorption/ionization (MALDI) mass spectrometry (MS) has been demonstrated to be useful for molecular profiling of common solid tumors. Using recently developed MALDI matrices for lipid profiling, we evaluated whether direct tissue MALDI MS analysis on proteins and lipids may classify human breast cancer samples according to the intrinsic subtype. Thirty-four pairs of frozen, resected breast cancer and adjacent normal tissue samples were analyzed using histology-directed, MALDI MS analysis. Sinapinic acid and 2,5-dihydroxybenzoic acid/α-cyano-4-hydroxycinnamic acid were manually deposited on areas of each tissue section enriched in epithelial cells to identify lipid profiles, and mass spectra were acquired using a MALDI-time of flight instrument. Protein and lipid profiles distinguish cancer from adjacent normal tissue samples with the median prediction accuracy of 94.1%. Luminal, HER2+, and triple-negative tumors demonstrated different protein and lipid profiles, as evidenced by permutation P values less than 0.01 for 0.632+ bootstrap cross-validated misclassification rates with all classifiers tested. Discriminatory proteins and lipids were useful for classifying tumors according to the intrinsic subtype with median prediction accuracies of 80.0-81.3% in random test sets. Protein and lipid profiles accurately distinguish tumor from adjacent normal tissue and classify breast cancers according to the intrinsic subtype

  15. A cardiorespiratory classifier of voluntary and involuntary electrodermal activity

    Directory of Open Access Journals (Sweden)

    Sejdic Ervin

    2010-02-01

    Full Text Available Abstract Background Electrodermal reactions (EDRs can be attributed to many origins, including spontaneous fluctuations of electrodermal activity (EDA and stimuli such as deep inspirations, voluntary mental activity and startling events. In fields that use EDA as a measure of psychophysiological state, the fact that EDRs may be elicited from many different stimuli is often ignored. This study attempts to classify observed EDRs as voluntary (i.e., generated from intentional respiratory or mental activity or involuntary (i.e., generated from startling events or spontaneous electrodermal fluctuations. Methods Eight able-bodied participants were subjected to conditions that would cause a change in EDA: music imagery, startling noises, and deep inspirations. A user-centered cardiorespiratory classifier consisting of 1 an EDR detector, 2 a respiratory filter and 3 a cardiorespiratory filter was developed to automatically detect a participant's EDRs and to classify the origin of their stimulation as voluntary or involuntary. Results Detected EDRs were classified with a positive predictive value of 78%, a negative predictive value of 81% and an overall accuracy of 78%. Without the classifier, EDRs could only be correctly attributed as voluntary or involuntary with an accuracy of 50%. Conclusions The proposed classifier may enable investigators to form more accurate interpretations of electrodermal activity as a measure of an individual's psychophysiological state.

  16. How well Can We Classify SWOT-derived Water Surface Profiles?

    Science.gov (United States)

    Frasson, R. P. M.; Wei, R.; Picamilh, C.; Durand, M. T.

    2015-12-01

    The upcoming Surface Water Ocean Topography (SWOT) mission will detect water bodies and measure water surface elevation throughout the globe. Within its continental high resolution mask, SWOT is expected to deliver measurements of river width, water elevation and slope of rivers wider than ~50 m. The definition of river reaches is an integral step of the computation of discharge based on SWOT's observables. As poorly defined reaches can negatively affect the accuracy of discharge estimations, we seek strategies to break up rivers into physically meaningful sections. In the present work, we investigate how accurately we can classify water surface profiles based on simulated SWOT observations. We assume that most river sections can be classified as either M1 (mild slope, with depth larger than the normal depth), or A1 (adverse slope with depth larger than the critical depth). This assumption allows the classification to be based solely on the second derivative of water surface profiles, with convex profiles being classified as A1 and concave profiles as M1. We consider a HEC-RAS model of the Sacramento River as a representation of the true state of the river. We employ the SWOT instrument simulator to generate a synthetic pass of the river, which includes our best estimates of height measurement noise and geolocation errors. We process the resulting point cloud of water surface heights with the RiverObs package, which delineates the river center line and draws the water surface profile. Next, we identify inflection points in the water surface profile and classify the sections between the inflection points. Finally, we compare our limited classification of simulated SWOT-derived water surface profile to the "exact" classification of the modeled Sacramento River. With this exercise, we expect to determine if SWOT observations can be used to find inflection points in water surface profiles, which would bring knowledge of flow regimes into the definition of river reaches.

