... Canceled Retirements § 837.803 Cancellation of retirement by judicial or administrative authority. (a... may only be canceled by the former employing agency in response to a direct and final order of a... requiring cancellation of the annuitant's separation or after the annuitant and the agency agree to cancel...
Full Text Available The unprecedented development of criminality at the social and economical levels, the tendency toglobalize some categories of crimes, of maximum gravity, as terrorism, armament traffic, drug traffic orhuman traffic, have determined the world states to undertake specific measures to prevent, combat and finallyreduce it. The first and most important measure taken by the Europe’s Council, regarding the intensificationof judicial cooperation in criminal matters was the adoption of the European Convention on extradition, inParis on 13 December 1957, completed by the two Additional Protocols in Strasbourg, on 15 October 1975and 17 March 1978. In this context, the release of the Council’s Framework Decision on 13 June 2002 on theEuropean arrest warrant and the procedures of delivery among the member states (2002/584/JAI representeda natural decision, with the purpose of contributing at ensuring a free, secure and just European space. TheEuropean arrest warrant is a judicial decision through which a competent judicial authority of a EuropeanUnion member state solicits the arrest and delivery by another member state, in order to proceed to theprosecution, trial or execution of a penalty or safety measure that is privative of freedom.
The author points out the fundamental complex of problems. From the 'undetermined' legal term of imperative prevention of damage as defined by Sect. 7 para. 2 (3) of the Atomic Energy Law follows the judicial claim for detailed analysis of facts in case of minor radioactive exposure under normal operation and in case of accident prevention. He discusses the relation of the Atomic Energy Law to the Basic Law and to the normative structure of the Atomic Energy Law. The re-orientation to be found in the judicial approach to control does recognize sanctuaries of the executive. Control density and the right of third parties to take action are closely interrelated. From the integration - according to subjective law and basic law - of the Atomic Energy Law into the realtionship existing between technological and cultural development, and the material relation of licences granted for nuclear installations follows a reduction of judicial control intensity, at least for the procedural constellation of third-party actions. (HSCH) [de
Full Text Available The detection, investigation and prosecution of crimes against the environment has its specificity compared to other forms of crime, because of the nature of these crimes, the manner of execution (modus operandi and the characteristics of their perpetrators. Although there is no objective need for modification of the rules of criminal procedure with regard to these offenses, there is an obvious need for a specialized body of the procedure (prosecutors, judges and authorized officers of the internal affairs. This is due the fact that only specific additional, specialized knowledge about the environmental issues, which is usually multidisciplinary, can provide high-quality, professional and competent research and detection of crimes against the environment. In this paper, the authors deal with the problems of specialization of judicial and other authorities in connection with criminal proceedings for offenses against the environment, of reasonableness and necessity, given the current situation in domestic practice, as well as some comparative solutions and experiences.
... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...
Conclusions: Therapeutic rationality issues are evident in prescription drugs ordered by judicial protection, which may involve greater risks to the health of patients. A more rigorous scientific advice is recommended in order to avoid possible interactions and therapeutic duplications.
Full Text Available Novelties in the field of matters of succession brought by implementation of Regulation (EU No 650/2012 of the European Parliament and of the Council of 4 July 2012 on jurisdiction, applicable law, recognition and enforcement of decisions and acceptance and enforcement of authentic instruments in matters of succession and on the creation of a European Certificate of Succession are disscused in the paper. Especial emphasis is on jurisdiction, competent judicial authority and proceedings under Regulation on succession. In this sense, in the first part of the paper detailed analysis of provisions of Commission Implementing Regulation (EU No 1329/2014 of 9 December 2014 establishing the Forms referred to in Regulation (EU No 650/2012 of the European Parliament and of the Council on jurisdiction, applicable law, recognition and enforcement of decisions and acceptance and enforcement of authentic instruments in matters of succession and on the creation of a European Certificate of Succession and provisions of Croatian Law on implementation of Regulation (EU No 650/2012 of the European Parliament and of the Council on jurisdiction, applicable law, recognition and enforcement of decisions and acceptance and enforcement of authentic instruments in matters of succession and on the creation of a European Certificate of Succession is provided. In the second part of the paper case C404/14 Matoušková v. Republic of Czech is presented and difficulties in determining whether the case at issue falls within the scope of Regulation (EC No 2201/2003 or Regulation No 650/2012 on succession which could occur in matters of succession with cross-border implications are reffered to.
Tumanyants Yeranuhi S.
Full Text Available In article some aspects of the constitutional reforms of the Republic of Armenia which guarantee the realization of the principle of self-dependence judicial authority are considered. In particular, questions concerning the activity of the Supreme judicial council (the assignee of present Council of justice as the guarantee of self-dependence of judicial authorities, and the procedure of selection (appointment of judges are separated. Changes which have been made during the constitutional reform are also considered, the assessment to the carried-out reforms based on the recommendations of the international organizations and the international documents is given. On the basis of the comprehensive analysis practical recommendations about the direction of further improvement of the legislation concerning realization of the principle of self-dependence of judicial authority, in particular concerning activity of the Supreme judicial council and the procedure of selection (appointment of judges are offered.
Full Text Available The specific objective of the present study lies in identifying how respected the principle of joint exercise of parental authority, enshrined in the Romanian legislature. The aim of Civil fundamental rule is to recognize the active participation regarding compliance by the parents of the right to psychological and physical welfare of their children, growth, education, training and their health. Analysis interests of the child enshrined rule that parental rights are not only father but also parental duties so that this breach legal obligations should be duly reasoned. Knowledge of basic civil complying with the requirements resulting from commitments made by Romania in the European integration process and the new status of our country's membership of the European Union. Jurisprudence should share the idea that joint parental authority is the rule and the exception exclusive. The availability principle in subsequent civil trial must be the protection of the interests of the child. Just this social reality we can talk about a Europe constituted by and for children.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Judicial review. 71.42 Section 71.42....42 Judicial review. Section 3805 of title 31, United States Code, authorizes judicial review by an... assessments under this part and specifies the procedures for such review. ...
... Your Recovery After Cesarean Birth (Part 1) - English MP3 Your Recovery After Cesarean Birth (Part 1) - 简体中文 (Chinese, Simplified (Mandarin dialect)) MP3 Your Recovery After Cesarean Birth (Part 1) - English ...
Rukh, G.; Akhtar, S.
To determine the clinical and epidemiological characteristics in patients having their first cesarean section (FCS) and compare it with findings in patients with repeated cesarean section (RCS). This study included all the women who gave birth by cesarean sections, 817 of the total 5992 deliveries, at this unit during the study period. Data on potential risk factors for the first cesarean section (FCS) and repeated cesarean section (RCS were extracted from medical records, which were reviewed and compared between these two groups of women. Data were statistically analyzed with student t-test for comparison between means and Chi-square test for comparison between percentages. Crude odds ratio (OR) with 95% confidence interval (95% CI) were calculated. Significance was taken at p 0.05). The frequency of first cesarean section and repeat cesarean section is high in our setup. Adequate following of the programs to diminish the percentage of FCS by curtailing its predisposing factors is needed. (author)
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Judicial review. 1264.141 Section 1264.141... PENALTIES ACT OF 1986 § 1264.141 Judicial review. Section 3805 of Title 31, United States Code, authorizes judicial review by an appropriate United States District Court of a final decision of the authority head...
Comtois, Suzanne; de Graaf, K.J.
'Principles of judicial and quasi-judicial independence are fundamental to all democracies and yet, the notion of independence is still elusive. What is judicial and quasi-judicial independence and why is it important? From whom and what are the judiciary and other adjudicators to be independent? Is
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 16.42 Section 16.42... FRAUD CIVIL REMEDIES ACT OF 1986 § 16.42 Judicial review. Section 3805 of title 31, United States Code, authorizes judicial review by an appropriate United States District Court of a final decision of the...
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Judicial review. 35.42 Section 35.42... CLAIMS AND STATEMENTS § 35.42 Judicial review. Section 3805 of title 31, U.S. Code, authorizes judicial review by an appropriate U.S. District Court of a final decision of the Secretary imposing penalties or...
... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 423.2136 Section 423.2136 Public...) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.2136 Judicial review. (a) General rule. To the extent authorized by sections 1876(c...
... 6 Domestic Security 1 2010-01-01 2010-01-01 false Judicial review. 13.42 Section 13.42 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.42 Judicial review. Section 3805 of title 31, United States Code, authorizes judicial review by an appropriate...
Puia, Denise M.
A descriptive study design was used to describe the decision of women having a cesarean surgery. The Cesarean Birth Decision Survey was used to collect data from 101 postpartum women who underwent a cesarean. Most of the surgeries were to primipara women who reported doctor recommendation and increased safety for the baby as the main reasons for the cesarean. Those women who had repeat cesarean surgery all cited their previous cesarean as the main reason for the current surgery. Women’s knowledge of cesarean surgery needs to be assessed early in pregnancy so that appropriate education may be provided. Accurate and ongoing information may decrease the number of women choosing a cesarean surgery. PMID:24868134
Sparić, Radmila; Kadija, Saša; Stefanović, Aleksandar; Spremović Radjenović, Svetlana; Likić Ladjević, Ivana; Popović, Jela; Tinelli, Andrea
The study aim was to evaluate management of myomas during cesarean section, the pro and cons and the outcomes of cesarean myomectomy. Moreover, we tried to investigate the long-term outcomes of cesarean myomectomy. The authors conducted a literature review using scientific databases, focusing on the benefits and outcomes of cesarean myomectomy and the recent trends regarding this topic, and identified relevant articles, related references and other papers citing them. Despite the demonstrated advantages of cesarean myomectomy, postponed myomectomy after cesarean section was recommended in some instances. Apart from recent reports on the safety and feasibility of cesarean myomectomy, the current literature also describes serious complications of cesarean myomectomy, including even maternal death. This poses a question about the reported rate of complications: whether it is underestimated in common practice. Although some studies strongly suggest the safety of cesarean myomectomy, data on the long-term outcomes of cesarean myomectomy in women are lacking. The risk-benefit ratio of cesarean myomectomy should be re-evaluated in the new century, given the increasing patient age, incidence of myoma in pregnancy, and the wide use of assisted reproductive techniques. © 2017 Japan Society of Obstetrics and Gynecology.
... Twitter Pinterest Email Print What is a cesarean delivery? A cesarean delivery is a surgical procedure in which a fetus ... 32.2% of U.S. births were by cesarean delivery. 2 The CDC also found that the number ...
Radošević Ratko S.
Full Text Available Administrative silence is a situation in which the competent authority, within the statutory deadline, has not issued an administrative act at the request of the party. In the case of administrative silence, given the fact that the citizens are unable to protect their rights and legal interests without an administrative act, they are provided with legal protection. In this case, the same legal relationship is created, directly on the basis of the statute, as in the situation in which the party's request is rejected. This means that the party may, under the conditions prescribed by the statute, initiate the procedure of judicial review of administrative silence. In the paper, the author explains the conditions under which the judicial review of administrative silence can be initiated and the role of the court in this judicial procedure.
... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Judicial proceedings. 218.14... ADMINISTRATIVE REVIEW PROCESSES Predecisional Administrative Review Process for Hazardous Fuel Reduction Projects Authorized by the Healthy Forests Restoration Act of 2003 § 218.14 Judicial proceedings. The objection...
Stojanović Dragan M.
Full Text Available In principle, the constitutional precepts envisage that judicial decisions are not subject to extrajudicial control. However, in the course of deciding on constitutional complaints, the Constitutional Court reviews the compliance of individual legal acts and actions of state authorities with the Constitution, including court decisions on cases involving the constitutionally guaranteed rights. Hence, in order to eliminate tension or even contradiction between the constitutional precepts, the constitutional review of judicial decisions should be considered as a special form of judicial control, regardless of the fact that the Constitutional Court is not part of the judicial structure in the strict organizational sense. Thus, unlike the cases where the Court is involved in the normative control of the applicable law, in the process of reviewing judicial decision of lower courts the constitutional judiciary acts in the capacity of a specific judicial authority. According to another possible interpretation of the aforementioned constitutional norms, the direct constitutional protection of the constitutionally guaranteed rights may only be pursued in the process of reviewing individual legal acts and actions of state authorities, but not by pursuing a judicial review of court decisions which the Constitutional Court has no jurisdiction to decide upon. Thus, the dogma of judicial independence would prevail over the dogma of direct protection of fundamental rights. The third interpretation of this relationship maintains that that judicial decisions may be subject to control but, in this specific case, the Constitutional Court may only issue an opinion (a statement rather than a binding decision which would cancel the lower court judgment. Then, it is up to the judicial authorities of the lower instance to adjust their judicial decision, which in the opinion of the Constitutional Court constitutes a violation of the constitutionally guaranteed rights
Chervenak, Frank A; McCullough, Laurence B
Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach. Copyright © 2017. Published by Elsevier Ltd.
Decisions of administrative authorities concerning the permission to use fissile material contain a prognosis about the probability of damage which may be caused by using this material. The judicial criteria used in order to determine the probability of such a damage occurring can be improved by risk analysis. This will not, of course, reduce administrative decisions to simple 'yes-or-no decisions', but the calculation of probabilities will gain more exactness. (orig.) [de
Petersen, Kathrine Birch; Hoffmann, Elise; Rifbjerg Larsen, Christian
OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE...
Pedro Bordalo; Nicola Gennaioli; Andrei Shleifer
We present a model of judicial decision making in which the judge overweights the salient facts of the case. The context of the judicial decision, which is comparative by nature, shapes which aspects of the case stand out and draw the judge’s attention. By focusing judicial attention on such salient aspects of the case, legally irrelevant information can affect judicial decisions. Our model accounts for a range of recent experimental evidence that bears on the psychology of judicial decisions...
Dec 5, 2017 ... Conclusion: Ropivacaine administration produced rapid induction of ... KEYWORDS: Ropivacaine, spinal anesthesia, intrathecal, cesarean section. Intrathecal .... expressed as mean standard deviation (SD). One-way.
... Foundation) Cesarean Section: The Operation (March of Dimes Birth Defects Foundation) Statistics and Research Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011 (National ...
Rytter, Jens Elo
The article analyses the extent to which judicial restraint in cases concerning national security is justified. It is argued that the extent of restraint must depend on the normative issue/aspect which is subject to judicial review.......The article analyses the extent to which judicial restraint in cases concerning national security is justified. It is argued that the extent of restraint must depend on the normative issue/aspect which is subject to judicial review....
Full Text Available The Editor-in-Chief and Publisher of the International Journal of Women’s Health have been alerted by Dr Nadine Sherif, the corresponding author, to unacceptable levels of duplication with a previously published paper: Ali A, Essam A. Abdominoplasty Combined with Cesarean Delivery: Evaluation of the Practice. Aesthetic Plastic Surgery. 2011;35(1:80–86.It is worth noting that this paper was peer-reviewed by two peer-reviewers and the Editor-in-Chief of the International Journal of Women’s Health before publication. The paper concerned is: Thabet WN, Hossny AS, Sherif NA. Feasibility of abdominoplasty with Cesarean section. International Journal of Women’s Health. 2012;4:115–121.
Application of the behavioral approach to the study of the judicial process is examined including methodological approaches used, typical findings, and "behavioralists'" rejection of the case method of studying law. The author concludes that the behavioral approach to the study of judicial politics has not been substantially productive. (JT)
Buiren, S. van; Ballerstedt, E.; Grimm, D.
In this study it is examined how the judiciary deals with those sections that are crucial for the use of nuclear energy. The authors get down to the pre-dominant problem of the law relating to technical safety. In the process they encounter the central dilemma of modern democracy, i.e. the strained relations which exist between judicial control and democratic responsibility. Since nuclear energy entered the market place, it has been the administrative courts which - in practice - have decided whether and to what extent nuclear energy may be used. On the one hand, this is a result of the fast growth of, and rapid change in, science and technology. On the other hand, it is a result of administrative law standards which have developed in the Federal Republic of Germany after World War II. The former requires the normative structure of the atomic law, the latter postulates how to deal with it. Legal protection against an act of public authority is guaranteed by the Basic Law and usually with some justification considered a splendid achievement of our state which is based on the rule of law. It has lead to developments in the atomic law and in many parts of the law relating to technical safety on which opinions are divided. In a dogmatic manner it has been legally examined to what extent an extensive review competence of the judiciary is a must, and whether there are any possibilities of judicial control of acts of public authorities without having to interfere with the original competence of administrations. (orig./HP) [de
Zhang Xiangqun; Xu Yikai; Luo Xiaoqin
Objective: To analyze MRI findings of cesarean scar pregnancy (CSP). Methods: The MR findings in 18 patients who were diagnosed as CSP by surgery from March 2010 to November 2011 were retrospectively analyzed, and comparison was made between the MRI findings and surgical results. Results: All Gestational sacs (18) were clearly detected by MRI. Among the 18 cases,gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 16 cases. In 2 of the 16 cases, gestational sac was found within the myometrium, whereas in the remaining 14 cases, gestational sac was found partially within the myometrium with extension into the uterine cavity. The anterior wall of isthmus uteri became thinner. In the remaining 2 of the 18 cases, gestational sac presented as irregular, multilobolated mass, growing deep into the myometrium as well as into the uterine cavity. On T 2 WI, the mass showed heterogeneous signal intensity. A small amount of hemorrhage within the mass and uterine cavity could be seen on T 1 WI. An enhancing solid component with a heterogeneous mass could be seen. All gestational sacs in 18 cases were located at or adjacent to the previous cesarean scar. In the area of cesarean scar,the signal of the uterine wall was disconnected, with focal indentation or thinning and the previous cesarean scar exhibited hypointensity on both T 1 WI and T 2 WI. Conclusion: CSP has its unique findings on MRI, these specific features can provide useful information in the management of CSP. (authors)
CONCLUSION: Abdominal wall endometriosis frequently presents with cyclical pain during menstruation which is localised to a palpable mass in the abdominal wall especially in those who have had previous cesarean section. Complete surgical excision is curative.
Garoupaa, Nuno; Grembi, Veronica
Due to the collapse of the party system during the mid-nineties, Italy represents an interesting case study to test the effects of a transition from a consensual to a majoritarian model of democracy on judicial behavior at the level of the Constitutional Court. Using a dataset of 972 cases...... of substantive judicial review (ricorsi in via principale) from 1985 to 2005, and proposing new measures of political alignment within constitutional review, we analyze the effect of a change in the political party system on judicial behavior. Our results show that political alignment is a stronger predictor...... of judicial decision making under majoritarian than consensual model of democracy....
Martinsen, Dorte Sindbjerg
to override unwanted jurisprudence. In this debate, the Court of Justice of the European Union (CJEU) has become famous for its central and occasionally controversial role in European integration. This article examines to what extent and under which conditions judicial decisions influence European Union (EU......) social policy outputs. A taxonomy of judicial influence is constructed, and expectations of institutional and political conditions on judicial influence are presented. The analysis draws on an extensive novel data set and examines judicial influence on EU social policies over time, that is, between 1958...
International Labour Review, 1993
Summarizes recent judicial decisions in various countries concerning application of general legal principles to labor law, access to employment, conditions of employment, occupational safety and health, social security, and labor relations. (Author/SK)
Pope, Thaddeus Mason
A capacitated pregnant woman has a nearly unqualified right to refuse a cesarean section. Her right to say "no" takes precedence over clinicians' preferences and even over clinicians' concerns about fetal health. Leading medical societies, human rights organizations, and appellate courts have all endorsed this principle. Nevertheless, clinicians continue to limit reproductive liberty by forcing and coercing women to have unwanted cesareans. This "Legal Briefing" reviews recent court cases involving this type of obstetric violence. I have organized these court cases into the following six categories: 1. Epidemic of Unwanted Cesareans 2. Court-Ordered Cesareans 3. Physician-Coerced Cesareans 4. Physician-Ordered Cesareans 5. Cesareans for Incapacitated Patients 6. Cesareans for Patients in a Vegetative State or Who Are Brain Dead. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.
... Pinterest Email Print What is vaginal birth after cesarean (VBAC)? VBAC refers to vaginal delivery of a baby after a previous pregnancy was delivered by cesarean delivery. In the past, pregnant women who had ...
Full Text Available Although Indonesia judicial review system is not opens the possibility of regulations review under the act against the constitution, das sollen pracitically these conditions may still occur. From political of law the legal authority of constitutional court should be able to put the interests of citizens rights that are based on the principles of recognition, guarantees, protection and legal certainty of a fair and equal treatment before the law. Given that changes in the constitution can not be done easily, then the judicial review in UUD 1945 should not be formulated too limitedly that restricting the organic law to complete and explore the authority that is adaptable to any concrete problem. Keywords: politics of law, constitutional court, UUD 1945, limitedly.
Alec Stone Sweet
Full Text Available The arbitral world is at a crucial point in its historical development, poised between two conflicting conceptions of its nature, purpose, and political legitimacy. Formally, the arbitrator is an agent of the contracting parties in dispute, a creature of a discrete contract gone wrong. Yet, increasingly, arbitrators are treated as agents of a larger global community, and arbitration houses concern themselves with the general and prospective impact of important awards. In this paper, I address these questions, first, from the standpoint of delegation theory. In Part I, I introduce the basic “Principal-Agent” framework [P-A] used by social scientists to explain why actors create new institutions, and then briefly discuss how P-A has been applied to the study of courts. Part II uses delegation theory to frame discussion of arbitration as a mode of governance for transnational business and investment. In Part III, I argue that the International Center for the Settlement of Investment Disputes (ICSID is presently in the throes of judicialization, indicators of which include the enhanced use of precedent-based argumentation and justification, the acceptance of third-party briefs, and a flirtation with proportionality balancing. Part IV focuses on the first wave of awards rendered by ICSID tribunals pursuant to Argentina’s response to the crushing economic crisis of 2000-02, wherein proportionality emerged, adapted from the jurisprudence of the Appellate Body of the World Trade Organization.
Mahajan, Divyesh; Kang, Mandeep; Sandhu, Manavjit Singh; Jain, Vanita; Kalra, Naveen; Khandelwal, Niranjan
Cesarean scar pregnancy (CSP) and cesarean scar dehiscence (CSD) are the most dreaded complications of cesarean scar (CS). As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH) leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG) and confirmed on magnetic resonance imaging (MRI). These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions
Full Text Available Cesarean scar pregnancy (CSP and cesarean scar dehiscence (CSD are the most dreaded complications of cesarean scar (CS. As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG and confirmed on magnetic resonance imaging (MRI. These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions.
Yamani, Tarik Y.; Rouzi, Abdulrahim A.
A case-control study was conducted at the Department of Obstetrics and Gynaecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia to determine the value of computed tomography pelivimetry in patients with a previous cesarean section. Between January 1993 and December 1995, 219 pregnant women with one previous cesarean had antenatal CT pelvimetry for assessment of the pelvis. One hundred and nineteen women did not have CT pelvimetry and served as control. Fifty-one women (51%) in the CT pelvimetry group were delivered by cesarean section. Twenty-three women (23%) underwent elective cesarean section for contracted pelvis based upon the findings of CT pelvimetry and 28 women (28%) underwent emergency cesarean section after trial of labor. In the group who did not have CT pelvimetry, 26 women (21.8%) underwent emergency cesarean section. This was a statistically significant difference (P=0.02). There were no statistically significant differences in birthweight and Apgar scores either group. There was no prenatal or maternal mortality in this study. Computed tomography pelvimetry increased the rate of cesarean delivery without any benefit in the immediate delivery outcomes. Therefore, the practice of documenting the adequacy of the pelvis by CT pelvimetry before vaginal birth after cesarean should be abandoned. (author)
U.S. Environmental Protection Agency — This dataset contains selected cases involving EPA's Regional Judicial Officers (RJOs) from 2005 to present. EPA's Regional Judicial Officers (RJOs) perform...
... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Judicial review. 179.125 Section 179... EVIDENTIARY PUBLIC HEARING Judicial Review § 179.125 Judicial review. (a) The Administrator's final decision... judicial review within the period ending on the 60th day after the date of the publication of the order...
... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 423.1976 Section 423.1976 Public...) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Reopening, ALJ Hearings, MAC review, and Judicial Review § 423.1976 Judicial review. (a) Review of ALJ's decision. The enrollee may request judicial...
... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Judicial review. 296.15 Section 296.15..., DEPARTMENT OF COMMERCE CONTINENTAL SHELF FISHERMEN'S CONTINGENCY FUND § 296.15 Judicial review. Any claimant... determination, seek judicial review of the determination in the United States District Court for such judicial...
... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Judicial review. 178.65 Section 178.65... REQUESTS FOR HEARINGS Judicial Review § 178.65 Judicial review. An order issued under § 178.37 is final... of the order in the Federal Register. The failure to file a petition for judicial review within the...
... of process for all judicial proceedings where a claimant is suing the Administrator of FEMA pursuant... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Judicial review. 62.22... ADJUSTMENT OF CLAIMS Claims Adjustment, Claims Appeals, and Judicial Review § 62.22 Judicial review. (a) Upon...
This essay highlights the anomalies of judicial reforms in Bhutan. It presents a historical perspective of Bhutanese judicial reforms and addresses recent developments. It discusses court performance and experiences and approaches adopted in making the courts efficient. Much of the reform initiatives emanate from the throne. His Majesty the King has always advocated an efficient judicial system for the Kingdom. In obedience to the Royal Commands, the judicial system and judicial process in Bh...
f AQ FREQUENTLY ASKED QUESTIONS FAQ070 LABOR, DELIVERY, AND POSTPARTUM CARE Vaginal Birth After Cesarean Delivery • What is a vaginal birth after cesarean delivery (VBAC)? • What is a trial of labor ...
Full Text Available Italian SMEs share capabilities and routines that permit them to reach high level of competition. But in a global system that is affected by structural deficiencies and negative performance of judicial system, it is very hard to maintain high performances. In this work, starting from the resilience capacity of a group of SMEs of surviving to the crisis, we try to analyse the quality of the expectations of a sample of resilient firms. Our study leads to the hypothesis that the economic crisis is in line with a crisis of confidence in the judicial system. This is all the more serious when considering that this distrust is rooted in those firms located in Southern Italy, where the inefficiency of the judicial system is particularly pronounced.
Imarengiaye, Charles O.; Osaigbovo, Etinosa P.; Tudjegbe, Sampson O.
Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)
Hc, C.; Yahya, M.S.; Mooi, C.S.
Objective: To identify the risk factors for cesarean delivery among primigravida at Hospital Serdang. Methodology: This was a case control study which involved total 260 of 130 primigravida patients that underwent cesarean section (cases) and 130 primigravida patients that underwent vaginal delivery (control) at obstetrics and gynaecology department of Hospital Serdang, Malaysia from January until June 2013. A standardized proforma was used to collect the data of each primigravida patient presenting in spontaneous labour at term with singleton pregnancy with either caesarean or vaginal delivery. Results: Majority of the cases were Malaysian (86.9%) and mostly were from Malay ethnic group (75.4%). In multivariate logistic regression analysis, presence of hypertension status (odds ratio (OR) 5.7, 95% CI; 1.56-20.84) and gestational age less than 40 weeks (OR 2.60, 95% CI 1.34-5.02), fetal weight more than 3000 gm (OR 1.8, 95% CI 1.1-2.95), were associated with higher odds of cesarean delivery. Conclusion: Primigravida with presence of hypertension, having gestational age less than 40 weeks and heavier fetus were associated with higher odds of cesarean delivery. (author)
Aabakke, Anna J M; Krebs, Lone; Ladelund, Steen
OBJECTIVE: To estimate the incidence of incisional hernias requiring surgical repair after cesarean delivery over a 10-year period. METHODS: This population- and register-based cohort study identified all women in Denmark with no history of previous abdominal surgery who had a cesarean delivery...... the inclusion period. The cumulated incidence of a hernia repair within 10 years after a cesarean delivery was 0.197% (95% CI 0.164-0.234%). The risk of a hernia repair was higher during the first 3 years after a cesarean delivery, with an incidence after 3 years of 0.157% (95% CI 0.127-0.187%). CONCLUSIONS...
A growing number of college students report that campus judicial systems are more concerned with political correctness than with fairness, or that the systems are unfair regardless of the discipline issue, and complain about the secrecy of proceedings. Shift from a paternalistic discipline policy to a legalistic one is seen. (MSE)
Becker, Louise Giovane
Reviews computer applications in judicial, legal, and legislative information activities being used to support litigation and court administration, assist in searching for legislation and laws, aid criminal justice information systems, and provide appropriate bibliographic and reference assistance. Management issues in automating systems are…
Chen Shanshan; Xia Fei; Shen Zongji; Xu Jianyin; Gu Xinxian
Objective: To study the sonographic characteristics of cesarean scar pregnancy(CSP), and the value of color Doppler in the diagnosis of CSP. Methods: Twelve cases of CSP were all confirmed by transabdominal and transvaginal ultrasound. Results: The ultrasonogram of CSP could be divided into gestational sac type and mixed mass type. Conclusion: Color Doppler can give guidance to the early diagnosis, treatment and following-up of CSP because of the sonographic specifity of CSP. (authors)
Background: We evaluated the data of patients who had applied myomectomy during cesarean section operation in our clinic between April, 2008 and December, 2010. Objective: In this period, 3689 cesarean sections were done in our clinic, we analyzed their data retrospectively and determined 27 myomectomy cases ...
Kapinos, Kandice A; Yakusheva, Olga; Weiss, Marianne
Cesarean delivery accounts for nearly one-third of all births in the U.S. and contributes to an additional $38 billion in healthcare costs each year. Although Cesarean delivery has a long record of improving maternal and neonatal mortality and morbidity, increased utilization over time has yielded public health concerns and calls for reductions. Observational evidence suggests Cesarean delivery is associated with increased maternal postpartum weight, which may have significant implications for the obesity epidemic. Previous literature, however, typically does not address selection biases stemming from correlations of pre-pregnancy weight and reproductive health with Cesarean delivery. We used fetal malpresentation as a natural experiment as it predicts Cesarean delivery but is uncorrelated with pre-pregnancy weight or maternal health. We used hospital administrative data (including fields used in vital birth record) from the state of Wisconsin from 2006 to 2013 to create a sample of mothers with at least two births. Using propensity score methods, we compared maternal weight prior to the second pregnancy of mothers who delivered via Cesarean due to fetal malpresentation to mothers who deliver vaginally. We found no evidence that Cesarean delivery in the first pregnancy causally leads to greater maternal weight, BMI, or movement to a higher BMI classification prior to the second pregnancy. After accounting for correlations between pre-pregnancy weight, gestational weight gain, and mode of delivery, there is no evidence of a causal link between Cesarean delivery and maternal weight retention.
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Judicial review. 1250.110 Section 1250.110... PROGRAMS OF NASA-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 1250.110 Judicial review. Action taken pursuant to section 602 of the Act is subject to judicial review as provided in section 603...
... 47 Telecommunication 1 2010-10-01 2010-10-01 false Judicial review. 1.1529 Section 1.1529 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Implementation of the Equal... Judicial review. Judicial review of final agency decisions on awards may be sought as provided in 5 U.S.C...
... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 414.920 Section 414.920 Public... Under Part B § 414.920 Judicial review. The following areas under the CAP are not subject to administrative or judicial review: (a) The establishment of payment amounts. (b) The awarding of vendor contracts...
... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Judicial review. 1262.309 Section 1262.309... PROCEEDINGS Procedures for Considering Applications § 1262.309 Judicial review. Judicial review of final... the determination to the court of the United States having jurisdiction to review the merits of the...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 27.8 Section 27.8... OF DEPARTMENT OF THE TREASURY NAMES, SYMBOLS, ETC. § 27.8 Judicial review. A final Notice of Assessment issued under this party may be subject to judicial review pursuant to 5 U.S.C. 701 et seq. ...
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Judicial review. 201.58 Section 201.58 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Regulations Pertaining to the Equal Access to Justice Act § 201.58 Judicial review. Judicial review of final...
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Judicial review. 17.10 Section 17.10... Origin § 17.10 Judicial review. Action taken pursuant to section 602 of the act is subject to judicial review as provided in section 603 of the act. [29 FR 16293, Dec. 4, 1964] ...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 28.630 Section 28.630 Money and Finance: Treasury Office of the Secretary of the Treasury NONDISCRIMINATION ON THE BASIS... Judicial review. Action taken pursuant to 20 U.S.C. 1682 is subject to judicial review as provided in 20 U...
... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Judicial review. 27.12 Section 27.12... UNDER TITLE II OF PUBLIC LAW 93-153 § 27.12 Judicial review. Action taken pursuant to this part is subject to judicial review. ...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 6.16 Section 6.16... EQUAL ACCESS TO JUSTICE ACT Procedures for Considering Applications § 6.16 Judicial review. Judicial review of final agency decisions on awards may be sought as provided in 5 U.S.C. 504(c)(2). ...
... 42 Public Health 3 2010-10-01 2010-10-01 false Judicial review. 422.612 Section 422.612 Public... Judicial review. (a) Review of ALJ's decision. Any party, including the MA organization, may request judicial review (upon notifying the other parties) of an ALJ's decision if— (1) The Board denied the party...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Judicial review. 1703.601 Section 1703.601 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL COMMISSION ON LIBRARIES AND INFORMATION SCIENCE GOVERNMENT IN THE SUNSHINE ACT Judicial Review § 1703.601 Judicial review. Any person may...
... 49 Transportation 8 2010-10-01 2010-10-01 false Judicial review. 1016.310 Section 1016.310 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT... Judicial review. Judicial review of final Board decisions on awards may be sought as provided in 5 U.S.C...
... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Judicial review. 180.30 Section 180.30... EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Procedural Regulations § 180.30 Judicial review. (a) Under FFDCA section 408(h), judicial review is available in the United States Courts of Appeal as to the...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 92.18 Section 92.18... States Mint § 92.18 Judicial review. A Final Notice of Assessment issued under the procedures in this subpart may be subject to judicial review pursuant to 5 U.S.C. 701 et seq. ...
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Judicial review. 405.501 Section 405.501 Employees' Benefits SOCIAL SECURITY ADMINISTRATION ADMINISTRATIVE REVIEW PROCESS FOR ADJUDICATING INITIAL DISABILITY CLAIMS Judicial Review § 405.501 Judicial review. You may file an action in a Federal district...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Judicial review. 1203.11 Section 1203.11 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE... Judicial review. Action taken pursuant to section 602 of title VI is subject to judicial review as provided...
The Doctrine of Judicial Review as a legal order to perform the reviewand or re-testing of the laws and regulations within the meaning of the WetGrondwet (testing constitutionalism), the constitution or the constitution bythe Constitutional Court even though relatively new in the state system, buthas grown and developed rapidly both in countries of the Common Law Systemas well as adherents of the countries adherents Civil Law System, even in countries adherents Law Mixed System that claims hi...
Metcalf Katrin Nyman
Full Text Available The article examines how regional integration courts can act as judicial brakes, at a time when “constitutional coups” – leaders staying in power past constitutional time limits or other forms of actions against the spirit if not always the letter of the constitution – are alarmingly common. The article discusses how regional courts can be used to modify or protect national rule of law and the constitutional order from the outside (i.e. from the regional integration aspect and the extent to which this can be valid particularly to promote a uniform interpretation and application of human rights. Although this trend is visible in Europe, it is more striking, because less expected, on other continents, in particular Africa and the Americas, where the developments take place in less than perfect democratic environments. The article contains evidence from cases dealt with in the various regional courts, supporting that a system of political and judicial oversight, especially in regions with weak or fragile democratic systems, can be a useful addition to national judicial or other mechanisms of protection of rule of law and control of the executive. Action by regional courts helps defeat perceptions of majoritarian politics, which in many countries allow for the winner to take all. Under a system of regional oversight, states become aware of the limits they themselves have set and citizens become aware of their possibilities to challenge political power.
Sandmire, H F; DeMott, R K
We observed decreases in cesarean birth rates at two Green Bay hospitals after the 1990 publication of our first cesarean section study. The purpose of this study was to determine the causes of those decreases and to see whether any outcome changes occurred with lower rates. An additional objective was to determine the perceptions of the 10 physicians regarding the determinants of cesarean birth rates. We compared recent cesarean birth rates (1990 to 1992) to former rates (1986 to 1988) for 10 of the 11 physicians analyzed in our previous studies. Newborn outcomes were analyzed to determine whether variations occur in comparing low to high cesarean rate physician groups. The total, primary, and repeat cesarean birth rates declined from 13.3% to 10.2%, 8.6% to 6.8%, and 4.7% to 3.4%, respectively, between 1986 to 1988 and 1990 to 1992. Variations in cesarean rates occurred among physicians and groups of physicians. Higher cesarean rates did not result in better perinatal outcome. Literature reports, residency training, continuing medical education attendance, and liability risks were the major determinants of cesarean birth as perceived by the 10 physicians in the study. The least important determinant, rated fifteenth of 15, was the national cesarean birth rate.
Abildgaard, Helle; Ingerslev, Marie Diness; Nickelsen, Carsten; Secher, Niels Joergen
To investigate the effect of cervical dilation at the time of cesarean section due to dystocia and success in a subsequent pregnancy of attempted vaginal delivery. Retrospective study. University hospital in Copenhagen capital area. All women with a prior cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010. Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural anesthesia and mode of birth was collected. A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully or almost fully dilated cervix (9-10 cm) (p dystocia done late in labor and women with a vaginal delivery prior to their cesarean section had a greater chance of a successful vaginal birth during a subsequent delivery. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Ernesto López Freire
Full Text Available This paper demonstrates the various unconstitutional and fallacies of the Organic Law of Judicial guarantees and Constitutional Control. For that, there will be a comprehensive collation between the mentioned law and the Constitution of the Republic of Ecuador and force. Through this analysis shows a lack of knowledge of Ecuadorian law or legal science by their authors. This study elucidated, inter alia, the inconsistencies in matters relating to the interpretation of constitutional provisions, full compensation, material and integral; challenge administrative acts, judicial unit.
A. Naudé Fourie (Andria)
textabstractThis PhD dissertation conceptualizes the World Bank Inspection Panel as a mechanism of quasi-judicial review or oversight, aimed at enhancing the accountability and legitimacy of the World Bank – which is conceived as an international institution exercising public power. The author
Results: The incidence of cesarean section was 254 (22.30% out of which emergency cesarean section accounted for 167 (65.7% and elective cesarean section for 87 (34.3%. The usual indications of emergency cesarean section were fetal distress, previous cesarean section in labour, non progress of labour and prolonged second stage of labour. The usual indications of elective cesarean section were previous cesarean section, breech, cephalopelvic disproportion and cesarean section on demand. There was found to be no significant difference in age, period of gestation, blood loss and blood transfusion in emergency vs. elective cesarean section. There was significant difference seen in the length of hospital stay, fever, urinary tract infection, wound infection and low APGAR in five minutes indicating that these were more common in emergency cesarean section. Significant difference was also seen in the incidence of postpartum haemorrhage indicating that it was seen more in elective cesarean section. Conclusions: The incidence of cesarean section in Nepal Medical College Teaching Hospital is high and the overall complication rate is higher in emergency cesarean section than in elective cesarean section. Keywords: cesarean section; fetal and maternal outcome.
This paper discusses issues regarding the judicial autopsy of radiation accidents. In the litigation which follows a radiation accident, a claimant calls on the legal system to adjudicate a dispute. Scientific questions are thrust upon the court. The legal system (through attorneys for the parties) then invites scientists to assist the court in resolving such questions. The invitation, however, does not allow the scientist to bring along his full kit. Experimentation, such as repeating the accident with dosimeters to gather more accurate data, is generally not allowed. Also, the scientist must give up his practice of choosing which questions he will pursue
Full Text Available The aim of this paper is to point out that the guarantees of judicial independence have to be regulated by the Constitution as they create de iure framework for the independence of the judiciary in the rule of law system. The author is aware that the constitutional guarantees are per se insufficient and that their primary features may yield different effects depending on the political environment and cultural matrix in which they take effect. The judicial system operates in the circumstances of the separation of powers, where the independent judiciary is corroborated a guarantee of the rule of law. Hence, it is important to concurrently elaborate on the institutional and personal guarantees of judicial independence, focusing on the responsibility of the political authorities to create a relevant social environment for the operation of the independent judiciary as well as on the responsibility of the judiciary to independently exercise their judicial function. The author's intention in this paper is to provides a comparative analysis on the guarantees of independent judiciary and the minimum rules that constitute the cohesive core which serves as the common meeting grounds not only for the EU member states but also for all countries of the European-Continental legal system in their efforts to ensure the judicial independence as the primary condition for exercising the rule of law. The corpus of constitutional guarantees on independent judiciary includes the following elements: the judicial appointments and termination of a judicial office; the permanence of the judicial office and impartiality in decision-making processes; the professional responsibility and judicial immunity; as well as the recently established judicial councils, which have been given the constitutional authority to protect the independence of the judiciary.
Cristina Moisei; Romina M. Sima; Liana Pleş
The enlargement of the parotid gland develops in inflammatory or stenotic conditions but after Cesarean section the symptomatology is unusual. A 38 year old patient with no obstetrical history referred to our clinic for pregnancy, which followed our national program of prenatal care. The outcome of the pregnancy was favorable for both mother and fetus. During labor the fetus developed bradycardia and the patient delivered by Cesarean section a 3400 g baby-boy with 8 Apgar Score; the anesthesi...
Twickler, D.; Setiawan, H.; Harrell, R.; Brown, C.E.L.
Febrile morbidity following cesarean section is often evaluated with CT, although the CT appearance of the normal uterus has not been evaluated. This study was undertaken to learn the normal uterine appearance after cesarean section. To date, 15 women who also underwent bilateral tubal ligation have been studied. Six had a vertical uterine incision; nine had a low transverse incision. Contrast-enhanced pelvic CT was performed 1--5 days after surgery. All women were asymptomatic, with a normal postpartum course
Ni, L; Elsaharty, A; McConachie, I
Cesarean birth is known as both cesarean section (CS) and cesarean delivery (CD). The International Journal of Obstetric Anesthesia (IJOA) is the leading obstetric anesthesia journal, and a barometer of attitudes within the profession. The journal recently published the hundredth issue, spanning 25 years (to December 2016). It is an opportune time to examine the evolution of surgical birth terminology (CS versus CD) during that period. We examined 1583 articles in IJOA, subdividing them into editorials, papers, review articles, debates and case reports. We searched for the terms CS, CD, neither or both; and examined the geographical origin of the articles, dividing them into "North America", Europe" and "Rest of the World". There has been a change in terminology from CS towards CD - mainly from the mid-2000s onwards. Cesarean delivery was predominantly used in North American publications, while CS was predominantly favoured in European publications. It is possible that some of these trends represent policies of journal reviewers, although this does not explain all geographical differences. The term CS may represent tautology as the Latin roots of "cesarean" and "section" both refer to cutting. This would suggest CD to be the preferred terminology. Cesarean delivery also aligns with other terminology, for example vaginal and forceps delivery. A consistent approach would improve clarity. Copyright © 2017 Elsevier Ltd. All rights reserved.
...) specifying that we review certain aspects of the Judicial Survivors' Annuities System (JSAS), which is one of several survivor benefit plans applicable to particular groups of federal employees...
Atacag, T; Yayci, E; Guler, T; Suer, K; Yayci, F; Deren, S; Cetin, A
The objective of this study was to assess the frequency of urinary tract infection (UTI) with urine samples obtained via catheterization among women undergoing cesarean delivery at term pregnancy. A cross-sectional study involving 159 women in whom cesarean delivery was conducted at term pregnancy after a regular follow-up from first to third trimester. For screening and diagnosis of UTI during antenatal period, the authors used dipstick test and microscopic urinalysis, and urine culture was used in the presence of symptomatic UTI unresponsive to initial antibiotic therapy. A urine sample was obtained immediately after insertion of Foley catheter for urine dipstick test, microscopic urinalysis, and culture during cesarean delivery. Obstetric and UTI data were recorded. Of 159 pregnant women, 95 (59.8%) did not develop UTI during antenatal care. There was no patient with symptomatic UTI at the admission for cesarean delivery. The authors found UTI with urine dipstick and microscopic urinalysis in 12 patients and of them, four patients had no history of UTI, and all the remaining eight patients had asymptomatic UTI during antenatal follow-up. UTI according to urine culture was encountered in three patients, two of them had one episode of UTI, and one had two episodes of UTI during antenatal follow-up. After regular antenatal follow-up screening with urine dipstick, microscopic urinalysis, and counseling of pregnant women regarding UTIs, the frequency of bacteriuria decreases considerably during cesarean delivery.
Due to its special political nature, the attention given to high court selection processes has tended to focus either on the selection process itself and on the relationship and tensions between governments and justices on features such as ideology or policy issues at the federal level. Yet, the
Viswanathan, Meera; Visco, Anthony G; Hartmann, Katherine; Wechter, Mary Ellen; Gartlehner, Gerald; Wu, Jennifer M; Palmieri, Rachel; Funk, Michele Jonsson; Lux, Linda; Swinson, Tammeka; Lohr, Kathleen N
The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed the evidence on the trend and incidence of cesarean delivery (CD) in the United States and in other developed countries, maternal and infant outcomes of cesarean delivery on maternal request (CDMR) compared with planned vaginal delivery (PVD), factors affecting the magnitude of the benefits and harms of CDMR, and future research directions. We searched MEDLINE, Cochrane Collaboration resources, and Embase and identified 1,406 articles to examine against a priori inclusion criteria. We included studies published from 1990 to the present, written in English. Studies had to include comparison between the key reference group (CDMR or proxies) and PVD. A primary reviewer abstracted detailed data on key variables from included articles; a second senior reviewer confirmed accuracy. We identified 13 articles for trends and incidence of CD, 54 for maternal and infant outcomes, and 5 on modifiers of CDMR. The incidence of CDMR appears to be increasing. However, accurately assessing either its true incidence or trends over time is difficult because currently CDMR is neither a well-recognized clinical entity nor an accurately reported indication for diagnostic coding or reimbursement. Virtually no studies exist on CDMR, so the knowledge base rests chiefly on indirect evidence from proxies possessing unique and significant limitations. Furthermore, most studies compared outcomes by actual routes of delivery, resulting in great uncertainty as to their relevance to planned routes of delivery. Primary CDMR and planned vaginal delivery likely do differ with respect to individual outcomes for either mothers or infants. However, our comprehensive assessment, across many different outcomes, suggests that no major differences exist between primary CDMR and planned vaginal delivery, but the evidence is too weak to conclude definitively that differences
Topil'skaia, E V; Kadochnikov, D S; Makarov, I Iu; Pankratova, I V; Rakitin, V A
The authors report the results of analysis of the rights of the participants in judicial proceedings (both the prosecution and the defense) to appoint and carry out forensic medical expertise in the course of the criminal court process.
... 49 Transportation 5 2010-10-01 2010-10-01 false Judicial review. 397.225 Section 397.225... MATERIALS; DRIVING AND PARKING RULES Preemption Procedures § 397.225 Judicial review. A party to a proceeding under § 397.205(a), § 397.213(a), or § 397.223(a) may seek review by the appropriate district...
... 49 Transportation 5 2010-10-01 2010-10-01 false Judicial review. 386.67 Section 386.67... Decision § 386.67 Judicial review. (a) Any party to the underlying proceeding, who, after an administrative... service of the Final Agency Order, petition for review of the order in the United States Court of Appeals...
... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Judicial review. 200.64... AND ETHICS; AND INFORMATION AND REQUESTS Canons of Ethics § 200.64 Judicial review. The Congress has provided for review by the courts of the decisions and orders by this Commission. Members should recognize...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 29.406 Section 29.406 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER CERTAIN DISTRICT OF COLUMBIA RETIREMENT PROGRAMS Claims and Appeals Procedures § 29.406 Judicial review...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Judicial review. 29.515 Section 29.515 Money and Finance: Treasury Office of the Secretary of the Treasury FEDERAL BENEFIT PAYMENTS UNDER... Overpayments § 29.515 Judicial review. An individual whose request for reconsideration has been denied (in...
... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Judicial review. 173.9 Section 173.9 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS PROCEDURES GOVERNING... Judicial review. The State may appeal an order rescinding, in whole or in part, its primary enforcement...
... Labor, shall not be subject to judicial review in any criminal or other civil proceedings (49 U.S.C... law judge, shall be transmitted by the Administrative Review Board, United States Department of Labor... 29 Labor 9 2010-07-01 2010-07-01 false Judicial review. 1978.110 Section 1978.110 Labor...
... 29 Labor 3 2010-07-01 2010-07-01 false Judicial construction. 785.7 Section 785.7 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL... Hours Worked § 785.7 Judicial construction. The United States Supreme Court originally stated that...
... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Judicial review. 204.9 Section 204.9 Patents, Trademarks, and Copyrights COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT OFFICE AND PROCEDURES PRIVACY ACT: POLICIES AND PROCEDURES § 204.9 Judicial review. Within two years of the...
Full Text Available EU substantive law is based on a system of circulation freedoms which encompasses the idea that the Union, its internal market or other areas of legal rule, such as the area of freedom, security and justice are, above all, spaces of liberty, which rejects the limits represented before by internal borders. So, the essential EU integrative concepts could be formulated as free circulation principles or instruments aiming to such freedoms. The free movement of judgments and judicial decisions represents concomitantly the consequence and the expression formulated through freedom of circulation, which is specific to EU law, of the principle of mutual recognition of judgments and judicial decisions between member states in both civil and criminal matters. This principle is based upon the mutual trust that member states owes to each other. Finally, the study analyses the principle of mutual recognition in EU law as a transplant from the internal market in the judicial cooperation in criminal matters, which produces numerous application instruments, among them the first and most productive is the European Arrest Warrant. This paper studies also the common standard and paradigm that all instruments based upon the free movement of judgments and judicial decision have, amongst others: the warrant/order typology, direct communication between the competent authorities of Member States, elimination of the recognition procedure, the express mentioning of the mandatory and optional grounds of refusal, the partial removal of double criminality requirement etc.
Sergei Evgenievich Strakhov
Full Text Available In today's world, a crucial role is played by the judiciary. In the period lasting judicial reform, it is important to explore this institution not only at the present stage, but also to trace the history of its development, including - through analysis and synthesis of existing studies of the judiciary and judicial reforms.The purpose of this study - to explore the historiography of general, special and regional studies of judicial reform of1864 inRussia, to classify research on history and on the subject of the study.Scientific, theoretical and practical significance of the work lies in the fact that the study of this topic will summarize the significant weight of the studies of the judicial reform of 1864 and classified by facilitating orientation interested in individuals in the study subjects.The author uses historical, comparative, hermeneutical, mathematical methods, as well as general methods of scientific research.The author analyzes the historiography of general, special and regional studies of the judicial reform of1864 inRussia, introducing a classification of such studies in chronological order (pre-revolutionary, Soviet and modern stages and subject matter (common - affecting all aspects of judicial reform, special - dedicated to a particular aspect (legal agencies, prosecutors, legal, etc. and regional - dedicated to judicial reform, or some aspects of it in some regions of Russia.The results of this study are scientific and practical value, because they can be useful for teaching students - in industry disciplines "judiciary", "advocacy", "notary public", "public prosecutor's supervision" and general theoretical "History of State and Law," "History of the fatherland" ; in science - by picking up information about the historiography of the judicial reform, and in practice - said work can serve as a guide to research judicial reform, which may be useful to practitioners of judicial and investigative bodies, as well as - prosecutors
Perslev, Anette; Jørgensen, Finn Stener; Nielsen, Leif Kofoed
OBJECTIVE: To investigate the degree of fetomaternal hemorrhage (FMH) caused by elective cesarean section. DESIGN: Descriptive study. SETTINGS: University Hospitals in Copenhagen, Denmark. POPULATION: Women scheduled for elective cesarean section, in the period September 2007 to January 2009, at ...
Ai Zhigang; Gao Shufeng; Zhang Xuehui
Objective: To evaluate uterine arterial chemoembolization combined with curettage in treating cesarean scar pregnancy. Methods: Super-selective bilateral uterine arterial catheterization and angiography was performed in 64 patients with cesarean scar pregnancy (duration of amenorrhea 43-84 days), which was followed by arterial infusion of MTX and embolization with Gelfoam particles. Then curettage was carried out. The technical success rate and the therapeutic results were observed and analyzed. Results: Technical success in catheterization and in performing chemoembolization was achieved in all 64 patients. The pregnant tissues were successfully cleared away in 62 patients. The average blood loss during curettage procedure was 21.4 ml. For the remaining two patients lesion resection together with repair of lower segment was employed. No severe complications occurred after the treatment. Conclusion: Uterine arterial chemoembolization combined with curettage is a safe,minimally-invasive and effective treatment for cesarean scar pregnancy. It is worth popularizing this technique in clinical practice. (authors)
Lee, Amy Su May; Kirkman, Maggie
In the context of international concern about increasing rates of cesarean sections, we used discourse analysis to examine explanations arising from feminism and the disciplines of medicine and midwifery, and found that each was positioned differently in relation to the rising rates. Medical discourses asserted that doctors are authorities on birth and that, although cesareans are sometimes medically necessary, women recklessly choose unnecessary cesareans against medical advice. Midwifery discourses portrayed medicine as paternalistic toward both women and midwifery, and feminist discourses situated birth and women's bodies in the context of a patriarchally structured society. The findings illustrate the complex ways in which this intervention in birth is discursively constructed, and demonstrate its significance as a site of disciplinary conflict.
Karbeyaz, Kenan; Çelikel, Adnan
Elder abuse is a health and human rights problem that may occur among every race and ethnic group all around the world. This study aims at describing all cases of physical abuse of elderly which have been reported to, and investigated by Eskisehir - a western city of Turkey. Physical abuse incidents above 65 years of age which were evaluated by the Eskisehir Council of Forensic Medicine for expert witness opinion during 5year period between 01.01.2010 and 12.31.2014 are examined in this descriptive, cross-sectional study. 253 cases are found and evaluated in the scope of the study. It is determined that all aggressors are the acquaintance of the victim, and for 114 cases (45.1%) the aggressor is the victim's son. It is found that only investigation procedures of cases are completed, but no protection and rehabilitation program has been issued. In conclusion, it is determined that elder victims are abused by family members and relatives who are mostly the care givers. It is seen that emergency physicians play a great role in the detection of abuse. Copyright © 2017 Elsevier B.V. All rights reserved.
Delnord, M.; Blondel, B.; Drewniak, N.; Klungsøyr, K.; Bolumar, F.; Mohangoo, A.; Gissler, M.; Szamotulska, K.; Lack, N.; Nijhuis, J.; Velebil, P.; Sakkeus, L.; Chalmers, J.; Zeitlin, J.; Haidinger, G.; XMartens, G.; Misselwitz, B.; Wenzlaff, P.; Bonham, S.; Jaselioniene, J.; Gatt, M.; Klungsøyr, K.; Barros, H.; Novak, Z.; Gottvall, K.
Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and
Full Text Available This article examines the problematic processes in a case that has had few parallels in Indian judicial history. The apex court in T. N. Godavarman took upon the responsibility of deciding how forest resources in the country should be accessed and who is (or is not to have such access. Purportedly done to protect the environment, through the ′clarification and fine-tuning′ of national forest-laws, the case has seriously affected the life, livelihood, and habitat of millions of marginal groups. Recent trends demonstrate the wider trend of constitutional courts assuming the roles of adjudication, administration and legislation, all rolled into one, whereby they become problematic sites for creating a hierarchy of conflicting public interests, which claim constitutional validity from different vantage points. Thus, constitutional values of ′protection of environment′ and ′justice - social, political and economic′ ′are pitted against each other′ where unelected courts take it upon themselves to define the legitimate precincts of the theoretical discourse of sustainable use / development; and importantly also implement it into ′everyday′ ′reality, in the way it feels fit′. The article seeks to make sense of this contemporary process of forest governance.
Full Text Available Youssef’s syndrome is characterized by cyclic hematuria (menouria, absence of vaginal bleeding (amenorrhea, and urinary incontinence due to vesicouterine fistula (VUF, the least common of the urogynecological fistulas. Youssef’s syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.
Stokholm, Jakob; Thorsen, Jonathan; Chawes, Bo L
BACKGROUND: Delivery by means of cesarean section has been associated with increased risk of childhood immune-mediated diseases, suggesting a role of early bacterial colonization patterns for immune maturation. OBJECTIVE: We sought to describe the influence of delivery method on gut and airway......-driven partial least squares analyses. The initial airway microbiota was unaffected by birth method. CONCLUSION: Delivery by means of cesarean section was associated with early colonization patterns of the neonatal gut but not of the airways. The differences normalized within the first year of life. We speculate...
Hu Peng; Li Yuwei; Li Yunhui; Luo Bin; Wen Wen; Yang Bo
Objective: to analyze the causes of uterine hemorrhage occurred after cesarean section and to investigate the value of angiography and transcatheter artery embolization (TAE) in the diagnosis and treatment of postpartum hemorrhage after cesarean section. Methods: During the period from Jan. 2001 to Dec. 2011, a total of 65 cases suffering from uterine bleeding after cesarean section had underwent uterine arteriography to clarify the diagnosis, which was followed by transcatheter uterine artery embolization (TUAE). The clinical data, the causes of bleeding and the angiographic features were retrospectively analyzed. Results: The causes of uterine bleeding after cesarean section included uterine artery pseudoaneurysm (n=26), uterine atony (n=18), placental factors (n=11), gestational hypertension (n=8), coexisting uterine fibroids (n=1) and uterine bleeding of unknown reason (n=1). Uterine artery angiography revealed contrast extravasation in all patients except one patient. The angiographic findings confirmed the diagnosis of uterine artery bleeding after cesarean section. The bleeding stopped after TUAE, and the patients were in stable condition. No serious complications occurred. Conclusion: Pseudoaneurysm is the primary cause of postpartum uterine hemorrhage after cesarean section. Transcatheter uterine artery angiography can promptly and reliably determine the causes of bleeding, and, at the same time, embolization therapy can be carried out to effectively stop the bleeding. (authors)
... CONDUCT Disciplinary Actions Concerning Postemployment Conflict of Interest § 5.68 Judicial review. A respondent against whom the Commission has issued an order imposing disciplinary action under this part may...
... Coordination Act of 1974 § 207.8 Judicial actions. (a) Enforcement of subpoenas; contempt. Any United States... such an order of the court may be punished by the court as contempt. (b) Injunctions. Whenever it...
Full Text Available Given the perennial problem of lack of access to justice; the fact that there was no shortage of superior court judges until 1994; the demands on court process which flow directly from transition to the constitutional democratic system; and the urgent and justified necessity for the demographic transformation of judicial personnel, two challenges to the capacity of the judicial system present themselves in South Africa: Enlarging the number of suitable candidates for judicial appointment to redress the former demographic imbalance; and developing the kind of skills among those appointed as judges to be able to respond with confidence across a wide range of often complex legal issues; and developing a theory of judicial deference which observes the separation of powers and preserves judicial independence. This paper explores these challenges, after setting out the socio-political context, as it impacts directly on their nature and scope, and the prospects of meeting them.Debido al constante problema de la falta de acceso a la justicia, al hecho de que no hubo escasez de jueces de tribunales superiores hasta 1994, las demandas del proceso judicial que surgen directamente de la transición al sistema democrático constitucional, y la necesidad urgente y justificada de la transformación demográfica del personal judicial, el rendimiento judicial en Sudáfrica se encuentra con dos desafíos: Aumentar el número de candidatos aptos al nombramiento judicial para compensar el anterior desequilibrio demográfico y desarrollar en los jueces nombrados aquellas habilidades que les permitan responder con confianza a asuntos jurídicos a menudo complejos; y desarrollar una teoría de deferencia judicial que respete la separación de poderes y preserve la independencia judicial. Este artículo explora estos desafíos tras explicar el contexto sociopolítico, ya que éste afecta directamente a su naturaleza y alcance, y las probabilidades de que se superen
Zafar, B.; Shehzad, F.; Safdar, C.A.
Objective of study is to compare peri-operative complications between exteriorization and intraabdominal repair of uterus after cesarean delivery. Study Design: Randomized controlled trial. Place and Duration of Study: Obstetrics and Gynecology Department of Pakistan Ordinance Factory Hospital, Wah Cantt, from 1st April 2010 to 30th September 2010. Material and Methods: Patients planned for 1st cesarean section under spinal anesthesia were randomly allocated by lottery method to exteriorized (A) or in situ uterine repair (B) group. Patients with history of uterine surgeries and cesarean section were excluded from study. Variables analyzed were operation time, peri-operative hemoglobin (Hb) fall, nausea and vomiting during the cesarean delivery. Results: The study analyzed 170 patients and divided them in 2 groups, having no significant difference with respect to maternal demographics, procedure statistics and indication of cesarean section. Significant difference was observed in operation time being 32.78 min in exteriorized group and 36.38 min in situ uterine repair group (p-value 0.0001). Hb percent fall was 0.85 g/dl and 0.92 g/dl respectively in both groups (p-value 0.62) Nausea and vomiting was 23.5 percent in group A and 11.8 percent in group B (p-value 0.02, 0.04 respectively) Conclusion: Peri-operative complications like operative time and Hb fall are less in uterine repair after temporary exteriorization as compared to intra-abdominal repair of uterus after cesarean delivery. Nausea and vomiting were increased in exteriorized group but proper regional anesthetic technique and achieving adequate analgesia can reduce patient discomfort. (author)
Choi, Hyun Ah; Lee, Yeon Kyung; Ko, Sun Young; Shin, Son Moon
Neonatal clavicle fracture in cesarean delivery is rare and has not been extensively studied. We performed a retrospective review of cesarean deliveries with neonatal clavicle fracture during a 12-year period. Maternal and neonatal factors as well as surgical factors related to cesarean delivery for the fracture were determined and compared to the control group to analyze their significance. Among a total 89 367 deliveries during the study period, 36 286 babies were born via cesarean section. Nineteen cases of clavicle fractures in cesarean section were identified (0.05% of total live births via cesarean section). In the analysis of maternal and neonatal risk factors, birthweight, birthweight ≥ 4000 g and maternal age were significantly associated with clavicle fracture in cesarean section. However, clavicle fractures were not correlated with the selected surgical factors such as indication for cesarean section, skin incision to delivery time and incision type of skin and uterus. Logistic regression analysis showed that birthweight was the major risk factor for clavicle fracture. Clavicle fractures complicated 0.05% of cesarean deliveries. The main risk factor related to a clavicle fracture in cesarean section was the birthweight of an infant. As reported in previous studies associated with vaginal delivery, clavicle fracture is considered to be an unavoidable event and may not be eliminated, even in cesarean delivery.
Eulalia Hernández Ciro
Full Text Available From the interceptions between the Italian microhistory and anthropology, this article aims to provide a central debate of contemporary historiography account of popular culture and subaltern classes from the intensive and exhaustive judicial proceedings. To do this, some of the impacts of anthropology will be addressed in the historical work, as the appearance and questioning notion of popular culture, the ethnographic value of court files and finally, some possibilities in the case of Judicial Historical Archive of Medellin.
Németh, Gábor; Molnár, András
The tendency of increasing cesarean section rate has drawn worldwide attention. The vaginal birth after cesarean section is a useful method to decrease cesarean section rate at defined cases. Retrospective overview of factors resulting successful vaginal birth, labor/induction's condition, criterias, short and long term benefits and consequences. Overview recommendations of international guidelines and publications' results concerned vaginal birth after cesarean section in "PubMed", "MEDLINE", "Cochrane" databases from 1996 to 2016. Reviewing results of recommendations and publications we can declare that statements are inconsistent, however the option of vaginal birth after cesarean section is appropriate for decrease complications and trend of increasing cesarean section rate. It would be important in our country to define a uniform recommendation regarding vaginal birth after cesarean section, with supporting evidence in obstetrical and gynecological practice. Orv Hetil. 2017; 158(30): 1168-1174.
Wang, Weimin; Long, Wenqing; Yu, Qunhuan
To probe into the clinical manifestation, diagnosis, as well as treatment of pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester. Analysis of 14 patients with pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester was made after conservative treatment by drugs from January 1996 to December 1999. The 14 patients with a pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester were painless, had slight vaginal bleeding, and concurrently had increased serum beta-subunit human chorionic gonadotropin (beta-HCG). Doppler ultrasonic examination revealed an obvious enlargement of the previous cesarean section cicatrix in the uterine isthmus, and found a gestational sac or mixed mass attached to the cicatrice, with a very thin myometrium between the gestational sac and bladder walls. Among the 14 patients, 12 patients had crystalline trichosanthes injected into the cervix, mifepristone taken orally, or methotrexate in the form of intramuscular injection. Following this procedure, their serum beta-HCG dropped to normal. The other 2 patients had a total hysterectomy. Pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester is a complication of cesarean section. Early diagnosis and effective conservative treatment by drugs are instrumental in decreasing the potential occurrence of uterine rupture, which is also conducive to preserving the patient's future fertility.
Full Text Available This article tends to deal with one of the most worrying issues in the judicial system of Kosovo the problem of judicial civil procedure dragging out. The article analyses the reasons of these dragging outs of the judicial civil procedure focusing on the context of one of the basic procedural principles in civil procedure-the principle of economy or efficiency in the courts. Dragging out of civil procedure in Kosovo has put in question not only the basic principles of civil procedure, but it also challenges the general principles related to human rights and freedoms sanctioned not only by the highest legal act of the country, but also with international treaties. The article tends to give a reflection to the most important reasons that effect and influence in these dragging outs of civil procedure, as well as, at the same time aims to give the necessary alternatives to pass through them by identifying dilemmas within the judicial practice. As a result, the motives of this scientific paper are exactly focused at the same time on identifying the dilemmas, as well as presenting ideas, to overstep them, including the judicial practice of the European Court of Human Rights on Article 6 of the European Convention on Human Rights, by which it is given the possibility to offering people efficient and within a reasonable time legal protection of their rights before national courts. For these reasons, the paper elaborates this issue based on both, the legal theory and judicial practice.
Krebs, Lone; Langhoff-Roos, Jens
and anemia (RR 0.91; 95% CI 0.84, 0.97), and operations for wound infection (RR 0.69; 95% CI 0.57, 0.83) than emergency cesarean delivery. There was a higher rate of puerperal fever and pelvic infection (RR 1.20; 95% CI 1.11, 1.25) than for vaginal delivery. Thromboembolic disease occurred in 0.1% of women......OBJECTIVE: To compare the maternal complications of elective cesarean delivery for breech at term with those after vaginal or emergency cesarean delivery. METHODS: We conducted a population-based, retrospective cohort study of 15441 primiparas who delivered singleton breech at term. Information...... was obtained from the Danish Medical Birth Register, the Register of Death Causes, and the Denmark Patient Register. RESULTS: Elective cesarean delivery was associated with lower rates of puerperal fever and pelvic infection (relative risk [RR] 0.81; 95% confidence interval [CI] 0.70, 0.92), hemorrhage...
Madsen, Kristine; Grønbeck, Lene; Larsen, Christian Rifbjerg
Cesarean section is a common operation and one of the first surgeries performed independently by trainees/residents in obstetrics and gynecology. Determination of trainees' technical skills level is dependent upon subjective faculty assessment. Based on three studies on learning curves in cesarea...... Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology....
Sevelsted, Astrid; Stokholm, Jakob; Bønnelykke, Klaus
OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated with the develo......OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated...... with the development of some of these diseases. METHODS: Mature children born by cesarean delivery were analyzed for risk of hospital contact for chronic immune diseases recorded in the Danish national registries in the 35-year period 1977-2012. Two million term children participated in the primary analysis. We...... studied childhood diseases with a suspected relation to a deviant immune-maturation and a debut at young age. The effect of cesarean delivery on childhood disease incidences were estimated by means of confounder-adjusted incidence rate ratios with 95% confidence intervals obtained in Poisson regression...
Lopez, O.L.; Maisano, E.R.
Gallium-67 distribution in normal patients is well known; it is also known that the concentration in some tissues may vary according to an individual physiologic stimulus. In this report, the case of a young woman is presented who was studied 15 days after a cesarean section and showed physiologic and pathologic Ga-67 accumulation.
Objective: The aim of the present study was to evaluate the optimum dose of ropivacaine by comparing three different dosing regimens of isobaric ropivacaine 1% (naropin 10 mg/ml, Astra Zeneca) administered intrathecally and to demonstrate the effects of anesthesia in pregnant women scheduled for cesarean section.
Lopez, O.L.; Maisano, E.R.
Gallium-67 distribution in normal patients is well known; it is also known that the concentration in some tissues may vary according to an individual physiologic stimulus. In this report, the case of a young woman is presented who was studied 15 days after a cesarean section and showed physiologic and pathologic Ga-67 accumulation
Vangen, S; Stoltenberg, C; Skrondal, A; Magnus, P; Stray-Pedersen, B
We studied prevalences and risk factors for cesarean section among different groups of immigrants from countries outside Western Europe and North America in comparison to ethnic Norwegians. The study is population based using data from the Medical Birth Registry of Norway. A total of 553,491 live births during the period 1986-1995 were studied, including 17,891 births to immigrant mothers. The prevalences of cesarean section ranged from 10.1% among women from Vietnam to 25.8% in the group of Filipino origin. The use of abdominal delivery was also high in the groups from Sri Lanka/India (21.3%), Somalia/Eritrea/Ethiopia (20.5%) and Chile/Brazil (24.3%), while the frequency among women from Turkey/Morocco (12.6%) and Pakistan (13.2%) was approximately the same as among ethnic Norwegians (12.4%). Feto-pelvic disproportion, fetal distress and prolonged labor were the most important diagnoses associated with the high prevalences, but the significance of these diagnoses differed among the groups. Other unknown factors come into play, particularly among women from Somalia/Eritrea/Ethiopia and Chile/Brazil. There was substantial variation in the use of cesarean section among ethnic groups in Norway. The diagnoses feto-pelvic disproportion, fetal distress and prolonged labor may be confounded by a number of factors including maternal request for cesarean section and difficulties in handling the delivery. Further research is needed to explain the observed differences.
Iasna Chaves Viana
Full Text Available The judge’s action setting became modern ágora, preferential space of the relevant public deliberations. Today there is an invasion of the public choices’ usual spaces by the legalization of politics, result of Brazil's institutional design. The concepts of judicial activism and judicial protagonism oppose this scenario. At present it must be judicial action protagonist, transforming reality, understood that which is back to lend maximum effect to the Constitutional text. Especially relevant when it comes to environmental issues, given the enormous complexity of today's society. Case studies aim to show the evolution of the Brazilian Judicial understanding in this regard.
Sharyn Roach Anleu
Full Text Available Judicial performance evaluation processes and programs tend to imply an abstract, normative model of the proper judge. The focus is on the individual judicial officer, identifying how judges ought to perform their judicial work and assessing any departures from the model. However, there is considerable diversity in judging which abstract models of JPE may not anticipate. Importantly, judicial performance occurs within a context – the practical and natural settings in which every day judicial work is undertaken. This entails time constraints, workload patterns, and dependence on the activities of others, factors over which the judicial officer may have little control, but which in turn may affect his/her behaviour. Often, judicial performance is taken to refer to in-court work only. Judicial work also occurs outside court and outside regular court hours and so may be less visible for judicial performance evaluation. Although there is considerable variety in judicial experiences of judging, JPE only sometimes includes self-perceptions or judges’ own reflections on their work. Social science and socio-legal research, including original empirical data from Australia, investigates judging in various contexts and explores judicial officers’ experiences of their work. Such empirical research can widen understandings of judicial performance and evaluation. Los procesos y programas de evaluación del rendimiento judicial tienden a implicar un modelo normativo abstracto del juez competente. La atención se centra en el funcionario judicial individual, identificando cómo deben realizar su labor los jueces y determinando cualquier desviación respecto al modelo. Sin embargo, a la hora de juzgar, existe una gran diversidad que los modelos abstractos de evaluación del rendimiento judicial no pueden anticipar. Es importante destacar que el desempeño judicial se produce en un contexto – el marco práctico y natural en el que se desarrolla cada d
BARBER, Emma L.; LUNDSBERG, Lisbet; BELANGER, Kathleen; PETTKER, Christian M.; FUNAI, Edmund F.; ILLUZZI, Jessica L.