  17. 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

  18. Use of information barriers to protect classified information

    International Nuclear Information System (INIS)

    This paper discusses the detailed requirements for an information barrier (IB) for use with verification systems that employ intrusive measurement technologies. The IB would protect classified information in a bilateral or multilateral inspection of classified fissile material. Such a barrier must strike a balance between providing the inspecting party the confidence necessary to accept the measurement while protecting the inspected party's classified information. The authors discuss the structure required of an IB as well as the implications of the IB on detector system maintenance. A defense-in-depth approach is proposed which would provide assurance to the inspected party that all sensitive information is protected and to the inspecting party that the measurements are being performed as expected. The barrier could include elements of physical protection (such as locks, surveillance systems, and tamper indicators), hardening of key hardware components, assurance of capabilities and limitations of hardware and software systems, administrative controls, validation and verification of the systems, and error detection and resolution. Finally, an unclassified interface could be used to display and, possibly, record measurement results. The introduction of an IB into an analysis system may result in many otherwise innocuous components (detectors, analyzers, etc.) becoming classified and unavailable for routine maintenance by uncleared personnel. System maintenance and updating will be significantly simplified if the classification status of as many components as possible can be made reversible (i.e. the component can become unclassified following the removal of classified objects)

  19. Neural network classifier of attacks in IP telephony

    Science.gov (United States)

    Safarik, Jakub; Voznak, Miroslav; Mehic, Miralem; Partila, Pavol; Mikulec, Martin

    2014-05-01

    Various types of monitoring mechanism allow us to detect and monitor behavior of attackers in VoIP networks. Analysis of detected malicious traffic is crucial for further investigation and hardening the network. This analysis is typically based on statistical methods and the article brings a solution based on neural network. The proposed algorithm is used as a classifier of attacks in a distributed monitoring network of independent honeypot probes. Information about attacks on these honeypots is collected on a centralized server and then classified. This classification is based on different mechanisms. One of them is based on the multilayer perceptron neural network. The article describes inner structure of used neural network and also information about implementation of this network. The learning set for this neural network is based on real attack data collected from IP telephony honeypot called Dionaea. We prepare the learning set from real attack data after collecting, cleaning and aggregation of this information. After proper learning is the neural network capable to classify 6 types of most commonly used VoIP attacks. Using neural network classifier brings more accurate attack classification in a distributed system of honeypots. With this approach is possible to detect malicious behavior in a different part of networks, which are logically or geographically divided and use the information from one network to harden security in other networks. Centralized server for distributed set of nodes serves not only as a collector and classifier of attack data, but also as a mechanism for generating a precaution steps against attacks.

  20. [Horticultural plant diseases multispectral classification using combined classified methods].

    Science.gov (United States)

    Feng, Jie; Li, Hong-Ning; Yang, Wei-Ping; Hou, De-Dong; Liao, Ning-Fang

    2010-02-01

    The research on multispectral data disposal is getting more and more attention with the development of multispectral technique, capturing data ability and application of multispectral technique in agriculture practice. In the present paper, a cultivated plant cucumber' familiar disease (Trichothecium roseum, Sphaerotheca fuliginea, Cladosporium cucumerinum, Corynespora cassiicola, Pseudoperonospora cubensis) is the research objects. The cucumber leaves multispectral images of 14 visible light channels, near infrared channel and panchromatic channel were captured using narrow-band multispectral imaging system under standard observation and illumination environment, and 210 multispectral data samples which are the 16 bands spectral reflectance of different cucumber disease were obtained. The 210 samples were classified by distance, relativity and BP neural network to discuss effective combination of classified methods for making a diagnosis. The result shows that the classified effective combination of distance and BP neural network classified methods has superior performance than each method, and the advantage of each method is fully used. And the flow of recognizing horticultural plant diseases using combined classified methods is presented. PMID:20384138

  1. Classifying, archiving and digitalizing documents related to normal conducting magnets & preparing graphs of magnetic measurement results