OBJECTIVE To examine physician-documented indications for cesarean delivery in order to investigate the specific indications contributing to this increase. METHODS We analyzed rates of primary and repeat cesarean delivery, including indications for the procedure, among 32,443 live births at a major academic hospital between 2003–2009. Time trends for each indication were modeled to estimate the absolute and cumulative annualized relative risk of cesarean by indication over time and the relative contribution of each indication to the overall increase in primary cesarean delivery rate. RESULTS The cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009; 50.0% of the increase was attributable to an increase in primary cesarean delivery. Among the documented indications, nonreassuring fetal status, arrest of dilation, multiple gestation, pre-eclampsia, suspected macrosomia, and maternal request increased over time, while arrest of descent, malpresentation, maternal-fetal indications, and other obstetric indications (eg, cord prolapse, placenta previa) did not increase. The relative contributions of each indication to the total increase in primary cesarean rate were: Non-reassuring fetal status (32%), labor arrest disorders (18%), multiple gestation (16%), suspected macrosomia (10%), pre-eclampsia (10%), maternal request (8%), maternal-fetal conditions (5%), and other obstetric conditions (1%). CONCLUSION Primary cesarean births accounted for 50% of the increasing cesarean rate. Among primary cesareans, more subjective indications (nonreassuring fetal status and arrest of dilation) contributed larger proportions than more objective indications (malpresentation, maternal-fetal, and obstetric conditions). PMID:21646928
Much effort is being made to safeguard judicial integrity – but what is it? In this article, two discourses on judicial integrity will be outlined: one in which judicial integrity is said to be at stake and one in which the emphasis lies on safeguarding judicial integrity. These discourses are by no
Diana Anca Artene
Full Text Available As a result of the integration within the European Union, in the economical and social life of Romania, new judicial entities have been developed. The cluster is amongst the most recent advent in the judicial spectre. The cluster represents a group of people both individuals and legal persons which is considered to act on the basis of an association contract conceptualized under the existent agreements of the organizations found within the spectrum of science and accredited innovation and/or accredited higher education institutions ,as well as, other noncommercial institutions. At the same time, economic agents, local public administrative authorities, employers` or professionals associations, non-judicial individuals, financial institutions, international organizations, local and foreign investors are relevant for the emergence of the scientific and educational research activities, as well as for the technological transfer of the scientific and innovative results and their valorisation through economical activities. 2 Therefore, it can be argued that the cluster has appeared as a result of the necessity to create a proper environment that would reunite the business partners in order to develop common resources and competences. These are based on similar marketing strategies, the participation to similar projects and initiatives, the opportunity to create a brand, etc. An additional circumstance that has determined the development of this entity in its more recent form, is represented by the possibility of ensuring (at least in a pageant manner the independence for every partner on the basis of the dualism between competition- cooperation. The cluster can be organized as an entity with or without judicial personality. The definition of the cluster makes us reflect upon the ways in which it can be constituted: legal person with lucrative purpose, legal person without lucrative purpose, association without legal personality (simple association of
Guerra, Alice; Tagliapietra, Claudio
office to another after three years of mandate, and the law prescribes their transfer after ten years to guarantee their independence. Flaws in the process managing the backlog of outbound judges and the existence of asynchrony between outbound and inbound transfers produce a chain of delays...... to the disposition of court cases. Using a novel dataset on Court of Appeal Districts in Italy (2008–2012), we provide evidence of a strong negative relation between high turnover rates and judicial performance. We find that marginal increases in judge turnover rates lead to a statistically significant decrease...... in judicial performance over two years of time...
Perslev, Anette; Jørgensen, Finn Stener; Nielsen, Leif Kofoed
Objective. To investigate the degree of fetomaternal hemorrhage (FMH) caused by elective cesarean section. Design. Descriptive study. Settings. University Hospitals in Copenhagen, Denmark. Population. Women scheduled for elective cesarean section, in the period September 2007 to January 2009......, at the Department of Gynecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Denmark. Methods. Two maternal blood samples were taken, the first before cesarean section and the second immediately after. Both samples were analyzed at the Blood Bank, Rigshospitalet, Copenhagen, for the presence...
Peng Chiong Tan
Conclusion: In women who have had prior vaginal birth attempting a trial of labor after cesarean, a vaginal delivery before cesarean delivery is an independent risk factor for repeat cesarean. Women with two or more prior vaginal births have a similar risk for repeat cesarean and neonatal admission to women with only one prior vaginal birth.
Full Text Available The enlargement of the parotid gland develops in inflammatory or stenotic conditions but after Cesarean section the symptomatology is unusual. A 38 year old patient with no obstetrical history referred to our clinic for pregnancy, which followed our national program of prenatal care. The outcome of the pregnancy was favorable for both mother and fetus. During labor the fetus developed bradycardia and the patient delivered by Cesarean section a 3400 g baby-boy with 8 Apgar Score; the anesthesia was spinal. 18 hours after delivery the patient presented mild respiratory distress. The symptomatology was caused by the enlargement of the parotid gland. The treatment was supportive and the remission occurred 10 hours after the onset. The initial discussion that raised this case was caused by the viral, infection and stenotic cause of the parotiditis. All these reasons had no medical argument. It was also debated about the anesthesia but, until now, the medical literature didn’t report any case of association between parotiditis and spinal anesthesia. It is also impossible to correlate the parotiditis with IVF procedure. As a conclusion, this case is unique because it represents the parotiditis without unknown case that appeared after Cesarean section and spinal anesthesia in a healthy woman.
Muñoz-Enciso, José Manuel; Rosales-Aujang, Enrique; Domínguez-Ponce, Guillermo; Serrano-Díaz, César Leopoldo
Caesarean section is the most common surgery performed in all hospitals of second level of care in the health sector and more frequently in private hospitals in Mexico. To determine the behavior that caesarean section in different hospitals in the health sector in the city of Aguascalientes and analyze the indications during the same period. A descriptive and cross in the top four secondary hospitals in the health sector of the state of Aguascalientes, which together account for 81% of obstetric care in the state, from 1 September to 31 October 2008. Were analyzed: indication of cesarean section and their classification, previous pregnancies, marital status, gestational age, weight and minute Apgar newborn and given birth control during the event. were recorded during the study period, 2.964 pregnancies after 29 weeks, of whom 1.195 were resolved by Caesarean section with an overall rate of 40.3%. We found 45 different indications, which undoubtedly reflect the great diversity of views on the institutional medical staff to schedule a cesarean section. Although each institution has different resources and a population with different characteristics, treatment protocols should be developed by staff of each hospital to have the test as a cornerstone of labor, also request a second opinion before a caesarean section, all try to reduce the frequency of cesarean section.
Mohammed, Abdel-Baset F; Bayo, Arabo I; Abu-Jubara, Mahmoud F
To assess the maternal and neonatal consequences of scheduling elective repeated cesarean section (ERCS) at 39 weeks rather than 38 weeks and to assess the impacts of delivering by emergency cesarean section (CS) before the planned date. Retrospective Cohort study. Patients with previous two or more CS planned for ERCS at term during the period from January to June 2011. Medical records were reviewed for demographic and clinical data, planned timing of CS, emergency cesarean and any adverse maternal or neonatal outcome. Adverse maternal or neonatal outcome. Four hundred and twenty women were included, 71.4% of cases were posted <39 weeks and 28.6% were posted at ≥39 weeks. Patients posted ≥ 39 weeks were more prone to deliver by emergency CS (16.6 vs. 10.6%) and the neonates were less prone to RDS and NICU admission (p < 0.05). Our data support the justification to book patients for ERCS at ≥39 weeks.
Magee, Susanna R; Battle, Cynthia; Morton, John; Nothnagle, Melissa
In this commentary we describe our experience developing a "gentle cesarean" program at a community hospital housing a family medicine residency program. The gentle cesarean technique has been popularized in recent obstetrics literature as a viable option to enhance the experience and outcomes of women and families undergoing cesarean delivery. Skin-to-skin placement of the infant in the operating room with no separation of mother and infant, reduction of extraneous noise, and initiation of breastfeeding in the operating room distinguish this technique from traditional cesarean delivery. Collaboration among family physicians, obstetricians, midwives, pediatricians, neonatologists, anesthesiologists, nurses, and operating room personnel facilitated the provision of gentle cesarean delivery to families requiring an operative birth. Among 144 gentle cesarean births performed from 2009 to 2012, complication rates were similar to or lower than those for traditional cesarean births. Gentle cesarean delivery is now standard of care at our institution. By sharing our experience, we hope to help other hospitals develop gentle cesarean programs. Family physicians should play an integral role in this process. © Copyright 2014 by the American Board of Family Medicine.
... PROCEDURES Procedures for Original Jurisdiction Cases Special Counsel Disciplinary Actions § 1201.127 Judicial review. (a) An employee subject to a final Board decision imposing disciplinary action under 5 U.S... appropriate United States district court. 5 U.S.C. 1508. Special Counsel Corrective Actions ...
McKnight, R. Neal
Describes a college course which examines the organizational and behavioral characteristics of trial courts in the American judicial process. A major course objective is to help students understand the trial court process as a political process by showing how trial court organizations are involved in the allocation of social values. (RM)
... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Judicial review. 325.11 Section 325.11 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE MISCELLANEOUS REGULATIONS EXPORT TRADE CERTIFICATES OF...
... determination on appeal, from depositing statements of account and royalty fees by those sections. [59 FR 23981... ARBITRATION ROYALTY PANEL RULES AND PROCEDURES COPYRIGHT ARBITRATION ROYALTY PANEL RULES OF PROCEDURE Procedures of Copyright Arbitration Royalty Panels § 251.58 Judicial review. (a) Any order of determination...
... Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR SURFACE COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS... to judicial review by a court of competent jurisdiction, as provided for in the State program, but...
The Constitutional Court subscribes to a standard of "deference" in judicial review.1. The principle of deference concerns the function of the judge in mediating between the law and legislative and executive politics. The principle recognises the need to protect the institutional character of each of the three arms of ...
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Judicial review. 117.18 Section 117.18 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION NONDISCRIMINATION IN FEDERALLY... reasonable attorney's fees, but that the complainant must demand these costs in the complaint; (iii) That...
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Judicial review. 6.57 Section 6.57 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND... District Court in which the requestor resides or has his or her principal place of business or in which the...
Fritz Edward Siregar
Full Text Available Indonesia Constitutional Court will celebrate 12th birthday this August 2015, and it cannot be denied that the Court play significant role in securing democracy in Indonesia. In exercising their authorities, including the election result dispute and judicial review, the Court continue to affirm institutional judicial legitimacy and pursue their role to guard 1945 Constitution and continue to do so. The first Chief Justice Jimly showed how within five years of the Court’s creation, he could strategically maximise its momentum and build up the Court as a respectful institution. The Chief Justice Mahfud MD was then elected to reduce the judicial activism started by Jimly’s bench. However, against promises and expectations, Mahfud MD brought the Court to a level far beyond the imagination of the Constitution drafters. Parliament and President tried to limit Court’s authority, not ones, and the Court able to overcome those constrain. Current various available studies observed only how the Court issued their decision and solely focus to the impact of the decision. Scholars slightly ignore that study about the Court, by reducing other constitutional actor in Indonesia, produce study about the Court itself isn’t complete. In fact, political environment in which the Court operated at that time is one of utmost importance the strengthen of the Court institutional legitimacy. This paper is trying to discover the rise of the Indonesia Constitutional Court, not from what the Court did, but from political environment outside the court. Political parties realize that the Court is the only institution that act as political dispute resolution among them. Political parties maturity and political constraint are the key factor that support the development of the Court’s institutional power.
Full Text Available Low trust in courts has been recorded in many EU countries. According to the procedural justice paradigm, this phenomenon has negative repercussions for judicial legitimacy, since people who (or when they distrust an authority tend also not to perceive this authority as legitimate (which, in turn, has consequences for their compliance and cooperation with this authority and its decisions. Legitimacy of judiciary, objectively conceived, has several elements, some of which are connected to procedural justice concerns. This article focuses on the latter. In the second part, moreover, the article addresses some of the possible challenges to the judicial procedural justice, drawing on sociological and socio-legal observations regarding legal institutions in the late modern world, where, for example, efficiency-oriented goals mix with justice- and other public good-oriented ones, often creating internal pressures that may impact on the legitimacy of the institution in question. Numerosos países de la UE han registrado una baja confianza en los tribunales. Según el paradigma de la justicia procesal, este fenómeno tiene repercusiones negativas para la legitimidad judicial, ya que las personas que (o cuando desconfían de una autoridad, también tienden a no percibir esta autoridad como legítima (lo que, a su vez, tiene consecuencias para su conformidad y cooperación con esta autoridad y sus decisiones. La legitimidad del poder judicial, concebida de forma objetiva, tiene diversos elementos, algunos de los cuales están relacionados con las preocupaciones de la justicia procesual. Este artículo se centra en estos elementos. En la segunda parte, además, el artículo aborda algunos de los posibles desafíos de la justicia de procesal, basándose en observaciones sociológicas y sociojurídicas relacionadas con las instituciones legales en el mundo moderno reciente, donde, por ejemplo, los objetivos orientados a la eficiencia se mezclan con objetivos
Guo, Hui-Ping; Li, Hui; Guo, Jing; Li, Yan-Wen
To evaluate the clinical effect of preventing gastroesophageal reflux (GER) and aspiration in neonates delivered by elective cesarean section with hand immediately after birth. On the basis of the principles for drowning resuscitation and evaluation of the principal factors causing GER and aspiration, the author adopted immediate manual management to promote emptying of gastroesophageal and airway contents in 496 newborns delivered by elective cesarean section. No GER and aspiration occurred in the babies receiving the management, and no complication was recorded. As an early preventive measure, manual management is effective in clearing gastroesophageal and airway contents against GER and aspiration, and Apgar scoring can be readily conducted.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Grant authority. 93.4 Section 93.4 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROVISIONS IMPLEMENTING THE VIOLENT CRIME CONTROL... violent offenders, and (2) The integrated administration of other sanctions and services, which shall...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Statutory authority. 93.2 Section 93.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROVISIONS IMPLEMENTING THE VIOLENT CRIME CONTROL... under the Violent Crime Control and Law Enforcement Act of 1994, Title V, Public Law 103-322, 108 Stat...
Seyedhejazi, M.; Madarek, E.
To compare the hemodynamic, nausea and vomiting with small dose bupivacaine-fentanyl spinal anesthetic versus a conventional dose of spinal bupivacaine in parturients undergoing cesarean section. Forty patients aged 17-35 years old which underwent cesarean section were randomized into two groups. Group-A received spinal anesthesia with 8 mg of bupivacaine and 10 microg fentanyl, group B received 12 mg bupivacaine. The mean dose of ephedrine needed was 4mg in group A and 11.75 mg in group B (P=0.006). The mean ratio of lowest systolic pressure to baseline systolic pressure was 0.75 for group A and 0.65 for group B (P=0.04). Nausea and vomiting was observed in 10% of group A versus 20% in group B. Small dose of bupivacaine and fentanyl provides good spinal anesthesia for cesarean section with less hypotension, nausea and vomiting. (author)
Thysen, Anna Hammerich; Larsen, Jeppe Madura; Rasmussen, Mette Annelie
Immune programming in early life may affect the risk of developing immune-related diseases later in life. Children born by cesarean section seem to be at higher risk of asthma, allergic rhinitis, and type-1 diabetes. We hypothesized that delivery by cesarean section may affect immune maturation i...
Chai, Ze-Ying; Hu, Hua-Min; Ren, Xiu-Ling; Zeng, Bao-Jin; Zheng, Ling-Zhi; Qi, Feng
This study aims to reduce cesarean section rate and increase rate of vaginal delivery. By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared. After patients with a valid medical reason for cesarean were excluded, the main causes of cesarean section were maternal request, labor pain, parturient women assessment, and labor observation. A series of measures was implemented, including an improved parturient women assessment system, strengthened pregnancy nutrition guidance, implementation of painless labor techniques, enhanced midwifery team building, and promotion of childbirth-assist skills. Ten months after introduction of the improvement measures, the cesarean section rate decreased from 41.83% to 32.00%, and the Six Sigma score (ie, Z value) increased from 1.706 to 1.967 (P < .001). LSS is an effective way to reduce the rate of cesarean section. © 2016 John Wiley & Sons, Ltd.
Following a failed induction of labor with a deteriorating maternal condition despite resuscitation, emergency cesarean delivery was offered with good maternal outcome. Cesarean delivery could avert further disease progression and possible maternal death in cases of severe preterm placental abruption where vaginal ...
Background: Several risk factors for placenta praevia exist, including previous cesarean section(C/S). This association has been investigated long time ago, however in this hospital there is no documented evidence. This study was done to assess the risk of placenta praevia based on number of previous cesarean sections.
Introduction: Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in ...
Full Text Available In the article the author depicts the process of creating the codification of judicial principles of professional conduct. Firstly, the author describes the beginnings of the “model of a good judge”, followed thereafter by discussion in judicial environment on the need of normative conceptualization of the principles of conduct, which would constitute a separate collection. The proposals of the ethical codifications are presented, together with the two concluding works: The Judicial Set of Principles of Conduct [Zbiór zasad postępowania sędziów] created by the Association of Judges “Iustitia” and The Set of Principles of Professional Conduct for Judges and Candidate Judges [Zbiór zasad etyki zawodowej sędziów i asesorów Sądowych] by the National Council of the Judiciary in Poland.
... 46 Shipping 1 2010-10-01 2010-10-01 false Judicial review. 1.01-30 Section 1.01-30 Shipping COAST... Judicial review. (a) Nothing in this chapter shall be construed to prohibit any party from seeking judicial review of any Commandant's decision or action taken pursuant to the regulations in this part or part 5 of...
... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Stays pending judicial review. 1780.57 Section... Posthearing Proceedings § 1780.57 Stays pending judicial review. The commencement of proceedings for judicial... Director pending a final decision on a petition for review of that order. ...
... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Stays pending judicial review. 509.41 Section... pending judicial review. The commencement of proceedings for judicial review of a final decision and order... finds just, stay the effectiveness of all or any part of its order pending a final decision on a...
M.A. Loth (Marc); E. Mak (Elaine)
textabstractWhere will the Dutch judicial system be in 2015? One of us answered a similar type of question elsewhere with a sketch of two frightening scenarios.* In the first scenario the judicial system will have insufficiently adapted itself to its surroundings. The judicial system will become
Burgos, Jorge; Iglesias, María; Pijoan, José I; Rodriguez, Leire; Fernández-Llebrez, Luis; Martínez-Astorquiza, Txantón
To identify factors associated with cesarean delivery following successful external cephalic version (ECV). In a prospective study, data were obtained for ECV procedures performed at Cruces University Hospital, Spain, between March 2002 and June 2012. Women with a singleton pregnancy who had a successful, uncomplicated ECV and whose delivery was assisted at the study hospital, with the fetus in cephalic presentation, were included. A multivariate model of risk factors of cesarean delivery was developed. Among 627 women included, 92 (14.7%) delivered by cesarean. A cesarean was performed among 33 (8.5%) of 387 women with spontaneous labor versus 59 (24.6%) of 240 who were induced (P < 0.001). Multivariate analysis showed that higher BMI (P = 0.006), labor induction (P = 0.001), and prior cesarean (P < 0.001) were associated with cesarean. Time between ECV and delivery was inversely associated with probability of cesarean during the first 2 weeks. Thus, the probabilities of cesarean delivery on the first day were 0.53 (95% CI 0.35-0.71) and 0.34 (95% CI 0.18-0.51) following induced and spontaneous labor, respectively. On the seventh day, the probabilities were 0.23 (95% CI 0.15-0.32) and 0.12 (95% CI 0.07-0.18), respectively. Following ECV, induction of labor, an interval of less than 2 weeks to delivery, BMI, and previous cesarean were associated with an increased risk of cesarean. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available The separation of judicial functions falls, indisputably, in the news gallery of the Romanian criminal trial current rules. The previous Criminal Procedure Code, namely that of 1968, as well as the older ones, hadn‟t enrolled in their content such a principle. However, the doctrine identified, under mentioned legal regulations, the existence of distinct procedural functions and their need to separate, in the idea of genuine criminal justice accomplishment. These procedural functions were: the indictment function (or charges, the defense function the trial function. In the new code, this principle proclaims the existence of four judicial functions that aim the efficiency and speed of the criminal trial, but also guarantee the presumption of innocence, equal opportunity of parties, protection of rights and fundamental freedoms. This research try to explain this principle and its connections with other institutions of the criminal trial.
Full Text Available In 2014 we celebrate the 150th anniversary of the Judicial Reform in Russia. The 1860s are known as a time of major reforms in various spheres of life, one of them being the Judicial Reform adopted in 1864. Before 1864 civil procedure was considered to be the classical form of inquisitorial justice1 with active judges and passive parties. Inquisitorial procedure was a written process conducted in secret with no legal representatives in court, and with formal evaluation of evidence (otsenka dokazatel’stv. Instead of an inquisitorial procedure the Judicial Reform introduced an adversarial system with active parties and more or less passive judges, an open, oral (public process, legal representatives, and free evaluation of evidence. So, for Russian procedure it was a revolution as it happened in other countries of Europe, which turned away from an inquisitorial to an adversarial system of justice.
Full Text Available This paper discusses the forms and effects of the ‘invasion’ of the ‘temples of the law’ by new economic and managerial forms of performance evaluation. While traditional judicial evaluation focused on how to select and promote individual judges and on the legal quality of the single case, new quantitative methods and formulas are being introduced to assess efficiency, productivity and timeliness of judges and courts. Building on two case studies, from Spain and the Netherlands, the paper illustrates two contrasting approaches to judicial performance evaluation. On the one hand individual judges' productivity is evaluated through quantitative data and mathematical algorithms: in the extreme case considered here, judge's remuneration was adjusted accordingly. On the other hand quantitative and qualitative data, collected by a variety of methods and theoretical frameworks, are used as the basis of a multi-layered negotiation process designed to find a synthesis between competing economic, legal and social values aimed at improving overall organizational performance. Considering the flaws of unidimensional measurement and evaluation systems and considering the incommensurability of the results of the multiple evaluative frameworks (economic, legal, sociological required to overcome such flaws, the authors argue there is a need for political dialogue between relevant players in order to allocate the values appropriate to judicial evaluation. Este artículo analiza las formas y efectos de la “invasión” de los “templos de la ley” por nuevas formas económicas y de gestión como la evaluación del rendimiento. Mientras que la evaluación judicial tradicional se ha centrado en la forma de seleccionar y promocionar a jueces individuales, y en la calidad jurídica de un caso individual, hoy en día se están introduciendo nuevos métodos cuantitativos y fórmulas para determinar la eficiencia, productividad y oportunidad de jueces y
Shariska S. Petersen
Full Text Available We describe a patient with Class C diabetes who presented for nonstress testing at 36 weeks and 4 days of gestation with nonreassuring fetal heart tones (NRFHT and oligohydramnios. Upon delivery, thrombosis of the umbilical cord was grossly noted. Pathological analysis of the placenta revealed chorangiosis, vascular congestion, and 40% occlusion of the umbilical vein. Chorangiosis is a vascular change of the placenta that involves the terminal chorionic villi. It has been proposed to result from longstanding, low-grade hypoxia in the placental tissue and has been associated with such conditions such as diabetes, intrauterine growth restriction (IUGR, and hypertensive conditions in pregnancy. To characterize chorangiosis and its associated obstetric outcomes we identified 61 cases of “chorangiosis” on placental pathology at Henry Ford Hospital from 2010 to 2015. Five of these cases were omitted due to lack of complete records. Among the 56 cases, the cesarean section rate was 51%, indicated in most cases for nonreassuring fetal status. Thus, we suggest that chorangiosis, a marker of chronic hypoxia, is associated with increased rates of cesarean sections for nonreassuring fetal status because of long standing hypoxia coupled with the stress of labor.