    CERN Document Server

    Bayramoglu, Gultug

    2016-01-01

    The main project aims to classify and digitalize documents related to normal conducting magnets. These documents include magnetic measurement results and their graphs, inspection reports, manufacturing reports and so on. The archive of Normal Conducting Magnets Section consists lots of different types of normal conducting magnets documents. Besides these magnet varieties, there are still documents from the times of first accelerator at CERN. In that moment, my project involves to identify, classify and digitalize documents and make them ready to be uploaded in NORMA - database of normal conducting magnets. In addition part of my time I’ve spent on second project, which was preparing graphs of magnetic measurement results of magnets such as current and magnetic field. The aim of these graphs is to compare parameters of magnets the same type and check measurement results’ consistency according to reference points. All of these graphs are on time basis.

  2. SpectraClassifier 1.0: a user friendly, automated MRS-based classifier-development system

    Directory of Open Access Journals (Sweden)

    Julià-Sapé Margarida

    2010-02-01

    Full Text Available Abstract Background SpectraClassifier (SC is a Java solution for designing and implementing Magnetic Resonance Spectroscopy (MRS-based classifiers. The main goal of SC is to allow users with minimum background knowledge of multivariate statistics to perform a fully automated pattern recognition analysis. SC incorporates feature selection (greedy stepwise approach, either forward or backward, and feature extraction (PCA. Fisher Linear Discriminant Analysis is the method of choice for classification. Classifier evaluation is performed through various methods: display of the confusion matrix of the training and testing datasets; K-fold cross-validation, leave-one-out and bootstrapping as well as Receiver Operating Characteristic (ROC curves. Results SC is composed of the following modules: Classifier design, Data exploration, Data visualisation, Classifier evaluation, Reports, and Classifier history. It is able to read low resolution in-vivo MRS (single-voxel and multi-voxel and high resolution tissue MRS (HRMAS, processed with existing tools (jMRUI, INTERPRET, 3DiCSI or TopSpin. In addition, to facilitate exchanging data between applications, a standard format capable of storing all the information needed for a dataset was developed. Each functionality of SC has been specifically validated with real data with the purpose of bug-testing and methods validation. Data from the INTERPRET project was used. Conclusions SC is a user-friendly software designed to fulfil the needs of potential users in the MRS community. It accepts all kinds of pre-processed MRS data types and classifies them semi-automatically, allowing spectroscopists to concentrate on interpretation of results with the use of its visualisation tools.

  3. A novel statistical method for classifying habitat generalists and specialists

    DEFF Research Database (Denmark)

    Chazdon, Robin L; Chao, Anne; Colwell, Robert K;

    2011-01-01

    We develop a novel statistical approach for classifying generalists and specialists in two distinct habitats. Using a multinomial model based on estimated species relative abundance in two habitats, our method minimizes bias due to differences in sampling intensities between two habitat types...... as well as bias due to insufficient sampling within each habitat. The method permits a robust statistical classification of habitat specialists and generalists, without excluding rare species a priori. Based on a user-defined specialization threshold, the model classifies species into one of four groups......: (1) generalist; (2) habitat A specialist; (3) habitat B specialist; and (4) too rare to classify with confidence. We illustrate our multinomial classification method using two contrasting data sets: (1) bird abundance in woodland and heath habitats in southeastern Australia and (2) tree abundance...

  4. COMPARISON OF SVM AND FUZZY CLASSIFIER FOR AN INDIAN SCRIPT

    Directory of Open Access Journals (Sweden)

    M. J. Baheti

    2012-01-01

    Full Text Available With the advent of technological era, conversion of scanned document (handwritten or printed into machine editable format has attracted many researchers. This paper deals with the problem of recognition of Gujarati handwritten numerals. Gujarati numeral recognition requires performing some specific steps as a part of preprocessing. For preprocessing digitization, segmentation, normalization and thinning are done with considering that the image have almost no noise. Further affine invariant moments based model is used for feature extraction and finally Support Vector Machine (SVM and Fuzzy classifiers are used for numeral classification. . The comparison of SVM and Fuzzy classifier is made and it can be seen that SVM procured better results as compared to Fuzzy Classifier.

  5. A Topic Model Approach to Representing and Classifying Football Plays

    KAUST Repository

    Varadarajan, Jagannadan

    2013-09-09

    We address the problem of modeling and classifying American Football offense teams’ plays in video, a challenging example of group activity analysis. Automatic play classification will allow coaches to infer patterns and tendencies of opponents more ef- ficiently, resulting in better strategy planning in a game. We define a football play as a unique combination of player trajectories. To this end, we develop a framework that uses player trajectories as inputs to MedLDA, a supervised topic model. The joint maximiza- tion of both likelihood and inter-class margins of MedLDA in learning the topics allows us to learn semantically meaningful play type templates, as well as, classify different play types with 70% average accuracy. Furthermore, this method is extended to analyze individual player roles in classifying each play type. We validate our method on a large dataset comprising 271 play clips from real-world football games, which will be made publicly available for future comparisons.

  6. Multiple-instance learning as a classifier combining problem

    DEFF Research Database (Denmark)

    Li, Yan; Tax, David M.J.; Duin, Robert P.W.;

    2013-01-01

    In multiple-instance learning (MIL), an object is represented as a bag consisting of a set of feature vectors called instances. In the training set, the labels of bags are given, while the uncertainty comes from the unknown labels of instances in the bags. In this paper, we study MIL with the...... assumption that instances are drawn from a mixture distribution of the concept and the non-concept, which leads to a convenient way to solve MIL as a classifier combining problem. It is shown that instances can be classified with any standard supervised classifier by re-weighting the classification....... The method is tested on a toy data set and various benchmark data sets, and shown to provide results comparable to state-of-the-art MIL methods. (C) 2012 Elsevier Ltd. All rights reserved....

  7. WORD SENSE DISAMBIGUATION BASED ON IMPROVED BAYESIAN CLASSIFIERS

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Word Sense Disambiguation (WSD) is to decide the sense of an ambiguous word on particular context. Most of current studies on WSD only use several ambiguous words as test samples, thus leads to some limitation in practical application. In this paper, we perform WSD study based on large scale real-world corpus using two unsupervised learning algorithms based on ±n-improved Bayesian model and Dependency Grammar(DG)-improved Bayesian model. ±n-improved classifiers reduce the window size of context of ambiguous words with close-distance feature extraction method, and decrease the jamming of useless features, thus obviously improve the accuracy, reaching 83.18% (in open test). DG-improved classifier can more effectively conquer the noise effect existing in Naive-Bayesian classifier. Experimental results show that this approach does better on Chinese WSD, and the open test achieved an accuracy of 86.27%.

  8. Iris Recognition Based on LBP and Combined LVQ Classifier

    CERN Document Server

    Shams, M Y; Nomir, O; El-Awady, R M; 10.5121/ijcsit.2011.3506

    2011-01-01

    Iris recognition is considered as one of the best biometric methods used for human identification and verification, this is because of its unique features that differ from one person to another, and its importance in the security field. This paper proposes an algorithm for iris recognition and classification using a system based on Local Binary Pattern and histogram properties as a statistical approaches for feature extraction, and Combined Learning Vector Quantization Classifier as Neural Network approach for classification, in order to build a hybrid model depends on both features. The localization and segmentation techniques are presented using both Canny edge detection and Hough Circular Transform in order to isolate an iris from the whole eye image and for noise detection .Feature vectors results from LBP is applied to a Combined LVQ classifier with different classes to determine the minimum acceptable performance, and the result is based on majority voting among several LVQ classifier. Different iris da...

  9. A History of Classified Activities at Oak Ridge National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Quist, A.S.

    2001-01-30

    The facilities that became Oak Ridge National Laboratory (ORNL) were created in 1943 during the United States' super-secret World War II project to construct an atomic bomb (the Manhattan Project). During World War II and for several years thereafter, essentially all ORNL activities were classified. Now, in 2000, essentially all ORNL activities are unclassified. The major purpose of this report is to provide a brief history of ORNL's major classified activities from 1943 until the present (September 2000). This report is expected to be useful to the ORNL Classification Officer and to ORNL's Authorized Derivative Classifiers and Authorized Derivative Declassifiers in their classification review of ORNL documents, especially those documents that date from the 1940s and 1950s.