Zhang Guofu; Wang Tianping; Gu Shouxin; Han Zhigang; Zhang Di; Tian Xiaomei; Wang Xuezhen; Yu Fei; Huang Zirong
Objective: To discuss the feasibility and safety of uterine artery chemoembolization in treating cesarean section scar pregnancy. Methods: During the period of Jun. 2005-Jun. 2010, uterine artery chemoembolization was performed in 130 patients with cesarean section scar pregnancy in authors' hospital. Via bilateral uterine arteries 100-150 mg MTX and 80 000 u Gentamycin were infused separately, which was followed by the embolization of bilateral uterine arteries with Gelfoam. Of the total 130 patients,coexisted leiomyoma was found in 23 and embolization therapy with PVA microspheres was employed. Curettage of uterus was carried out within 24-72 hours after the procedure. Results: The success rate of bilateral uterine artery chemoembolization was 100%. The blood loss during curettage procedure was 12-110 ml (mean 28.5 ml). No serious complications occurred. Conclusion: The uterine artery chemoembolization is an effective and safe treatment for cesarean section scar pregnancy. This technique can greatly avoid unnecessary uterectomy and, thus, preserve the fertility of the female patients. (authors)
Анна Дмитриевна Попова
Full Text Available The article deals with the importance of the judicial reform of 1864 for the course of Alexander's modernization and analyzes the role of the judicial reforms for various aspects of life in the post-reform Russia. There is used a wide range of sources - archival materials, memoirs of contemporaries of that period, publications of periodicals. The author concludes that the judicial reform of 1864 should be considered as a significant step towards civil society. The analysis of the sources shows that the judicial reform of 1864 contributed to the increase in the protection of human rights and freedoms. The activities of new courts changed the public consciousness - in the society there was growing representation of rule of law, necessity to respect the rights and freedoms of others, to meet obligations. The judicial reform played a major role in the process of merging classes, the development of market relations. Thus, the introduction of the controversial independent public trial not only improved the justice, but was also an important step in the formation of civil society in Russia.
Superfine, Benjamin Michael
Judicial decisions focusing on equal educational opportunity involve significant issues of educational governance and often involve explicit questions about the extent to which authority to make educational decisions should be centralized or decentralized across various institutions and entities. This review aims at clarifying scholars'…
I. Bambust (Isabelle); A. Kruger (Albert); T. Kruger (Thalia)
markdownabstract__Abstract__ The purpose of this contribution is to provide a very modest comparison of judicial language protection in South Africa and in Belgium. First of all, the authors sketch briefly the historical context and the constitutional status of languages in both countries. It is
Senturk, Mehmet Baki; Polat, Mesut; Doğan, Ozan; Pulatoğlu, Çiğdem; Yardımcı, Oğuz Devrim; Karakuş, Resul; Tayyar, Ahter Tanay
Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p 0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p 0.05). This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.
Milcent, Carine; Zbiri, Saad
Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008-2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.
Bertholdt, Charline; Menard, Sophie; Delorme, Pierre; Lamau, Marie-Charlotte; Goffinet, François; Le Ray, Camille
At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries in two gestational age groups: 24-25 weeks and 26-27 weeks. This single-center retrospective cohort study included all women with cesarean deliveries performed before 28 +0 weeks from 2007 through 2015. It compared the frequency of intraoperative adverse events between two groups: those at 24-25 weeks of gestation and at 26-27 weeks. Intraoperative adverse events were a classical incision, transplacental incision, difficulty in fetal extraction (explicitly mentioned in the surgical report), postpartum hemorrhage (≥500 mL of blood loss), and injury to internal organs. A composite outcome including at least one of these events enabled us to analyze the risk factors for intraoperative adverse events with univariate and multivariable analysis. Stratified analyses by the indication for the cesarean were performed. We compared 74 cesarean deliveries at 24-25 weeks of gestation and 214 at 26-27 weeks. Intraoperative adverse events occurred at higher rates in the 24-25-week group (63.5 vs. 30.8%, p cesarean. These results should help obstetricians and women making decisions about cesarean deliveries at these extremely low gestational ages. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.
Alcocer Urueta, Jaime; Bonilla Mares, Marcela; Gorbea Chávez, Viridiana; Velázquez Valassi, Beatriz
To identify risk factors for bladder injury during cesarean delivery, to let patients and doctors know them and their importance. We conducted a case-control study of women undergoing cesarean delivery at the Instituto Nacional de PerinatologíaIsidro Espinosa de los Reyes between January 2001 and December 2007. Cases were women with bladder injuries at the time of cesarean section. Two controls per case were selected randomly. Medical records were reviewed for clinical and demographic data to compare them. Twenty-one bladder injuries were identified among 24, 057 cesarean sections, (incidence 0.087%), only 19 were analized. Prior cesarean section was more prevalent among cases than controls (63% vs 42% p 0.134), with an OR of 2.35 (95% CI 0.759-7.319), when we take only patients with one cesarea in contrast with no cesarea the OR is 3.75 (95% CI 1.002- 14.07). Statistically significant differences (P values < .05) between cases and controls were found in gestacional age (38.16 vs 37.35 weeks), prior cesareans (42% vs 18%), adhesions (79% vs 5%), Odds ratio of 67.5 (95% CI 11.14- 408), VBAC (31.5 vs 3%), median skin incisión (16% vs 68%), Pfannenstiel (84% vs 32%), blood loss (744cc vs 509cc) and length of surgery 135 vs 58 minutes). No differences were found among age, BMI, prior surgery, labor, premature rupture of membranes, station, chorioamnioitis, induction, uterine incision, timing of delivery, uterine rupture. Prior cesarean section and adhesions are risk factors for bladder injury at the time of repeat cesarean delivery. Elective cesarean delivery is valid but it is duty of physicians to inform patients the risks of it.
McCoy, Jennifer; Downes, Katheryne L; Srinivas, Sindhu K; Levine, Lisa D
To determine the risk of cesarean delivery associated with postdates induction (≥41 weeks) compared to term induction (37-40w6d) among women with an unfavorable cervix, and to examine the risk factors associated with cesarean among women undergoing postdates induction. A planned secondary analysis of a large prospective cohort study on induction (n = 854) was performed. Women with a singleton gestation, intact membranes, and an unfavorable cervix (Bishop score of ≤6 and dilation ≤2 cm) who were undergoing a term (≥37 weeks) induction for any indication were included. Women with a prior cesarean were excluded. The primary outcome was cesarean delivery. Relative risk of cesarean was estimated using a modified Poisson's regression model. There was a significantly increased risk of cesarean for women undergoing postdates induction (n = 154) compared to women 37-40w6d (n = 700), (46.8 versus 26.0%, p cesarean remained after adjustment for race, parity, and pregnancy-related hypertension (aRR 1.70 [1.39-2.09], p cesarean among women ≥41 weeks included nulliparity (aRR 3.38 95%CI (2.42-4.74)), BMI ≥30 (aRR 1.72 95%CI (1.34-2.21)), and starting cervical dilation cesarean compared to women 37-40w6d, with nulliparity, obesity, and cervical dilation <1 cm being independent risk factors. These data can be used to augment patient counseling and support the ongoing discussion regarding the risk of post dates induction.
Full Text Available This article examines the issue of the regulation of the Russian state’s control over the activities of non-governmental organizations and the limits to that control. Important changes made in 2014–2016 in the regulation of the organization and activity of judicial power show that the tasks of transformation of the judicial power structure, establishment of effective control mechanisms and strengthening of the requirements on substantiation of court judgments have become more topical. Addressing this issue and taking it as the subject of study are motivated by the small number of works dealing with this issue. The task of enhancing the effectiveness of the exercise of their powers by public authorities necessitates consideration of special features of judicial control over disputes related to restriction of rights. The adoption of the Administrative Procedure Code of the Russian Federation and the statutory formalization of special features of judicial control with respect to certain non-commercial organizations imply changes in judicial practice related to challenging the decisions made by public authorities. In addition to special procedural features such changes also facilitate the spread in law enforcement practice of legal arrangements like the ‘proportionality test’ and determining the balance between competing constitutional values and conditions of public order observance. The analysis carried out by the author reveals tendencies of improvement in legislative action and allows identification of future lines of improvement in judicial practice.
Full Text Available Elek and Rottman argue that judicial evaluation is often biased against women and minority judges. The need to address bias is important, however often the desire for diversity seems so self-evident as to belie deeper analysis. This paper examines the two main rationales for gender equality on the bench. First, female judges are often considered necessary in order to bring a gendered perspective to judging, however it is argued that this rationale is flawed. Second, an alternative rationale based on equality and legitimacy is offered which avoids gender essentialism. While debates typically focus on these two rationales, a third rationale embraces both difference and equality/legitimacy. The presence of female judges has an important symbolic value which destabilises existing fraternal legal norms. Finally, increasing the number of female judges may not necessarily change judging, and this paper also analyses how the transformative potential offered by judicial diversity can work in practice. Elek y Rottman defienden que la evaluación judicial suele estar sesgada en contra de las mujeres y los jueces pertenecientes a minorías. La necesidad de abordar el sesgo es importante, sin embargo a menudo el deseo de diversidad parece tan evidente como para contradecir un análisis más profundo. Este artículo examina los dos motivos principales para la igualdad de género en el banquillo. En primer lugar, las mujeres jueces a menudo se consideran necesarias para aportar una perspectiva de género al hecho de juzgar, sin embargo, se defiende que este razonamiento es erróneo. En segundo lugar, se ofrece una alternativa lógica basada en la igualdad y la legitimidad que evita el esencialismo de género. Mientras que los debates suelen centrarse en estas dos razones, una tercera justificación abarca tanto la diferencia como la igualdad/legitimidad. La presencia de mujeres en la judicatura tiene un importante valor simbólico que desestabiliza las normas
Meo, S. A.; Siddique, S.; Meo, R. A.
Objective: To compare the patients satisfaction with spinal and general anesthesia after cesarean section at CMH Lahore. Study Design: Randomized controlled trials. Study Setting: The study was conducted at the department of Obstetrics and Gynaecology combined military Hospital, Lahore, for 6 months from July to Dec 2011. Patients and Methods: Total 70 patients were included in the study and randomly divided into two groups of 35 each using random numbers table. All patients between ages of 20-40 years admitted for elective cesarean section and presented for following up at day 5-7 who never had any type of anesthesia in the past. There included in the study patients with complaints of migraine, low backaches, positive history or any other medical disorder were excluded from the study. Results: A total number of patients included were 70. Out of these selected patients, 35 procedures were carried out under spinal anesthesia and 35 under general anesthesia. Insignificant difference was found in satisfaction level of both the groups (p=0.220). There is significant difference for the future choice between two groups (p<0.001). Conclusion: Spinal anesthesia provides equal satisfaction for patients of cesarean section than general anesthesia. (author)
Full Text Available This article addresses the building of a European Judicial Training Framework (EJT, notably the establishment, organization and functioning of the European Judicial Training Network (EJTN. After describing the EJTN and retracing its distinctive features – co-operation, decentralization, complementarity, targeting –, the article underlines its peculiar function within EJT, which reflects the role of EJT itself in the strategy for Europeanization of national judges. It then concludes by pointing out and situating other strategic areas where important synergies with EJT for the purpose of judicial Europeanization can be strengthened, notably enhancement of transnational judicial networks and introduction of knowledge management tools in national systems. The article is based on the analysis of documents and scientific literature as well as on empirical research and semi-structured interviews conducted by the author in 2013 and 2014.
previous cesarean section scar and other non medical indications like .... from the delivery record of the year 2011 (from January ... Confidentiality and privacy of all data were highly ..... monitoring, and lack of facility for electronic fetal heart.
This article revealed two valuable case reports about two young females suffered tuberculous meningitis after cesarean section. After antituberculous therapy, the condition of one patient improved and the other one became deteriorated.
Magnitude and factors associated with post-cesarean surgical site infection at Hawassa University Teaching and referral hospital, southern Ethiopia: a ... the hospital. Thus, it should be averted by implementing infection prevention techniques.
Handan, Eren; Sahiner, Nejla Canbulat; Bal, Meltem Demirgoz; Dissiz, Melike
This experimental study was conducted to determine the level of anxiety in women undergoing multiple cesarean section. Sixty multiple cesarean section referrals were randomly assigned to either the experimental or control groups. Data was collected at the Karaman Public Health Hospital in Turkey, from June 2015 to June 2016. Songs chosen earlier by the patients were played during the cesarean section procedure for the experimental group. The control group was studied without music. Data was collected using a questionnaire form, and Visual Analogue Scale (VAS) was used to determine the anxiety levels. The t-test and chi-square test were used to analyse statistically significant differences between the groups. The VAS scores before and during the procedure showed significantly lower scores for the experimental group, compared to the control group (p<0.05). Music therapy reduces the physiological and cognitive responses of anxiety in patients undergoing multiple cesarean section, and can be used in the clinical practice.
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Delegation of authority. 51.3 Section 51.3 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965, AS AMENDED General Provisions § 51.3 Delegation of authority...
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Law enforcement authority. 0.29j Section 0.29j Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE 4-Office of the Inspector General § 0.29j Law enforcement authority. Subject to guidelines promulgated by the Attorney General, Special Agents of the Offic...
Beresford, H Richard
Ethically salient issues in neurologic care may have important legal overtones. This chapter considers some of these, emphasizing how law may influence the outcome of controversies over how best to promote autonomy, beneficence, and justice in the care of individuals with neurologic disorders. Constitutional, statutory, and judicial dimensions are addressed. With respect to autonomy, discussion emphasizes legal dimensions of the doctrine of informed consent and the obligations of medical professionals to protect the privacy and confidentiality of their patients. The discussion of beneficence focuses on issues relating to actual or potential conflicts of interest in the care of patients and on the conduct of research involving human subjects. The section on justice considers how law aims to define protectable rights and interests of individuals and to provide a fair and efficient process for resolving disputes. Applications of legal principles and doctrines are illustrated primarily through the examples afforded by judicial decisions. These cases demonstrate how law both promotes ethical decision-making and protects the rights and interests of those affected. The cases also highlight some of the ethical quandaries that evoke resort to litigation and the limits of law in advancing ethically appropriate outcomes. © 2013 Elsevier B.V. All rights reserved.
-sections, 402 (59%) were done on laboring mothers and 198 (41%) were done on non-laboring mothers for indications like placenta previa, eclampsia, etc. Out of 402 C-sections done on laboring mothers, 241 (60%) were done in advanced labor and 161 (40%) in early labpr. The intra-operative complication rate was 19.8% versus 11% (p-value 0.001) in the study and control group respectively. The main indications for cesarean section in labor were prolonged labor, deep transverse arrest of fetal head and fetal distress. The main complications noticed were the cervico - uterine lacerations and intra-operative hemorrhage. Factors associated with increased maternal complications were; un-booked cases (p-value 0.01), stat-ion of the fetal head (p-value 0.02), good size baby (p-value 0.01) and experience of surgeon (p-value 0.04). Conclusion: Emergency cesarean section done in advanced labor is a high risk operation with significant maternal morbidity in terms of cervico - uterine tears and intra-operative bleeding. (author)
Levinzon, A S; Taran, O I; Pura, K R; Mishchenko, G S; Mamaeva, N V
The paper analyzes some experience gained in using various modes of regional anesthesia as an anesthetic appliance at cesarean sections and comparatively characterizes various types of central segmental blocks. The results of 213 cases of cesarean section performed under spinal or combined spinal and epidural anesthesia (CSEA) were generalized by the following parameters: block onset, maternal and fetal action, the quality of anesthesia and postoperative analgesia, which leads to the conclusion that CSEA is the method of choice.
Doctorvaladan, Sahar V.; Jelks, Andrea T.; Hsieh, Eric W.; Thurer, Robert L.; Zakowski, Mark I.; Lagrew, David C.
Objective?This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design?In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood...
Yisma, Engida; Smithers, Lisa G; Lynch, John W; Mol, Ben W
The objective of this study was to assess the prevalence and sociodemographic characteristics of cesarean section in Ethiopia. We used data collected for Ethiopia Demographic and Health Surveys (DHS) conducted in 2000, 2005, 2011, and 2016. A two-stage, stratified, clustered random sampling design was used to gather information from women who gave birth within the 5-year period before each of the surveys. We analyzed the data to identify sociodemographic characteristics associated with cesarean section using log-Poisson regression models. The national cesarean section rate increased from 0.7% in 2000 to 1.9% in 2016, with increases across seven of the eleven administrative regions of Ethiopia. Addis Ababa had the highest cesarean section rate (21.4%) in 2016 and the greatest increase since 2000. In the adjusted analysis, women who gave birth in private health facility had a 78.0% higher risk of cesarean section (adjusted prevalence ratio (aPR) (95% CI) 1.78 (1.22, 2.58)) compared with women who gave birth in public health facility. Having four or more births was associated with a lower risk of cesarean section compared with first births (aPR (95% CI) 0.36 (0.16, 0.79)). The Ethiopian national cesarean section rate is about 2%, but the rate varies widely among administrative regions, suggesting unequal access. Cesarean sections were highest among urban mothers, first births, births to women with higher education, and births to women from the richest quintile of household wealth.
Lyerly, Anne Drapkin; Little, Margaret Olivia
Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a taxonomy of considerations that should inform a responsible framework for guideline development and highlight critical distinctions between types of guidelines that have been blurred in the past. We then forward 2 central claims. First, in otherwise uncomplicated birth after a single previous cesarean, both vaginal birth after cesarean and repeat cesarean should be regarded as reasonable options; women, rather than policymakers, providers, insurance carriers, or hospitals, should determine delivery approach. Second, in complicated cases, providers and policymakers should carefully calibrate the strength of evidence to ensure differential risk and cost are adequate to justify directive guidelines given important variations in values women bring to childbirth. Copyright © 2010 Elsevier Inc. All rights reserved.
Djurić, Janko; Arsenijević, Slobodan; Banković, Dragic; Protrka, Zoran; Sorak, Marija; Dimitrijević, Aleksandra; Tanasković, Irena
One of the most frequent indications for cesarean section is dystocia. It is impossible to predict, difficult to identify and coincident with the rapid expiry of the expected time, so it is important to point out some mistakes in expecting vaginal delivery. The aim of this study was to examine the frequency and the length of dystocia-related cesarean delivery, as well as the vitality of the newborn immediately after birth. A prospective 3-year study was conducted including a total number of 6470 deliveries regardless of whether they were completed using cesarean section after an unsuccessful attempt of spontaneous vaginal delivery or not. The Apgar score, a proved useful tool for the assessment of the vitality of newborn children in the first minute, was used. On the basis of the established indications, 653 (10.10%) of deliveries were completed using cesarean section. Dystocia was the third most common indication for cesarean section (16.38%). Deliveries in which dystocia was established as a diagnosis lasted much longer (p = 0.030) which resulted in weaker vitality of newborn children (p = 0.000) compared to the deliveries ended by spontaneous vaginal delivery. This study shows that deliveries caused by dystocia last much longer and newborn children are of weaker vitality compared to other deliveries caused not by dystocia. Decisions concerning cesarean section must be made in a timely fashion.
Women's pursuit of medical interventions in childbirth has been a challenging issue in feminist and medical anthropological research on the medicalization of reproduction. This article addresses the gender politics surrounding maternal requests for cesarean sections in Taiwan. Since the 1990s, Taiwanese cesarean rates have been reported as among the highest in the world. That is not the case now, yet they are still perceived as such, and the current rate of 37% is indeed high by any standards. The government and public discourses attribute the high cesarean rate to women's demand for this intervention. However, my ethnographic research indicates that the Taiwanese hospital birthing system leads to the prevalence of cesareans, and that women's requests for them constitute strategic responses to the system and its existing high cesarean rates. Using women's attempt to avoid "suffering twice" as an example, I argue that maternal requests for cesareans often lie at the intersection between their restricted control over childbirth and their agency within the medical system. © 2014 by the American Anthropological Association.
Pomorski, Michal; Fuchs, Tomasz; Rosner-Tenerowicz, Anna; Zimmer, Mariusz
The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017. © 2017 Wiley Periodicals, Inc.
Full Text Available Principle of legality and legal certainty, as key notions even of the thinnest concept of rule of law, are largely endangered in our times by widening of judicial discretion range. That trend is more and more at hand in European states as well, due to convergence of common law and civil law legal systems. Judicial decision acquires higher and higher factual importance in European legal systems, although it is generally not considered as a source of law. After analysis of standings by leading scholars of legal realism theory, the author admits that a very high level of tension frequently exists between judicial decision and legal norm. Within that conflict often and relatively easy decision succeeds to tear off by the strict letter of the law. In application of general legal rules upon concrete case, by creative adjustment of the law to life, due to necessary general and abstract character of legal norms, judge becomes more creator of law, rather than the one who applies it. The author points to danger of subjective and prejudiced attitudes of the judges, as they, due to their wide discretion, make a decision more upon their own feeling of justice, rather than upon law itself. In that way the law transforms itself in judicial decision based upon subjective understanding of justice and fairness.
Full Text Available Aiming at the four outstanding problems of informationized supervision for judicial publicity, the judicial public data is classified based on data driven to form the finally valuable data. Then, the functional structure, technical structure and business structure of the data processing system are put forward, including data collection module, data reduction module, data analysis module, data application module and data security module, etc. The development of the data processing system based on these structures can effectively reduce work intensity of judicial open iformation management, summarize the work state, find the problems, and promote the level of judicial publicity.
Benzouina, Soukayna; Boubkraoui, Mohamed El-mahdi; Mrabet, Mustapha; Chahid, Naima; Kharbach, Aicha; El-hassani, Amine; Barkat, Amina
Introduction Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in elective versus emergency cesarean section performed in a tertiary maternity hospital. Methods This comparative cross-sectional prospective study of all the cases undergoing elective and emergency cesarean section for any indication at Souissi maternity hospital of Rabat, Morocco, was carried from January 1, to February 28, 2014. Data were analyzed with emphasis on fetal outcome and cesarean sections indications. Mothers who had definite antenatal complications that would adversely affect fetal outcome were excluded from the study. Results There was 588 (17.83%) cesarean sections among 3297 births of which emergency cesarean section accounted for 446 (75.85%) and elective cesarean section for 142 cases (24.15%). Of the various factors analyzed in relation to the two types of cesarean sections, statistically significant associations were found between emergency cesarean section and younger mothers (P cesarean section performed under general anesthesia (P cesarean section was fetal distress (30.49%), while the most frequent indication in elective cesarean section was previous cesarean delivery (47.18%). Conclusion The overall fetal complications rate was higher in emergency cesarean section than in elective cesarean section. Early recognition and referral of mothers who are likely to undergo cesarean section may reduce the incidence of emergency cesarean sections and thus decrease fetal complications. PMID:27347286
Kawakita, Tetsuya; Reddy, Uma M.; Landy, Helain J.; Iqbal, Sara N.; Huang, Chun-Chih; Grantz, Katherine L.