  10. What Does(n't) K-theory Classify?

    CERN Document Server

    Evslin, J

    2006-01-01

    We review various K-theory classification conjectures in string theory. Sen conjecture based proposals classify D-brane trajectories in backgrounds with no H flux, while Freed-Witten anomaly based proposals classify conserved RR charges and magnetic RR fluxes in topologically time-independent backgrounds. In exactly solvable CFTs a classification of well-defined boundary states implies that there are branes representing every twisted K-theory class. Some of these proposals fail to respect the self-duality of the RR fields in the democratic formulation of type II supergravity and none respect S-duality in type IIB string theory. We discuss two applications. The twisted K-theory classification has led to a conjecture for the topology of the T-dual of any configuration. In the Klebanov-Strassler geometry twisted K-theory classifies universality classes of baryonic vacua.

  11. 48 CFR 53.204-1 - Safeguarding classified information within industry (DD Form 254, DD Form 441).

    Science.gov (United States)

    2010-10-01

    ... information within industry (DD Form 254, DD Form 441). 53.204-1 Section 53.204-1 Federal Acquisition....204-1 Safeguarding classified information within industry (DD Form 254, DD Form 441). The following... specified in subpart 4.4 and the clause at 52.204-2: (a) DD Form 254 (Department of Defense (DOD)),...

  12. Examining the significance of fingerprint-based classifiers

    Directory of Open Access Journals (Sweden)

    Collins Jack R

    2008-12-01

    Full Text Available Abstract Background Experimental examinations of biofluids to measure concentrations of proteins or their fragments or metabolites are being explored as a means of early disease detection, distinguishing diseases with similar symptoms, and drug treatment efficacy. Many studies have produced classifiers with a high sensitivity and specificity, and it has been argued that accurate results necessarily imply some underlying biology-based features in the classifier. The simplest test of this conjecture is to examine datasets designed to contain no information with classifiers used in many published studies. Results The classification accuracy of two fingerprint-based classifiers, a decision tree (DT algorithm and a medoid classification algorithm (MCA, are examined. These methods are used to examine 30 artificial datasets that contain random concentration levels for 300 biomolecules. Each dataset contains between 30 and 300 Cases and Controls, and since the 300 observed concentrations are randomly generated, these datasets are constructed to contain no biological information. A modest search of decision trees containing at most seven decision nodes finds a large number of unique decision trees with an average sensitivity and specificity above 85% for datasets containing 60 Cases and 60 Controls or less, and for datasets with 90 Cases and 90 Controls many DTs have an average sensitivity and specificity above 80%. For even the largest dataset (300 Cases and 300 Controls the MCA procedure finds several unique classifiers that have an average sensitivity and specificity above 88% using only six or seven features. Conclusion While it has been argued that accurate classification results must imply some biological basis for the separation of Cases from Controls, our results show that this is not necessarily true. The DT and MCA classifiers are sufficiently flexible and can produce good results from datasets that are specifically constructed to contain no

  13. Text Classification: Classifying Plain Source Files with Neural Network

    Directory of Open Access Journals (Sweden)

    Jaromir Veber

    2010-10-01

    Full Text Available The automated text file categorization has an important place in computer engineering, particularly in the process called data management automation. A lot has been written about text classification and the methods allowing classification of these files are well known. Unfortunately most studies are theoretical and for practical implementation more research is needed. I decided to contribute with a research focused on creating of a classifier for different kinds of programs (source files, scripts…. This paper will describe practical implementation of the classifier for text files depending on file content.

  14. Dynamic Classifier Systems and their Applications to Random Forest Ensembles

    Czech Academy of Sciences Publication Activity Database

    Štefka, David; Holeňa, Martin

    Berlin: Springer, 2009 - (Kolehmainen, M.; Toivanen, P.; Beliczynski, B.), s. 458-468. (Lecture Notes in Computer Science. 5495). ISBN 978-3-642-04920-0. [ICANNGA'2009. International conference /9./. Kuopio (FI), 23.04.2009-25.04.2009] R&D Projects: GA AV ČR 1ET100300517; GA ČR GA201/08/0802 Institutional research plan: CEZ:AV0Z10300504 Keywords : classifier combining * dynamic classifier aggregation * random forests * classification Subject RIV: IN - Informatics, Computer Science

  15. A Vertical Search Engine – Based On Domain Classifier

    OpenAIRE

    Rajashree Shettar; Rahul Bhuptani

    2008-01-01

    The World Wide Web is growing exponentially and the dynamic, unstructured nature of the web makes it difficult to locate useful resources. Web Search engines such as Google and Alta Vista provide huge amount of information many of which might not be relevant to the users query. In this paper, we build a vertical search engine which takes a seed URL and classifies the URLs crawled as Medical or Finance domains. The filter component of the vertical search engine classifies the web pages downloa...

  16. Discrimination-Aware Classifiers for Student Performance Prediction

    Science.gov (United States)

    Luo, Ling; Koprinska, Irena; Liu, Wei

    2015-01-01

    In this paper we consider discrimination-aware classification of educational data. Mining and using rules that distinguish groups of students based on sensitive attributes such as gender and nationality may lead to discrimination. It is desirable to keep the sensitive attributes during the training of a classifier to avoid information loss but…

  17. Support vector machines classifiers of physical activities in preschoolers

    Science.gov (United States)

    The goal of this study is to develop, test, and compare multinomial logistic regression (MLR) and support vector machines (SVM) in classifying preschool-aged children physical activity data acquired from an accelerometer. In this study, 69 children aged 3-5 years old were asked to participate in a s...

  18. Weighted Hybrid Decision Tree Model for Random Forest Classifier

    Science.gov (United States)

    Kulkarni, Vrushali Y.; Sinha, Pradeep K.; Petare, Manisha C.

    2016-06-01

    Random Forest is an ensemble, supervised machine learning algorithm. An ensemble generates many classifiers and combines their results by majority voting. Random forest uses decision tree as base classifier. In decision tree induction, an attribute split/evaluation measure is used to decide the best split at each node of the decision tree. The generalization error of a forest of tree classifiers depends on the strength of the individual trees in the forest and the correlation among them. The work presented in this paper is related to attribute split measures and is a two step process: first theoretical study of the five selected split measures is done and a comparison matrix is generated to understand pros and cons of each measure. These theoretical results are verified by performing empirical analysis. For empirical analysis, random forest is generated using each of the five selected split measures, chosen one at a time. i.e. random forest using information gain, random forest using gain ratio, etc. The next step is, based on this theoretical and empirical analysis, a new approach of hybrid decision tree model for random forest classifier is proposed. In this model, individual decision tree in Random Forest is generated using different split measures. This model is augmented by weighted voting based on the strength of individual tree. The new approach has shown notable increase in the accuracy of random forest.

  19. Packet Payload Inspection Classifier in the Network Flow Level

    Directory of Open Access Journals (Sweden)

    N.Kannaiya Raja

    2012-06-01

    Full Text Available The network have in the world highly congested channels and topology which was dynamicallycreated with high risk. In this we need flow classifier to find the packet movement in the network.In this paper we have to be developed and evaluated TCP/UDP/FTP/ICMP based on payloadinformation and port numbers and number of flags in the packet for highly flow of packets in thenetwork. The primary motivations of this paper all the valuable protocols are used legally toprocess find out the end user by using payload packet inspection, and also used evaluationshypothesis testing approach. The effective use of tamper resistant flow classifier has used in onenetwork contexts domain and developed in a different Berkeley and Cambridge, the classificationand accuracy was easily found through the packet inspection by using different flags in thepackets. While supervised classifier training specific to the new domain results in much betterclassification accuracy, we also formed a new approach to determine malicious packet and find apacket flow classifier and send correct packet to destination address.

  20. Packet Payload Inspection Classifier in the Network Flow Level

    Directory of Open Access Journals (Sweden)

    N.Kannaiya Raja

    2012-06-01

    Full Text Available The network have in the world highly congested channels and topology which was dynamically created with high risk. In this we need flow classifier to find the packet movement in the network. In this paper we have to be developed and evaluated TCP/UDP/FTP/ICMP based on payload information and port numbers and number of flags in the packet for highly flow of packets in the network. The primary motivations of this paper all the valuable protocols are used legally to process find out the end user by using payload packet inspection, and also used evaluations hypothesis testing approach. The effective use of tamper resistant flow classifier has used in one network contexts domain and developed in a different Berkeley and Cambridge, the classification and accuracy was easily found through the packet inspection by using different flags in the packets. While supervised classifier training specific to the new domain results in much better classification accuracy, we also formed a new approach to determine malicious packet and find a packet flow classifier and send correct packet to destination address.