Background Obesity is a known risk factor for cesarean delivery. Limited data are available regarding the reasons for the increased rate of primary cesarean in obese women. It is important to identify the factors leading to an increased risk of cesarean to identify opportunities to reduce the primary cesarean rate. Objective We evaluated indications for primary cesarean across body mass index kg/m2 classes to identify the factors contributing to the increase rate of cesarean among obese women. Study design In the Consortium of Safe Labor study between 2002 and 2008, we calculated indications for primary cesarean including failure to progress or cephalopelvic disproportion, non-reassuring fetal heart tracing, malpresentation, elective, hypertensive disease, multiple gestation, placenta previa or vasa previa, failed induction, human immunodeficiency virus or active herpes simplex virus, history of uterine scar, fetal indication, placental abruption, chorioamnionitis, macrosomia, and failed operative delivery. For women with primary cesarean for failure to progress or cephalopelvic disproportion, dilation at the last recorded cervical examination was evaluated. Women were categorized according to body mass index on admission: normal weight (18.5-24.9), overweight (25.0-29.9), obese class I (30.0-34.9), II (35.0-39.9), and III (≥40). Cochran-Armitage Trend Test and Chi-square tests were performed. Results Of 66,502 nulliparous and 76,961 multiparous women in the study population, 19,431 nulliparous (29.2%) and 7,329 multiparous women (9.5%) underwent primary cesarean. Regardless of parity, malpresentation, failure to progress or cephalopelvic disproportion, and non-reassuring fetal heart tracing were the common indications for primary cesarean. Regardless of parity, the rates of primary cesarean for failure to progress or cephalopelvic disproportion increased with increasing body mass index (normal weight, class I, II and III obesity in nulliparous: 33.2%, 41.6%, 46
... cesarienne : etude de 97 cas colliges de Janvier 2008 a Decembre 2012 au chu Kara. Epidemiological, clinical and pronostical characteristics of stillbirth by cesarean se. Abstract · Vol 14, No 2 (2012): Series D - Articles Aspects epidemiologiques, cliniques et pronostiques de l'accouchement des adolescentes a Lome en ...
Marina G. Sedelnikova
Full Text Available The subject. The article is devoted to analysis of pension disputes resolution in courts.The purpose of the article is to reveal trends of pension disputes resolution and identify the ways of increasing the efficiency of judicial protection of citizens’ pension rights.The methodology. Both general scientific methods (analysis, synthesis, description and special scientific methods (formal-legal methods method of legal interpretation were used.Results, scope of application. Pension legislation still does not contain a legal definition of the term “pension dispute” despite currently the prevalence of this category of cases; the legal science still has not developed a uniform approach to definition of the essence of the pension dispute.Special attention is paid to the issues of definition of the facts in proof, that is complicated because of instability of the pension legislation and a large amount of normative array. Special rules relating to the admissibility of evidence are divided from legally significant circumstances. The attention is focused on the most problematic points that arise in the process of proving: the procedure for confirmation of experience, employment in certain types of work quotas.Recommendations aimed at improving the effectiveness of judicial protection of the pension rights of citizens are formulated on the basis on the analysis of the identified problems that arise during consideration of pension disputes by law enforcement authorities. Recommendations include the need to improve the quality of normative legal acts, systematization of the pension legislation, increasing demands for training of judges, the creation of conditions conducive to the judges’ specialization. The necessity of increase activities of the Supreme Court in the process of issuing clarifications on issues arising in the application of the pension legislation is also considered.Conclusions. The existence of a number of features of the substantive
Lieberman, E; Lang, J M; Heffner, L J; Cohen, A
Implicit in comparisons of unadjusted cesarean rates for hospitals and providers is the assumption that differences result from management practices rather than differences in case mix. This study proposes a method for comparison of cesarean rates that takes the effect of case mix into account. All women delivered of infants at our institution from December 1, 1994, through July 31, 1995, were classified according to whether they received care from community-based practitioners (N=3913) or from the hospital-based practice that serves a higher-risk population (N=1556). Women were categorized according to both obstetric history (nulliparas, multiparas without a previous cesarean, multiparas with a previous cesarean) and the presence of obstetric conditions influencing the risk of cesarean delivery (multiple birth, breech presentation or transverse lie, preterm, no trial of labor for a medical indication). We determined the percent of women in each parity-obstetric condition subgroup and calculated a standardized cesarean rate for the hospital-based practice using the case mix of the community-based practitioners as the standard. The crude cesarean rate was higher for the hospital-based practice (24.4%) than for the community-based practitioners (21.5%), a rate difference of 2.9% (95% confidence interval=0.4%, 5.4%; P=.02). However, the proportion of women falling into categories conferring a high risk of cesarean delivery (multiple pregnancy, breech presentation or transverse lie, preterm, no trial of labor permitted) was twice as high for the hospital-based practice (24.4% hospital, 12.1% community). The standardization indicates that if the hospital-based practitioners had the same case mix as community-based practitioners, their overall cesarean rate would be 20.1%, similar to the 21.5% rate of community providers (rate difference=-1.4%, 95% confidence interval =-3.1%, 0.3%; P=.11). Standardization for case mix provides a mechanism for distinguishing differences
Rosenbloom, Joshua I; Stout, Molly J; Tuuli, Methodius G; Woolfolk, Candice L; López, Julia D; Macones, George A; Cahill, Alison G
In 2010 the Consortium on Safe Labor published labor curves. It was proposed that the rate of cesarean delivery could be lowered by avoiding the diagnosis of arrest of dilation before 6 cm. However, there is little information on the uptake of the guidelines and on changes in cesarean delivery rates that may have occurred. The objective of the study was to test the following hypotheses: (1) among patients laboring at term, rates of arrest of dilation disorders have decreased, leading to a decrease in the rate of cesarean delivery; (2) in the second stage, pushing duration prior to diagnosis of arrest of descent has increased, also leading to a reduction in the rate of cesarean delivery for this indication. As a secondary aim, we investigated changes in maternal and neonatal morbidity. This was a secondary analysis of a prospective cohort study of all patients presenting at ≥37 weeks' gestation from 2010 through 2014 with a nonanomalous vertex singleton and no prior history of cesarean delivery. Rates of cesarean delivery, arrest of dilation, and changes in rates of maternal and neonatal morbidity were calculated in crude and adjusted models. Cervical dilation at diagnosis of the arrest of dilation, time spent at the maximal dilation prior to diagnosis of arrest of dilation, and time in the second stage prior to the diagnosis of arrest of descent were compared over the study period. There were 7845 eligible patients. The cesarean delivery rate in 2010 was 15.8% and, in 2014, 17.7% (P trend = .51). In patients undergoing cesarean delivery for the arrest of dilation, the median cervical dilation at the time of cesarean delivery was at 5.5 cm in 2010 and 6.0 cm in 2014 (P trend = .94). In these patients, there was an increase in the time spent at last dilation: 3.8 hours in 2010 to 5.2 hours in 2014 (P trend = .02). There was no change in the frequency of patients diagnosed with the arrest of dilation at labor management that have occurred over the initial years
HULPUŞ IOANA ALEXANDRA
Full Text Available Efficiency of justice is closely linked to the time factor as a key resource to be severely, judiciously used, saved. Because of the importance of this issue - of the preserved values - providing justice, the righteousness and not least the citizen himself, protecting its rights and interests, values that exceed privat sector priorities-the profit, time problem in judiciary management is more valuable. Time is a component of efficiency, performance, timeliness of trials being enshrined as a guiding principle and one of the most important procedural safeguards of the litigant. The study emphasizes an important aspect in terms of time management, the perspective of judiciary leader, who has to abide the law and its limitations and always having to balance between requirements, resources and optimum workload. In this context he should identify methods and work techniques that resonates with the legal provisions to manage time more efficiently.
Liliane Gonçalves Matos
Full Text Available The aim of the study it was to analyze the possibility of the economic group file a single request for judicial reorganization. Concerning the methodology, the study is a descriptive - analytic research, analyzing the legal doctrines and jurisprudence about the subject. It has been shown that the reorganization of groups, instead of separated companies may result benefits, as a company of the group can help to recover the others that are facing difficulties, but there is the possibility to create a negative incentive for the development of global business activity. It was concluded that the active joinder in bankruptcy is feasible, but it would be more prudent for each group company present its own reorganization plan.
Full Text Available This article explores the emotions of users and functionaries involved in the justice system and the administration of justice in Cali, Colombia. The analysis presented argues that the state not only employs a bureaucratic rational language but also invokes emotions and feelings. In this sense, it is not only the central imaginaries of the state justice system and judicial processes but also the idea of justice itself that is marked by tediousness, delay and chaos, imaginaries of the system that were identified by the users and the officials involved in the administration of the system. There is no justice if it is not a process that is tedious, marked by ritual, mysticism, disorder and difficulties. These findings demonstrate that, against liberal discourses that emphasize the order, unity and rationality of public actions, that the power of the state actually operates through the disaggregated, the irrational and the emotional, a much wider and inexplicable framework.
Full Text Available This article analyzes the current state of the debate on the minimum level of creativity needed for works to be copyrightable, including dominant principles in Russian jurisprudence and judicial practice, principal trends and contradictions that arise in the course of the application of various criteria for copyrightability. An analysis of the judicial practice of recent years warrants the conclusion that standards of creativity as a criterion for copyrightability have dropped drastically. Today’s standards are similar to those of the former American ‘sweat of the brow’ doctrine. But, unlike foreign legal systems that set comparatively low standards of protectability, the Russian judiciary has not yet evolved mechanisms of compensation for risks of monopolization of public domain content. First of all, there is no practice of granting exclusive rights to a work that is similar to an earlier work but has been created independently. Secondly, the practice of refusing protection to non-unique, standard, generally known, and generally available content is dying out. Thirdly, there is currently a trend for giving a large scope of protection to works of low authorship. As a result, exclusive rights are granted to standard or generally accessible content – content that must belong to the public domain – which puts unjustified restrictions on the creative activities of other authors. Moreover, it makes their legal status unpredictable as it establishes a basis for unintended copyright violations being penalized. This amounts to a classical case of overprotection.
Grasch, Jennifer L; Thompson, Jennifer L; Newton, J Michael; Zhai, Amy W; Osmundson, Sarah S
To examine whether labor compared with planned cesarean delivery is associated with increased maternal and neonatal morbidity. We conducted a retrospective cohort study of all women with body mass indexes (BMIs) at delivery of 50 or greater delivering a live fetus at 34 weeks of gestation of greater between January 1, 2008, and December 31, 2015. Pregnancies with multiple gestations and major fetal anomalies were excluded. The primary outcome was a composite of maternal and neonatal morbidity and was estimated to be 50% in superobese women based on institutional data. A sample size of 338 women determined the study period and was selected to show a 30% difference in the incidence of the primary outcome between the two groups. Multivariate logistic regression adjusted for potential confounders. There were 344 women with BMIs of 50 or greater who met eligibility criteria, of whom 201 (58%) labored and 143 (42%) underwent planned cesarean delivery. Women who labored were younger, more likely to be nulliparous, and less likely to have pre-existing diabetes. Among women who labored, 45% underwent a cesarean delivery, most commonly for labor arrest (61%) or nonreassuring fetal status (28%). Composite maternal and neonatal morbidity was reduced among women who labored even after adjusting for age, parity, pre-existing diabetes, and prior cesarean delivery (adjusted odds ratio 0.42, 95% CI 0.24-0.75). In the subgroup of women (n=234) who underwent a cesarean delivery, whether planned (n=143) or after labor (n=91), there were no differences in maternal and neonatal morbidity except that severe maternal morbidity was increased in women (n=12) who labored (8.8% compared with 2.1%, relative risk 4.2, 95% CI 1.14-15.4). Despite high rates of cesarean delivery in women with superobesity, labor is associated with lower composite maternal and neonatal morbidity. Severe maternal morbidity may be higher in women who require a cesarean delivery after labor.
Kushnir, Jonathan; Friedman, Ahuva; Ehrenfeld, Mally; Kushnir, Talma
Listening to music has a stress-reducing effect in surgical procedures. The effects of listening to music immediately before a cesarean section have not been studied. The objective of this study was to assess the effects of listening to selected music while waiting for a cesarean section on emotional reactions, on cognitive appraisal of the threat of surgery, and on stress-related physiological reactions. A total of 60 healthy women waiting alone to undergo an elective cesarean section for medical reasons only were randomly assigned either to an experimental or a control group. An hour before surgery they reported mood, and threat perception. Vital signs were assessed by a nurse. The experimental group listened to preselected favorite music for 40 minutes, and the control group waited for the operation without music. At the end of this period, all participants responded to a questionnaire assessing mood and threat perception, and the nurse measured vital signs. Women who listened to music before a cesarean section had a significant increase in positive emotions and a significant decline in negative emotions and perceived threat of the situation when compared with women in the control group, who exhibited a decline in positive emotions, an increase in the perceived threat of the situation, and had no change in negative emotions. Women who listened to music also exhibited a significant reduction in systolic blood pressure compared with a significant increase in diastolic blood pressure and respiratory rate in the control group. Listening to favorite music immediately before a cesarean section may be a cost-effective, emotion-focused coping strategy. (BIRTH 39:2 June 2012). © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.
Burk, Roy N
From time to time, the Council on Ethics and Judicial Affairs must investigate and act on the alleged unethical behavior of Texas Dental Association members. Because the alleged behavior is directed at a colleague and TDA member, the work of the council is neither comfortable nor inviting. Nonetheless, council decisions are made taking into account its mission to investigate the allegation between the parties and to improve dental ethics in the state.
Hadi, Niaz; Hanid, Ali Akbar
Post cesarean (CS) pain is a challenging problem for the obstetricians, because it may interfere with mother and baby's well-being. Many approaches have been ever proposed to diminish this pain, each one with particular benefits and limitations. Aromatherapy is a complementary therapy especially for controlling pain. This study aimed at evaluating the effect of lavender essence on post CS pain. In a single-blind clinical trial, 200 term pregnant women with planned elective CS were recruited in a 12 month period of time. They were randomized in two 100-patient groups; received either lavender essence (the case group) or a similar clinically neutral aromatic material (the control group) thorough oxygen mask for 3 min 3 h after receiving similar intravenous analgesics. The Visual Analogue Scale (VAS) was employed to determine the level of post CS pain. The VAS was documented half hour after first intervention. Eight and 16 h later, the aromatherapy was repeated and half hour after each intervention, corresponding VAS was documented. The two groups were matched for demographics and obstetrical history. The baseline VAS was comparable between the two groups. The mean VAS decreased significantly by 16 h after the first intervention in both groups (p aromatherapy by using lavender essence is a successful and safe complementary therapy in reducing pain after CS.
Full Text Available To increase discriminatory accuracy (DA for emergency cesarean sections (ECSs.We prospectively collected data on and studied all 6,157 births occurring in 2014 at four public hospitals located in three different autonomous communities of Spain. To identify risk factors (RFs for ECS, we used likelihood ratios and logistic regression, fitted a classification tree (CTREE, and analyzed a random forest model (RFM. We used the areas under the receiver-operating-characteristic (ROC curves (AUCs to assess their DA.The magnitude of the LR+ for all putative individual RFs and ORs in the logistic regression models was low to moderate. Except for parity, all putative RFs were positively associated with ECS, including hospital fixed-effects and night-shift delivery. The DA of all logistic models ranged from 0.74 to 0.81. The most relevant RFs (pH, induction, and previous C-section in the CTREEs showed the highest ORs in the logistic models. The DA of the RFM and its most relevant interaction terms was even higher (AUC = 0.94; 95% CI: 0.93-0.95.Putative fetal, maternal, and contextual RFs alone fail to achieve reasonable DA for ECS. It is the combination of these RFs and the interactions between them at each hospital that make it possible to improve the DA for the type of delivery and tailor interventions through prediction to improve the appropriateness of ECS indications.
... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Judicial proceedings-sovereign immunity. 357.23 Section 357.23 Money and Finance: Treasury Regulations Relating to Money and Finance... Securities System (Legacy Treasury Direct) § 357.23 Judicial proceedings—sovereign immunity. (a) Department...
Fersini, E.; Sartori, F.
Purpose: The need of tools for content analysis, information extraction and retrieval of multimedia objects in their native form is strongly emphasized into the judicial domain: digital videos represent a fundamental informative source of events occurring during judicial proceedings that should be stored, organized and retrieved in short time and…
Maintaining that the judicial process is particularly effective as a form of program evaluation, this article details organizational procedures and lists the following advantages for use of the judicial process: issues are investigated in an open forum, the community can participate, and exciting opportunities for teaching and learning are…
Minnesota Univ., Minneapolis. Project Social Studies Curriculum Center.
This resource unit, developed by the University of Minnesota's Project Social Studies, introduces eighth graders to the judicial process. The unit was designed with two major purposes in mind. First, it helps pupils understand judicial decision-making, and second, it provides for the study of the rights guaranteed by the federal Constitution. Both…
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Diniz, Debora; Machado, Teresa Robichez de Carvalho; Penalva, Janaina
This paper seeks to analyze the Judiciary's approach with respect to demands for the judicialization of the right to health by means of a case study of civil lawsuits for access to health care in Brazil's Federal District. Judicialization of the right to health signifies the judicialization of various of the health services provided. This is a descriptive and exploratory case study that covers the Federal District and uses mixed techniques to gather and analyze data. This study analyzed 385 lawsuits (87% of the total number of cases of judicialization of health for the period from 2005 to 2010 that reached the Appellate court). The results indicate that the most judicialized service is access to intensive care unit, followed by drugs and health care. Almost all lawsuits are filed by public defenders, with medical prescriptions and recommendations from the public health service. The results of this study challenge some dominant themes in the national debate, particularly the claim that judicialization is a phenomenon of the elites and that the services judicialized are drugs. The study does not seek to make generalizations, but highlights the fact that the phenomenon of judicialization of health has different aspects encompassed under the same concept.
Full Text Available The proposed study is based on the jurisdictional action of the Courts when adopting positions that go against the current legislation and even the Constitutional text, making use of premises of the neoconstitutional doctrine, which deals with the concrete application of the Federal Constitution, in order to demonstrate the use of these parameters as basis or foundation for judicial decisions of activist nature, and specifically to point out the effects of the judgments of this nature. The insecurity caused by the res judicata that adopt the practices worked in this doctrine, denying what is in the Law and in the Constitution, justify the relevance of the research, which faces these problems in the light of Contemporary Juridical Hermeneutics. The research method was the bibliographic survey and the study of judicial decisions, with emphasis on TSE and STF. Thus, in general, the objective is to make it clear that in these cases there is a misconception of the Judiciary in the form of interpreting and deciding, and it specifically points out that the decisions of the Electoral Courts reach out as an instrument of judicial activism, which is strengthened by the Neoconstitutional doctrine.
Helder Ferreira do Vale
Full Text Available This article explains how judicial review influences intergovernmental political dynamics in Brazil, Colombia and Spain. The argument is developed in light of two questions: how supreme courts have established themselves as pivotal institutions for settling vertical intergovernmental disputes, and how national and subnational politicians use judicial review in order to enhance their own interests. A comparison between the judicial review processes in federal Brazil, quasi-federal Spain, and unitary Colombia provides an answer to these questions. Accounting for the differences in the territorial organization and systems of government among these countries, the article assesses the patterns of judicial review originating from the subnational level. Findings suggest that courts affect the interaction between national and subnational politicians in the three country-cases, but through different patterns of judicialization of territorial politics.
Smith, Gordon C S; Cordeaux, Yolande; White, Ian R; Pasupathy, Dharmintra; Missfelder-Lobos, Hannah; Pell, Jill P; Charnock-Jones, D Stephen; Fleming, Michael
The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1) to characterize the association between maternal age and the outcome of labor, (2) to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3) to determine whether the contractility of uterine smooth muscle (myometrium) varied with maternal age. We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51). Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51) and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50). Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous activity and
Gordon C S Smith
Full Text Available The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1 to characterize the association between maternal age and the outcome of labor, (2 to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3 to determine whether the contractility of uterine smooth muscle (myometrium varied with maternal age.We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51. Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51 and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50. Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous
Lipschuetz, Michal; Cohen, Sarah M; Israel, Ariel; Baron, Joel; Porat, Shay; Valsky, Dan V; Yagel, Oren; Amsalem, Hagai; Kabiri, Doron; Gilboa, Yinon; Sivan, Eyal; Unger, Ron; Schiff, Eyal; Hershkovitz, Reli; Yagel, Simcha
Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. In an earlier study, neonatal head circumference was shown to be more strongly associated with delivery mode and other outcome measures than neonatal birthweight. In the present study we aimed to evaluate the association of sonographically measured fetal head circumference measured within 1 week of delivery with delivery mode. This was a multicenter electronic medical record-based study of birth outcomes of primiparous women with term (37-42 weeks) singleton fetuses presenting for ultrasound with fetal biometry within 1 week of delivery. Fetal head circumference and estimated fetal weight were correlated with maternal background, obstetric, and neonatal outcome parameters. Elective cesarean deliveries were excluded. Multinomial regression analysis provided adjusted odds ratios for instrumental delivery and unplanned cesarean delivery when the fetal head circumference was ≥35 cm or estimated fetal weight ≥3900 g, while controlling for possible confounders. In all, 11,500 cases were collected; 906 elective cesarean deliveries were excluded. A fetal head circumference ≥35 cm increased the risk for unplanned cesarean delivery: 174 fetuses with fetal head circumference ≥35 cm (32%) were delivered by cesarean, vs 1712 (17%) when fetal head circumference cesarean delivery by an adjusted odds ratio of 1.75 (95% confidence interval, 1.4-2.18) controlling for gestational age, fetal gender, and epidural anesthesia. The rate of prolonged second stage of labor was significantly increased when either the fetal head circumference was ≥35 cm or the estimated fetal weight ≥3900 g, from 22.7% in the total
Rebecca White Berch
Full Text Available Judicial performance evaluations are a relatively new tool for assessing judges and providing information to voters to help them determine whether to retain judges in contested or retention elections. Arizona implemented its judicial evaluation program about 20 years ago, and since that time, the state has continually strived to improve its process. The result is that today Arizona has one of the most progressive and comprehensive judicial performance evaluation programs in the United States. This article takes a critical look at the strengths and weaknesses of Arizona’s program, keeping in mind two key values that the system seeks to protect: judicial accountability and judicial independence. Las evaluaciones del rendimiento judicial son una herramienta relativamente nueva para evaluar a los jueces y ofrecer información a los votantes, que les ayude a decidir si quieren reelegir a los jueces en las elecciones. Arizona implementó su programa de evaluación judicial hace unos 20 años, y desde ese momento, el Estado se ha esforzado continuamente en mejorar el proceso. El resultado es que hoy en día, Arizona tiene uno de los programas de evaluación del rendimiento judicial más progresistas e integrales de los Estados Unidos. Este artículo ofrece una mirada crítica a las fortalezas y debilidades del programa de Arizona, teniendo en cuenta dos valores clave que el sistema trata de proteger: la responsabilidad judicial y la independencia judicial. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2533868
Albright, Catherine M; Rouse, Dwight J
Cesarean delivery, the most common surgery performed in the United States, is complicated by adhesion formation in 24-73% of cases. Because adhesions have potential sequelae, different synthetic adhesion barriers are currently heavily marketed as a means of reducing adhesion formation resultant from cesarean delivery. However, their use for this purpose has been studied in only two small, nonblinded and nonrandomized trials, both of which were underpowered and subject to bias. Neither demonstrated improvement in meaningful clinical outcomes. In the only cost-effectiveness analysis of adhesion barriers to date, the use of synthetic adhesion barriers was cost-effective only when the subsequent rate of small bowel obstruction was at least 2.4%, a rate far higher than that associated with cesarean delivery. In fact, intra-abdominal adhesions from prior cesarean delivery rarely cause maternal harm and have not been demonstrated to adversely affect perinatal outcome. Based on our review of the available literature, we think the use of adhesion barriers at the time of cesarean delivery would be ill-advised at the present time.
Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation. Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.
Minsart, Anne-Frederique; N'guyen, Thai-Son; Dimtsu, Hirut; Ratsimanresy, Rachel; Dada, Fouad; Ali Hadji, Rachid
To calculate the prevalence of maternal obesity and to determine the relation between obesity and cesarean delivery in an urban hospital in Djibouti. In an observational cohort study, all women who had a live birth or stillbirth between October 2012 and November 2013 were considered for inclusion. Body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was calculated throughout pregnancy, and women with a BMI of at least 30.0 were deemed to be obese. Multivariate logistic regression analyses were used to evaluate the relation between cesarean and obesity. Overall, 100 (24.8%) of 404 women were obese before 14 weeks of pregnancy, as were 112 (25.2%) of 445 before 22 weeks, and 200 (43.2%) of 463 at delivery. Obesity before 22 weeks was associated with a 127% excess risk of cesarean delivery (adjusted odds ratio 2.27; 95% CI 1.07-4.82; P=0.032). Similar trends were found when the analyses were limited to the subgroup of women without a previous cesarean delivery or primiparae. Prevalence of maternal obesity is high in Djibouti City and is related to an excess risk of cesarean delivery, even after controlling for a range of medical and socioeconomic variables. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Nakano, Andreza Rodrigues; Bonan, Claudia; Teixeira, Luiz Antônio
This article discusses the development of techniques for cesarean sections by doctors in Brazil, during the 20th century, by analyzing the title "Operação Cesárea" (Cesarean Section), of three editions of the textbookObstetrícia, by Jorge de Rezende. His prominence as an author in obstetrics and his particular style of working, created the groundwork for the normalization of the practice of cesarean sections. The networks of meaning practiced within this scientific community included a "provision for feeling and for action" (Fleck) which established the C-section as a "normal" delivery: showing standards that exclude unpredictability, chaos, and dangers associated with the physiology of childbirth, meeting the demand for control, discipline and safety, qualities associated with practices, techniques and technologies of biomedicine.
CONCLUSIONS: The rates of cesarean deliveries are increasing day by day. The increased rates of prior cesarean deliveries is a critical factor for the risks of recurrent surgeries and cost-effectiveness. We concluded that to determine the real indications for primary cesarean deliveries and to be more selective and careful are assumed to decrease the cesarean delivery rates.
Hsiu-Ting Tsai; Chia-Hsun Wu
Objective: The trend of increasing cesarean section rates had evoked worldwide attention. Many approaches were introduced to diminish cesarean section rates. Vaginal birth after cesarean section (VBAC) is a route of delivery with diverse agreements. In this study, we try to reveal the world trend in VBAC and our experience of a 10-year period in a medical center in northern Taiwan. Materials and methods: This is a retrospective study of all women who underwent elective repeat cesarean deli...
Schjoldager, Birgit T B G; Mikkelsen, Emmeli; Lykke, Malene R; Præst, Jørgen; Hvas, Anne-Mette; Heslet, Lars; Secher, Niels J; Salvig, Jannie D; Uldbjerg, Niels
During cesarean delivery in patients with placenta previa, hemorrhaging after removal of the placenta is often challenging. In this condition, the extraordinarily high concentration of tissue factor at the placenta site may constitute a principle of treatment as it activates coagulation very effectively. The presumption, however, is that tissue factor is bound to activated factor VII. We hypothesized that topical application of recombinant activated factor VII at the placenta site reduces bleeding without affecting intravascular coagulation. We included 5 cases with planned cesarean delivery for placenta previa. After removal of the placenta, the surgeon applied a swab soaked in recombinant activated factor VII containing saline (1 mg in 246 mL) to the placenta site for 2 minutes; this treatment was repeated once if the bleeding did not decrease sufficiently. We documented the treatment on video recordings and measured blood loss. Furthermore, we determined hemoglobin concentration, platelet count, international normalized ratio, activated partial thrombin time, fibrinogen (functional), factor VII:clot, and thrombin generation in peripheral blood prior to and 15 minutes after removal of the placenta. We also tested these blood coagulation variables in 5 women with cesarean delivery planned for other reasons. Mann-Whitney test was used for unpaired data. In all 5 cases, the uterotomy was closed under practically dry conditions and the median blood loss was 490 (range 300-800) mL. There were no adverse effects of recombinant activated factor VII and we did not measure factor VII to enter the circulation. Neither did we observe changes in thrombin generation, fibrinogen, activated partial thrombin time, international normalized ratio, and platelet count in the peripheral circulation (all P values >.20). This study indicates that in patients with placenta previa, topical recombinant activated factor VII may diminish bleeding from the placenta site without initiation
Abstract: This study aims to analyze the judicial control of public policies. Thus, the doctrinal concept of these policies will be explained, and the delimitation of political harvest and develops. A brief overview of the division of powers is necessary, in order to better define what can be considered as judicial activism. About this same theme of activism, will be shown that there is no consensus on their classification, but it depends on the time and place to be analyzed. A relevant discussion on the possible Reserve Theory is demonstrated, as well as whether or not their use when analyzing the legitimacy of judicial intervention in the sphere of activities of the other two branches of government. Finally, the subject of judicial intervention at the present time will be studied, and their possible consequences for democracy. Keywords: Public policy; Judicial activism; Possible reserve theory.
Full Text Available Much effort is being made to safeguard judicial integrity – but what is it? In this article, two discourses on judicial integrity will be outlined: one in which judicial integrity is said to be at stake and one in which the emphasis lies on safeguarding judicial integrity. These discourses are by no means homogeneous. Not only are there considerable differences between the English and the Dutch discourses, there are also differences within each discourse regarding the use and meaning of integrity. In order to gain a better understanding of the concept, normative theory is consulted. From a rule of law perspective, integrity as the proper professional character of an official appears to be a presupposed norm. From the perspective of democracy, integrity appears as the norm that correlates with public trust. Expounding on these norms – integrity as professional character and integrity as external accountability – enables a better understanding of the discourses on judicial integrity.
Full Text Available OBJECTIVE: Cesarean section has increased risks for maternal mortality and morbidity, and perinatal morbidity. The purpose of this study was to analyze the annual distribution of indications and rates of cesarean sections in all deliveries that happened between 2001 and 2005.\tMATERIAL-METHODS: We evaluated retrospectively the hospital records of 1806 patients who underwent cesarean section among 2416 deliveries at Suleyman Demirel University, School of Medicine, Department of Obstetrics and Gynecology, between 2001- 2005. The annual distribution of patients with cesarean section were analyzed with respect to age, parity, vaginal birth rate and cesarean section indications.\tRESULTS: The rate of cesarean section is between 58.1% and 85.2%. This rate increased by years. The most increased indications of cesarean section were previous cesarean, cephalo-pelvic disproportion, and fetal distress. While the rate of previous cesarean\twas 18.3 % in 2001, it increased to 29.6 % in 2005. In a same manner, the rates of cephalo-pelvic disproportion was raised from 2.8% to 21.4%.. The indications of fetal distress and desire of contraception were decreased during this period (p CONCLUSION: The cesarean rate has increased by years in our clinic. This increase was attributed to the increased rate of previous cesarean section, the increased number of primigravid women over 35 year old, and the management of breech presentations. The widespread use of antenatal diagnostic techniques also caused an increase in the rate of cesarean section.
Stanton, Cynthia; Ronsmans, Carine
Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries. Data are presented from selected countries, categorizing cesareans by three classification systems. A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings. Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery.
Judicial review is the core competence of the constitutional judicature in Europe, which is largely shaped by the Austrian and German models of constitutional justice. In that context, the issue of initiating the constitutional review of legislation is extremely important. Depending on the subject who is authorized to initiate this proceeding, the constitutional review may be twofold: the abstract control and the incidental control. The former type of constitutional review is generally initia...
Clausen, Tine Dalsgaard; Bergholt, Thomas; Eriksson, Frank
BACKGROUND: Unfavorable conditions associated with cesarean section may influence the risk of type 1 diabetes in offspring, but results from studies are conflicting. We aimed to evaluate the association between prelabor cesarean section and risk of childhood type 1 diabetes. METHODS: A Danish...... nationwide cohort study followed all singletons born during 1982-2010. Five national registers provided information on mode of delivery, outcome, and confounders. The risk of childhood type 1 diabetes with onset before the age of 15 years was assessed by Cox regression. A total of 1,760,336 singletons...... contributed 20,436,684 person-years, during which 4,400 were diagnosed with childhood type 1 diabetes. RESULTS: The hazard ratio for childhood type 1 diabetes was increased in children delivered by prelabor cesarean section compared with vaginal delivery when adjusted for year of birth, parity, sex, parental...
Fuglenes, Dorthe; Oian, Pål; Kristiansen, Ivar Sønbø
OBJECTIVE: The aim of this study was to test the hypothesis that obstetricians' choice of delivery method is influenced by their risk attitude and perceived risk of complaints and malpractice litigation. STUDY DESIGN: The choice of delivery method in ambiguous cases was studied in a nationwide...... survey of Norwegian obstetricians (n = 716; response rate, 71%) using clinical scenarios. The risk attitude was measured by 6 items from the Jackson Personality Inventory-Revised. RESULTS: The proportion of obstetricians consenting to the cesarean request varied both within and across the scenarios....... The perceived risk of complaints and malpractice litigation was a clear determinant of obstetricians' choice of cesarean in all of the clinical scenarios, whereas no impact was observed for risk attitude. CONCLUSION: Obstetricians' judgments about cesarean request in ambiguous clinical cases vary considerably...
Sevelsted, Astrid; Stokholm, Jakob; Bisgaard, Hans
in Childhood2000 is a high-risk birth cohort of 411 Danish children. Asthma was diagnosed prospectively by physicians at the research site, and associations with cesarean delivery were investigated using Cox proportional hazard models. From the Danish national prospective registry we included data from 1997......-2010. Childhood asthma was defined from recurrent use of inhaled corticosteroids filled at pharmacies. Cesarean delivery was classified as either before or after rupture of membranes, and the risk of asthma was compared with vaginal delivery. Results were adjusted stepwise for age and calendar year, sex, birth...... weight, gestational age, multiple births, parity, and maternal factors (age, smoking/antibiotics during pregnancy, employment status, and asthma). RESULTS: In the Copenhagen Prospective Studies on Asthma in Childhood2000 cohort, the adjusted hazard ratio for asthma was increased by cesarean delivery...
Full Text Available Extraperitoneal cesarean section was once used for the prevention of infection and postoperative adhesion. However, we report an unusual complication after this procedure. A 29-year-old woman had pus discharge from the anterior vaginal wall after extraperitoneal cesarean section. Broad-spectrum antibiotics failed to relieve her symptoms and vaginal culture yielded Morganella morganii. Magnetic resonance imaging, sagittal view, showed a cervical abscess measuring 5 × 5 cm with a tract extending to the anterior vagina. After performing dilation and abscess drainage via the cervical ostium, the symptoms gradually subsided with adequate antibiotic treatment. Cervical abscess may develop after extraperitoneal cesarean section and present initially as vaginal fistula. Detailed imaging study provides comprehensive anatomic information for effective management.
Carlos Eduardo Dieder Reverbel
Full Text Available O presente trabalho insere-se na Teoria do Estado e no Direito Constitucional. Parte da natural sociabilidade do humano para demonstrar que o Estado de Direito nasce para servir a pessoa, e esta abdica parte de sua liberdade em prol de um convívio harmônico e pacífico dentro da sociedade. Delimita, mesmo que não desenvolva, o que entende ser os princípios de Estado de Direito. Após, insere o estudo dentro das duas principais famílias de direito: common law e romano-germânica; apresentando o princípío prevalente em cada uma delas: legalidade e processualidade. Desenvolve distinção de McILWIAN entre jurisdictio y gubernaculum, pois o Estado de Direito só pode ser aquele que delimite e proteja uma área restrita à Política, e uma área restrita ao Direito. Por fim, antes da conclusão e da bibliografia, mostramos os entraves que o ativismo judicial – inclusive colacionando jurisprudências – tem gerado para o florescimento de um Estado de Direito racional.
Turla, Ahmet; Aydin, Berna; Sataloğlu, Neva
We aimed in this study to determine any mistakes or omissions made while preparing judicial reports, which contribute to the judicial process. In this study, we evaluated as samples 351 judicial reports of victims who applied to the Emergency Service of Ondokuz Mayis University between January 1, 2005 and December 31, 2005 with respect to the judicial facts, and we recorded any mistakes or omissions of data in these reports. We determined that there was no record of age in 6% of the judicial reports, of examination time in 71.8%, of traumatic lesion or not in 30.5%, of the state of consciousness in 58.7%, and of the presence or not of life-threatening risks in 2.6%. The name of the physician who prepared the report was not provided in 8.0% of the reports. The most important omission is that none of the reports had the name, surname or signature of the person who had taken the prepared report. We concluded that, after graduation, it is necessary for physicians, who are responsible for both treating the patients and writing judicial reports, to attend in-service training programs. They must also be properly advised regarding their responsibilities in judicial cases.
Fernando C. Barros
Full Text Available OBJECTIVE: To describe trends, geographic distribution, and risk factors for cesarean deliveries in Brazil in 2000-2011, and to determine if efforts to curtail rates have had a measurable impact. METHODS: This was an observational study using nationwide information from the Department of Informatics of the Unified Health System (DATASUS. Individual level analyses were based on data regarding maternal education, age, parity, and skin color. Ecological analyses at the level of 431 health districts investigated the relationships with health facility density and poverty level. RESULTS: Cesarean rates increased markedly, from 37.9% in 2000 to 53.9% in 2011. Preliminary results from 2012 showed a rate of 55.8%, with the richest geographic areas showing the highest rates. Rates at the municipal level varied from 9%-96%. Cesareans were more common in women with higher education, white skin color, older age, and in primi- paras. In the ecological analyses, the number of health facilities per 1 000 population was strongly and positively correlated with cesarean rates, with an increase of 16.1 percentage points (95% Confidence Interval [95%CI] = 4.3-17.8 for each facility. An increase of 1 percentage point in the poverty rate was associated with a decline of 0.5 percentage point in cesarean rates (95%CI = 0.5-0.6. CONCLUSIONS: The strong associations with maternal education and health facility density suggest that the vast majority of cesareans are not medically indicated. A number of policies and programs have been launched to counteract this trend, but have had virtually no impact.
Full Text Available OBJECTIVE: To evaluate how the country of origin affects the probability of being delivered by cesarean section when giving birth at public Portuguese hospitals. STUDY DESIGN: Women delivered of a singleton birth (n = 8228, recruited from five public level III maternities (April 2005-August 2006 during the procedure of assembling a birth cohort, were classified according to the country of origin and her migration status as Portuguese (n = 7908, non-Portuguese European (n = 84, African (n = 77 and Brazilian (n = 159. A Poisson model was used to evaluate the association between country of birth and cesarean section that was measured by adjusted prevalence ratio (PR and respective 95% confidence intervals (95%CI. RESULTS: The cesarean section rate varied from 32.1% in non-Portuguese European to 48.4% in Brazilian women (p = 0.008. After adjustment for potential confounders and compared to Portuguese women as a reference, Brazilian women presented significantly higher prevalence of cesarean section (PR = 1.26; 95%CI: 1.08-1.47. The effect was more evident among multiparous women (PR = 1.39; 95%CI: 1.12-1.73 and it was observed when cesarean section was performed either before labor (PR = 1.43; 95%CI: 0.99-2.06 or during labor (PR = 1.30; 95%CI: 1.07-1.58. CONCLUSIONS: The rate of cesarean section was significantly higher among Brazilian women and it was independent of the presence of any known risk factors or usual clinical indications, suggesting that cultural background influences the mode of delivery overcoming the expected standard of care and outcomes in public health services.
Manjas, Menkher; Helmi, Helfial
Early mobilization and good wound operation healing are the other aim of all treatment for cesarean section operation. Especially for wound healing we can use amniotic membrane which is soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient transparency which allows wound control without secondary redressing. From July 1999 until December 1999 total of 196 patients undergoing cesarean section with amnion as would covering were evaluated for injection of amnion, sign of wound injection, and duration of wound healing. Amniotic membrane gives best results in wound healing, no sing of rejection and there is no different results between emergency operation and elective operation, clean and dirty operation
Schauberger, Charles W; Chauhan, Suneet P
We explored the role that lack of a standard definition and heterogeneity in patient selection criteria in the literature might have on the apparent inability to routinely begin an emergency cesarean section in less than 30 minutes. A review of the literature on emergency cesarean delivery was performed. Although there are some similarities in definitions and the criteria used for patient selection in multiple studies, the variability in the definitions could be responsible for some of the apparent timeliness performance deficiency in the literature. A standard definition and directions for future research are suggested.
Nielsen, Nete M; Bager, Peter; Stenager, Egon
Apart from a recent study reporting a 2- to 3-fold increased risk of multiple sclerosis (MS) among women and men who were delivered by Cesarean section (C-section), little attention has been given to the possible association between mode of delivery and the risk of MS.......Apart from a recent study reporting a 2- to 3-fold increased risk of multiple sclerosis (MS) among women and men who were delivered by Cesarean section (C-section), little attention has been given to the possible association between mode of delivery and the risk of MS....
What factors allow some international courts (ICs) to rule against the express preferences of powerful member states, whereas others routinely defer to governments? While judicial independence is not the only factor explaining the strength of a given international institution, it is a necessary...... condition. The paper first develops three sets of competing explanatory variables that potentially can explain variations in the judicial independence of ICs. The causal effects of these explanatory variables upon variance in judicial independence are investigated in a comparative analysis of the ACJ, ECJ...
Henriksen, T B; Sperling, Lene; Hedegaard, M
for CS in twin pregnancies was made between two Danish counties, one with a high and one with a low overall CS rate in twin deliveries, taking into account the distribution of parity, mother's age, gestational age at birth, and birth weight. DESIGN: A population based, historic follow-up study based...... presentation. SECONDARY MEASURES: Perinatal and maternal outcome. RESULTS: The difference in CS rates between the two counties could not be explained by different distributions of background characteristics. Different attitudes were found towards CS in cases with previous CS, with twin A in breech presentation......OBJECTIVE: Based on a comparison of the clinical indications for cesarean section (CS) in two Danish counties and a review of the literature regarding this issue the aim of this study was to discuss possible explanations for variations in CS rates in twin pregnancies. The comparison of indications...
Madsen, Lene Duch; Glavind, Julie; Uldbjerg, Niels
Objectives: To evaluate the Cesarean scar defect depth and the residual myometrial thickness with 3-dimensional (3D) sonography concerning interobserver variation. Methods: Ten women were randomly selected from a larger cohort of Cesarean scar ultrasound evaluations. All women were examined 6......-16 months after their first Cesarean section with 2D transvaginal sonography and had 3D volumes recorded. Two observers independently evaluated “off-line” each of the 3D volumes stored. Residual myometrial thickness (RMT) and Cesarean scar defect depth (D) was measured in the sagittal plane with an interval...... of Cesarean section scar size and residual myometrium needs further investigation....
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Authority relating to advertisements, and purchase of certain supplies and services. 0.140 Section 0.140 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Authorizations With Respect to Personnel and Certain Administrative Matters § 0.140 Authority...
Roč. 3, č. 3 (2013), s. 208-224 ISSN 1805-8396 Institutional support: RVO:68378122 Keywords : judicialization * international relations * legal and extralegal factors Subject RIV: AG - Legal Sciences
Full Text Available The RIA/IAR asked several experts to give their opinion on the Italian system of judicial review of antitrust decisions and its compatibility with art. 6 of the ECHR following a set of common questions.
Judicial precedent is a basic principle of the administration of justice in .... precedent assume a natural position that is not different from any other ... L. Alexander, Precedent in a Companion to Philosophy of Law and Legal Theory 503-513,.
A paper by Professor Catharine MacMillan (Professor of Law and Legal History, University of Reading) exploring the enduring legacy of the Judicial Committee of the Privy Council on the development of Canadian law.
Plevani, Cristina; Incerti, Maddalena; Del Sorbo, Davide; Pintucci, Armando; Vergani, Patrizia; Merlino, Luca; Locatelli, Anna
Cesarean delivery rates are rising due to multiple factors, including less use of operative vaginal delivery and vaginal birth after cesarean delivery, which often reflect local obstetric practices. Objectives of the study were to analyze the relations between cesarean delivery, these practices, and perinatal outcomes. We included all deliveries in the 72 hospitals of Lombardia, a region in northern Italy, during the year 2013. The delivery certificate was used as data source. Pearson's correlation coefficient and logistic regression were used for statistical analysis. We included 87 896 deliveries. The number of deliveries per hospital ranged from 140 to 6123. The rate of cesarean delivery was 28.3% (range 9.9-86.4%), operative vaginal delivery 4.7% (range 0.2-10.0%), and vaginal birth after cesarean 17.3% (range 0-79.2%). We found a significant inverse correlation between rates of overall cesarean delivery and operative vaginal delivery (r = -0.25, p = 0.04). The correlation between rate of overall cesarean delivery and vaginal birth after cesarean was also inverse and significant (r = -0.57, p cesarean delivery rate and the rates of Apgar score at 5 min cesarean delivery, could reduce the rising cesarean delivery rate. This will require a change in obstetric culture, continuing education of healthcare providers, and leadership. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.
Full Text Available The South African Judicial Service Commission (JSC, considered to be exemplary for its independence, plays a pivotal part in judicial appointments. Yet the Commission has long been marred by tensions that have lately erupted into a full-blown conflict between those who could here be referred to as the transformationists, on the one hand, and the liberals, on the other. The transformationists, who may generally be regarded as falling within the sphere of influence of the ruling elite under the African National Congress (ANC, are bent on pursuing the policy of transformation. Hence they insist that the composition of the bench must reflect the national population profile and on individual judges' pursuing the ruling party's ideological goals. The liberals reject this as a threat to judicial independence and the professional competence of the judiciary. On close analysis the clash is based on incompatible interpretations of judicial independence and impartiality. This article is a critique of these interpretations against the backdrop of an assessment of what these notions can reasonably be expected to achieve. It is argued that the liberals are harbouring unrealistic views about judiciaries, believing them to wield power which may even extend over matters of political significance, powers on a par with or even outweighing those of the political branches. However, on proper analysis it is clear that the judiciary is in fact, firstly, inherently weak and dependent on the support of the political branches; and, secondly, it is integrated into the ruling elite with whom they share the same ideological assumptions without any inclination to oppose them. Hence, the impartiality of the courts, when it comes to politically sensitive issues, is distinctively politically (regime relative and ideologically conditioned. Ironically the transformationists have bought into the liberals' erroneous belief in the potency of the courts (in the above-mentioned sense
Full Text Available The sporadic or chronic use of drugs and alcohol is directly related to conduct disorders and to the triggering of psychopathological states of sub-acute or chronic course. The excessive consumption of alcohol and excessive traffic/consumption of illicit drugs by individuals without mental illness or disability are actions of free will; they are therefore criminally responsible for their behaviour, even if they commit a crime during the state of intoxication, which the individual chose voluntarily to experience. In clinical practice, it is widely accepted that the treatment of these disorders is only effective when the patient accepts it voluntarily and that involuntary commitment (compulsive treatment is only carried out when the psychopathological state associated justifies the presuppositions of Article 12 of the Mental Health Law. However, if the compulsive treatment is of a penal character, mandated by a judge, the individual is obligated to accept treatment, independent of whether or not he suffers from mental illness. The authors present two case studies, one of drug addiction, the other of alcoholism, and discuss the clinical and judicial perspectives on the treatment of these clinical entities.
Full Text Available Today’s perspective of the information society is characterized by the terminology of modern dictionaries of globalization including the terms such as convergence, digitization (media, technology and/or telecommunications and mobility of people or technology. Each word with progress, development, a positive sign of the rise of the information society. On the other hand in a virtual environment traditional evidence in judicial proceedings with the document on paper substrate, are becoming electronic evidence, and their management processes and criteria for admissibility are changing over traditional evidence. The rapid growth of computer data created new opportunities and the growth of new forms of computing, and cyber crime, but also the new ways of proof in court cases, which were unavailable just a few decades. The authors of this paper describe new trends in the development of the information society and the emergence of electronic evidence, with emphasis on the impact of the development of computer crime on electronic evidence; the concept, legal regulation and probative value of electronic evidence, and in particular of electronic documents; and the issue of electronic evidence expertise and electronic documents in court proceedings.
In France, radon has emerged as a public health issue mainly at the initiative of scientists. Even if public authorities have set up an embryo of regulations, for a long time scientists faced the radon issue alone, in producing knowledge, informing about their results, providing advice to public authorities, various bodies and individuals, and in participating in the process of technical standardisation. These functions are identified in the paper in order to sketch out a typology of different situations, formal and informal, in which researchers transformed into experts are called to collaborate. During their missions, experts are exposed to 'judicial risks', particularly in terms of civil liability or 'professional' responsibility and even criminal responsibility. They face legal difficulties because of the lack of a legal framework for public scientific expertise. The situation is confused: there is a growing will to involve scientific experts in decision-making in the field of public health, especially when the precautionary principle is at stake, and in parallel, no real materialisation of this expertise in terms of regulations, which puts on experts' shoulders some new responsibilities. Moreover we can observe a generalised increase in the attribution of blame and penal responsibility in French society which make the position of all actors involved more uncomfortable. We know that radon, as a domestic risk, is particular in many ways. Nevertheless, it can be used in an analysis of scientists' roles/actions and of the legal difficulties they face, to illustrate appropriately the problems that arise as expertise is developed about new risks. (author)
Peng, Fu-Shiang; Lin, Hsien-Ming; Lin, Ho-Hsiung; Tu, Fung-Chao; Hsiao, Chin-Fen; Hsiao, Sheng-Mou
Many countries have noted a substantial increase in the cesarean section rate (CSR). Several methods for lowering the CSR have been described. Understanding the impact of clinical audits on the CSR may aid in lowering CSR. Thus, our aim is to elucidate the effect of clinical audits on the CSR. We retrospectively analyzed 3781 pregnant women who gave birth in a medical center between January 2008 and January 2011. Pregnant women who delivered between January 2008 and July 2009 were enrolled as the pre-audit group (n = 1592). After August 2009, all cesarean section cases that were audited were enrolled in the audit group (n = 2189). The CSR was compared between groups. The overall CSR (34.5% vs. 31.1%, adjusted odds ratio [OR] = 0.83, p = 0.008) and the cesarean section rate due to dystocia (9.6% vs. 6.2%, p strategy for reducing the CSR. Therefore, we recommend strict monitoring of the indications in dystocia for cesarean section to reduce the CSR. Copyright © 2016. Published by Elsevier B.V.
Sedykh, S V
Early breast-feeding is a standard of perinatal care currently. After cesarean section it can be possible in case of early mother activation (verticalization). Assessment of perioperative analgesia influence on activation timing was the aim of our research. We included 120 parturient women. It was proved, that local analgesia using in postoperative period promotes early mother verticaliration, and optimal breast-feeding starting.
Richardson, M G; Collins, H V; Wissler, R N
Both hyper- and hypobaric solutions of bupivacaine are often combined with morphine to provide subarachnoid anesthesia for cesarean section. Differences in the baricity of subarachnoid solutions influence the intrathecal distribution of anesthetic drugs and would be expected to influence measurable clinical variables. We compared the effects of hyper- and hypobaric subarachnoid bupivacaine with morphine to determine whether one has significant advantages with regard to intraoperative anesthesia and postoperative analgesia in term parturients undergoing elective cesarean section. Thirty parturients were randomized to receive either hyper- or hypobaric bupivacaine (15 mg) with morphine sulfate (0.2 mg). Intraoperative outcomes compared included extent of sensory block, quality of anesthesia, and side effects. Postoperative outcomes, including pain visual analog scale scores, systemic analgesic requirements, and side effects, were monitored for 48 h. Sedation effects were quantified and compared using Trieger and digit-symbol substitution tests. We detected no differences in sensory or motor block, quality of anesthesia, quality of postoperative analgesia, incidence of side effects, or psychometric scores. Both preparations provide highly satisfactory anesthesia for cesarean section and effective postoperative analgesia. Dextrose alters the density of intrathecal bupivacaine solutions and is thought to influence subarachnoid distribution of the drug. We randomized parturients undergoing cesarean section to one of two often used spinal bupivacaine preparations, hypobaric and hyperbaric. We detected no differences in clinical outcomes between groups.
Objective: The objective of this study is to compare the safety of early versus delayed oral feeding after uncomplicated cesarean section (CS) under spinal anesthesia. Methods: This was a randomized, controlled trial that enrolled 152 women who had uncomplicated CS under spinal anesthesia between January 2014 and ...
Dicle, O. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Kuecuekler, C. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Pirnar, T. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Erata, Y. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey); Posaci, C. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey)
The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs.
Sperling, Lene; Schantz, A L; Toftager-Larsen, K
A case of non-obstructive cecal dilatation and perforation after cesarean section is reported, with a review of the literature on the diagnosis and management of this entity. Fifteen cases have been described. Attention is called to this rare complication and to the accompanying pseudo...
One patient had postoperative wound infection two weeks after discharge from the hospital. ... The safe delivery of the baby was always undertaken .... The five patients who spent more than five days had delayed wound healing. They all had emergency lower segment Cesarean section for obstructed labour. One of the ...
Pınar Solmaz Hasdemir
Full Text Available Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.
Lindholt, Jes Sanddal; Möller-Christensen, T; Steele, R E
Three methods of skin closure after cesarean section were tested and compared in a prospective trial. Eighty-nine (82.5%) appeared for follow-up investigation 4-5 months after delivery. The mean scar width was significantly narrower after phannenstiel incision compared with percutaneous nylon sut...
Pluymen, Linda P M; Smit, Henriëtte A; Wijga, Alet H; Gehring, Ulrike; De Jongste, Johan C; Van Rossem, Lenie
OBJECTIVES: To investigate whether children delivered by cesarean had a higher risk of being overweight from early until late childhood and whether they had a higher blood pressure in adolescence compared with children delivered vaginally. STUDY DESIGN: We used data from a Dutch birth cohort study
Objectives: To determine the prevalence, risk factors and common bacterial pathogens for surgical site infection (SSI), following cesarean section (CS). Materials and Methods: A retrospective case-control study of patients delivered by CS in Aminu Kano Teaching Hospital, Kano, Nigeria. The cases were the patients whose ...
Dicle, O.; Kuecuekler, C.; Pirnar, T.; Erata, Y.; Posaci, C.
The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs
Background: Cesarean section (CS) rates and indications give a reflection of the maternal health status in the environment. This study was carried out to compare the CS rates and indications in this unit in 1985 and 1995, with a view to determining changes in the health seeking behaviour and possibly maternal health of ...
Ethnic differences in birth weight and cesarean deliveries in Zaria, Nigeria. B Danborno, A Afegbua. Abstract. No Abstract. Journal of Experimental and Clinical Anatomy Vol. 5(1) 2006: 21-24. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Abstract. Objective: Cesarean section (C/S) is still being perceived as an abnormal means of delivery by many antenatal women in Nigeria. This study aims to determine the perceptions of antenatal clients in the southeastern Nigeria on C/S. Materials and Methods: The study was conducted using a structured questionnaire ...
A case of big oozing lump of unknown origin through a healed cesarean section stitchline, completely asymptomatic at presentation, origin discovered as omentum on exploratory laparotomy came on 10th postoperative day of an uneventful emergency surgery. This rare and silent presentation highlights the need to ...
Pyykönen, Aura; Gissler, Mika; Løkkegaard, Ellen; Bergholt, Thomas; Rasmussen, Steen C; Smárason, Alexander; Bjarnadóttir, Ragnheiður I; Másdóttir, Birna B; Källén, Karin; Klungsoyr, Kari; Albrechtsen, Susanne; Skjeldestad, Finn E; Tapper, Anna-Maija
The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Retrospective population-based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6-R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.
Okeke, GN. Vol 2 (2011) - Articles Fundamental Objectives and Directives Principles of State Policy: A Viable Anti-Corruption Tool in Nigeria Abstract PDF · Vol 2 (2011) - Articles A Legal Approach to Combating Terrorism: Modern Dimension Abstract PDF · Vol 1 (2010) - Articles Judicial precedent in the Nigerian legal ...
Tuuli, Methodius G; Liu, Jingxia; Stout, Molly J; Martin, Shannon; Cahill, Alison G; Odibo, Anthony O; Colditz, Graham A; Macones, George A
Preoperative skin antisepsis has the potential to decrease the risk of surgical-site infection. However, evidence is limited to guide the choice of antiseptic agent at cesarean delivery, which is the most common major surgical procedure among women in the United States. In this single-center, randomized, controlled trial, we evaluated whether the use of chlorhexidine-alcohol for preoperative skin antisepsis was superior to the use of iodine-alcohol for the prevention of surgical-site infection after cesarean delivery. We randomly assigned patients undergoing cesarean delivery to skin preparation with either chlorhexidine-alcohol or iodine-alcohol. The primary outcome was superficial or deep surgical-site infection within 30 days after cesarean delivery, on the basis of definitions from the Centers for Disease Control and Prevention. From September 2011 through June 2015, a total of 1147 patients were enrolled; 572 patients were assigned to chlorhexidine-alcohol and 575 to iodine-alcohol. In an intention-to-treat analysis, surgical-site infection was diagnosed in 23 patients (4.0%) in the chlorhexidine-alcohol group and in 42 (7.3%) in the iodine-alcohol group (relative risk, 0.55; 95% confidence interval, 0.34 to 0.90; P=0.02). The rate of superficial surgical-site infection was 3.0% in the chlorhexidine-alcohol group and 4.9% in the iodine-alcohol group (P=0.10); the rate of deep infection was 1.0% and 2.4%, respectively (P=0.07). The frequency of adverse skin reactions was similar in the two groups. The use of chlorhexidine-alcohol for preoperative skin antisepsis resulted in a significantly lower risk of surgical-site infection after cesarean delivery than did the use of iodine-alcohol. (Funded by the National Institutes of Health and Washington University School of Medicine in St. Louis; ClinicalTrials.gov number, NCT01472549.).
Kok, N.; Ruiter, L.; Lindeboom, R.; de Groot, C.; Pajkrt, E.; Mol, B. W.; Kazemier, B. M.
To determine neonatal and short term maternal outcomes according to intentional mode of delivery following a cesarean delivery (CD). Women pregnant after CD between January 2000 and December 2007 were categorized according to whether they had an elective repeat CD (ERCD) or a Trial of Labor (TOL).
Studsgaard, Anne; Skorstengaard, Malene; Glavind, Julie
OBJECTIVE: To compare outcomes with trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery on maternal request (ERCD-MR). DESIGN: Prospective cohort study. SETTING: Danish university hospital. POPULATION: Women with TOLAC (n = 1161) and women with ERCD-MR (n = 622) between 2003...... registration of the deliveries. MAIN OUTCOME MEASURES: Adverse neonatal outcomes, risk factors for emergency cesarean, and uterine rupture in case of TOLAC. RESULTS: TOLAC was associated with an increased risk of neonatal depression [odds ratio (OR) 3.6, 95% confidence interval (CI) 1.1-19.1] and neonatal...... vaginal delivery (adjusted OR 1.8, 95% CI 1.1-3.0), index emergency cesarean during labor (adjusted OR 3.0, 95% CI 2.3-4.1), maternal age ≥35 years (adjusted OR 1.9, 95% CI 1.3-2.8), pre-pregnancy body mass index ≥30 (adjusted OR 2.1, 95% CI 1.3-3.3), and birthweight 4000-4499 g (adjusted OR 1.5, 95% CI 1...
Rachael L. Johnstone
Full Text Available Review of the following book: Kári á Rógvi, West-Nordic Constitutional Judicial Review: A Comparative Study of Scandinavian Judicial Review and Judicial Reasoning (Copenhagen: Djøf Publishing, 2013. pp. 364, 45.00 GBP (paperback. ISBN: 8757429154
Virtually all judicial systems employ judicial staff members to assist judges in their work. However, except for US Supreme Court law clerks the role of these judicial assistants in judicial decision-making is minimally understood. This observation also holds true for the Netherlands, where an
Wan Jun; Gu Weijin; Wang Haiyun; Ye Lei; Wang Wei; Zhang Lei; Ji Lihua
Objective: To investigate the clinical application of bilateral uterine arterial chemoembolization in treating massive hemorrhage due to uterine scar pregnancy after cesarean section. Methods: Sixteen patients with massive hemorrhage due to cesarean scar pregnancy were enrolled in the study, the mean blood loss was (2 200 ± 1 400) ml. With Seldinger technique, abdominal angiography by using a pig-tail catheter was carried out. When bilateral uterine arterial bleeding was confirmed, selective or super-selective catheterization was employed and bilateral uterine arterial chemoembolization with infusion of 5-Fu or methotrexate (MTX) together with gelatin sponge via the catheters was conducted. The clinical results were observed. Results: The technical success was achieved in all 16 patients. No recurrent bleeding occurred during a follow-up of 3-6 months. Conclusion: The emergency bilateral uterine arterial chemoembolization is a safe and effective treatment for massive hemorrhage due to cesarean scar pregnancy with no serious complications, therefore, this technique is worth being used in clinical practice. (authors)
Zadeh, Fatemeh Javaherforoosh; Alqozat, Mostafa; Zadeh, Reza Akhond
Background Spinal anesthesia (SA) is a standard technique for cesarean section. Hypotension presents an incident of 80–85% after SA in pregnant women. Objective To determine the effect of intermittent pneumatic compression of lower limbs on declining spinal anesthesia induced hypotension during cesarean section. Methods This double-blind clinical prospective study was conducted on 76 non-laboring parturient patients, aged 18–45 years, with the American Society of Anesthesiologist physical status I or II who were scheduled for elective cesarean section at Razi Hospital, Ahvaz, Iran from December 21, 2015 to January 20, 2016. Patients were divided into treatment mechanical pump (Group M) or control group (Group C) with simple random sampling. Fetal presentation, birth weight, Apgar at 1 and 5 min, time taken for pre-hydration (min), pre-hydration to the administration of spinal anesthesia (min), initiation of spinal to the delivery (min) and total volume of intravenous fluids, total dose of ephedrine and metoclopramide were recorded. Data were analyzed by SPSS version 19, using repeated measures of ANOVA and Chi square test. Results Heart rate, MPA, DAP and SAP changes were significantly higher in off-pump group in the baseline and 1st-minute (p<0.05), and in the other times, this change was significantly different with control groups. Conclusion This research showed the suitability of the use of Sequential Compression Device (SCD) in reducing hypotension after spinal anesthesia for cesarean section, also this method can cause reducing vasopressor dosage for increased blood pressure, but the approval of its effectiveness requires repetition of the study with a larger sample size. Trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2015011217742N3. Funding The authors received no financial support for the research, authorship, and/or publication of this article. PMID:28713516
Hueston, W J; Sutton, A
After peaking during the early 1980s, cesarean section rates in the United States have been falling for the last decade. At the same time, managed care enrollment has increased dramatically. This study examines whether managed care penetration in local markets is associated with lower cesarean section rates in those geographic area. A cross-sectional comparison of cesarean section rates and health maintenance organization (HMO) market penetration in 61 selected metropolitan areas in the United States was conducted. National birth certificate data for 1996 were used to calculate crude and race-adjusted cesarean section rates for residents in each area. No relationship between overall cesarean section rates in the metropolitan areas and managed care penetration was observed. Subanalyses of racial groups demonstrated the existence of a weak association between managed care penetration and cesarean section rates for white women (21.2% for the highest quartile of HMO penetration, compared with 19.1% for the lowest quartile; P = .03), but not for African-Americans or other minorities. Managed care penetration in a market may have an association with cesarean section rates for white women, but the strength of this relationship is small. Even if managed care delivery systems reduce cesarean section rates in their own populations, this change is likely to have only a small impact on overall cesarean rates. HMO penetration is unlikely to influence national cesarean section rates, nor does it appear to explain state variations in these rates.
Schachter-Safrai, Natali; Karavani, Gilad; Haj-Yahya, Rani; Ofek Shlomai, Noa; Porat, Shay
Twin vaginal delivery presents a unique clinical challenge for obstetricians. The Twin Birth Study demonstrated the safety of planned vaginal delivery regarding neonatal outcomes. However, that study lacked a description of the risk factors associated with and the outcome of unplanned cesarean section. The aim of this study is to identify potential risk factors for cesarean section and delivery related neonatal morbidity and mortality in women with twin pregnancy attempting vaginal delivery. A retrospective cohort study including 1070 women with twin pregnancy that underwent a trial of labor between 2003 and 2015. The study population was divided according to the mode of delivery: vaginal delivery, combined vaginal-cesarean and intrapartum cesarean delivery of both twins. Several risk factors and neonatal outcomes were examined by both univariate analysis and multinomial logistic regression analysis. The rate of vaginal delivery of both twins was 88.3%, whereas the rates of combined vaginal cesarean and unplanned cesarean delivery were 4.6% and 7.1%, respectively. Nulliparity and nonvertex presentation of twin B were found to be independently associated with cesarean delivery for both twins. Additionally, nonvertex presentation of twin B was independently associated with combined vaginal-cesarean delivery. The proportion of neonates with Apgar score cesarean group compared with those delivered by the vaginal route alone. Nulliparity and nonvertex presentation of twin B were found to be associated with intrapartum cesarean delivery in twin pregnancies. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.
Chen, Yan; Han, Ping; Wang, Yi-Jia; Li, Yan-Xia
To analyze related risk factors of post-cesarean scar defects (PCSDs). A retrospective study of full-term women delivered by cesarean with singleton infants at our hospital from April 2014 to December 2015 was performed. 69 cases of diagnosed PCSDs and 107 cases with no PCSD who accepted cesarean were recruited for analysis. Individual medical case and operative report review were retrieved for maternal clinical characteristics analysis. There was no difference in age, gestational age, BMI and baby's weight between the two groups. PCSD group has more cases of anemia, higher neutrophil percentage and more cases of elected cesarean and emergency cesarean than controls (all p cesarean, there were more cases with cervix dilated larger than 3 cm in operation and more cases received cesarean at least one time before. In addition, women with cesarean interval of at least 5 years, women with ultrasonic measured echo longer than 3 cm, women with poor healing in uterine incision, women with retroposition of uterus and women who had intrauterine separation are more prone to develop PCSDs. The occurrence of a defective uterine scar after cesarean section is primarily a by-product of the combination of multiple factors: age ≥30 years, BMI ≥27.30, premature rupture of membranes, elective cesarean section, post-operative anemia, WBC count ≥12.5 × 10 9 g/L and retroposition of uterus. These are high risk factors of PCSDs.
Full Text Available In the research, a doctrinal and legal analysis of the concept of legal error is carried out. The author provides a self-defined definition of the concept addressed and highlights the main causes and conditions for the occurrence of judicial errors. At present, in the specialized legal doctrine of the Republic of Moldova, the problem of defining the judicial error has been little approached. In this respect, this scientific article is a scientific approach aimed at elucidating the theoretical and normative deficiencies and errors that occur in the area of reparation of the prejudice caused by judicial errors. In order to achieve our goal, we aim to create a core of ideas and referral mechanisms that ensure a certain interpretative and decisional homogeneity in the doctrinal and legal characterization of the phrase "judicial error".
Rafael Fernando dos Santos
Full Text Available This article was elaborated in order to analyze issues relating to the judicialization of cases involving health, understanding health as a public policy aimed at to guarantee the fundamental right to it linked, that is, the concept of health that the authos intended to work is not far from that contained in the combined reading of Articles 6 and 196 of the Constitution, consecrators to be the health, universal right and duty of the state, guaranteed through social and economic policies aimed at to reduce the risk of disease and other becomes, ensuring also the universal and equal access to actions and services for its promotion, protection and recovery. With this approach it is intended to analyze the feasibility and consequences of judicial control of social and economic policies of promotion, protection and recovery, access, anyway, the effective flow to the fundamental right. Relating to the methodological aspects employed in the analysis of the issue concerning to the health, it was searched in the interpretation of constitutional provisions that secure the subjective right the starting point of the analysis as well as the unwavering appreciation of inseparability of judicial control in the context of public policy, assessing possible limits of the judicial branch, and then to realize a brief analysis of previous trial in the Supreme Court and extract from this jurisprudencial context the minimum goals for aspects of health judicialization.
Full Text Available The purpose of this article is to provide a practical overview of the recently initiated modernization of Abu Dhabi’s judicial system. Beginning in 2007, Abu Dhabi’s Government launched a comprehensive effort to transform the Emirate’s judicial system. While the implementation of these reforms is ongoing, with the adoption of the law in May 2007 establishing the new judicial architecture the initial phase of the modernization program is already complete. The restructuring process encompasses court management and administration reform, a new judicial training regime, a redesigned organizational structure for the Emirate’s Judicial Department and courts, and the establishment of a system-wide strategic planning and budgeting process. Many of these initiatives are supported by applying advanced IT-based applications. Given the early achievements and ambitious broader aims of the restructuring process, Abu Dhabi’s example is relevant not only to the other Emirates within the Federal UAE system, but also within the context of the wider Middle East region.
It has passed 150th birth anniversary of a great, Italian Obstetrician Eduardo Porro, author of a cesarean section technique consisted of uterine corpus amputation and suturing of the cervix stump into the abdominal wall incision. Eduardo Porro was born in 1842 in Padwa. In 1876, he became the Head of Obstetrics Department in Pawia, and since 1882, the Head of Midwifery School in Milano. He died on May 25th, 1901. That original cesarean section method was introduced by him in 1876. Its main idea was exsection of the uterus, infected at the time of labor. The operation was also performed because of other reasons, such as: wide uterine ruptures, osteomalation, spacions vaginal cicatrization, and uterine atony. In the second part of the 18th century, maternal mortality following so called, classical cesarean section was nearly 100 percent. Introducing the Porro's operative technique decreased maternal mortality to 58%. This method aroused an interest of cesarean section technique improvement at all. The twilight, of the Porro's operation took place in the 1920s as the new method appeared, elaborated by Adolf Kehrer--uterine lower segment transverse incision.
Pyykönen, Aura; Gissler, Mika; Løkkegaard, Ellen
(3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change......Introduction: The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods: Retrospective population-based registry study including all deliveries...... in the total cesarean rate. Results: Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase...
Guzmán Sánchez, A; González Moreno, J; González Guzmán, M; Villa Villagran, F
The cesarean section (C) frequency has increased dramatically as high as 62%. This situation has been producing a real preoccupation in all the world as well as in México. Documented bibliography about this subject, is unquestionable. We feel that at this time there is a lack of punctuals strategies in order to reduce the high frequency of C. Our communication analyzes this problem in relation to antecedents, evolution and integrated general strategies in order to reduce the C rates. Special analysis and comments involve amnioinfusion, trials for vaginal deliveries in case of previous cesarean section, prostaglandins, and external version. With these actions, at the Antiguo Hospital Civil de Guadalajara we have achieved 10.8% of C. rates, without any increase in fetomaternal morbility and/or mortality.
Belinda Pereira da Cunha
Full Text Available This article analyzes the phenomenon of judicialization of environmental public policies, from the "lens" judicial activism, making sure that we can include the existence of this phenomenon in the treatment of these policies. In our post-modern era we have seen increasingly the role of the judiciary. Thus, it sought to address this issue of judicial activism against such contemporary issues as the environment, seeking to understand how the judiciary behaves in relation to environmental issues, which no longer has time to waive or give up the protection of natural resources and compliance with the principle of sustainable development. The methodology used was a literature review and secondary data collection. It was noticed a different activism in the face of environmental issues.
Abdulfatai O. Sambo
Full Text Available The contemporary Arab world has witnessed uprisings and turmoil as a result of alleged power-overreaching by political elites. Consequently, people call for democracy with emphasis on constitutionalism, accountability and protection of human rights. Yet, the voice of the judiciary seems not to be heard in championing these values in many Muslim nations despite the clear roles Islam places on the judiciary regarding political matters. This paper therefore analyses the power of judicial review on political questions from the perspective of Islamic jurisprudence. It finds that the power of judicial review and its main institution existed in early Islamic periods after the demise of the Prophet (SAW. The paper concludes that failure to observe judicial review in many contemporary Muslim countries results in the absence of effective checks on the powers of the rulers by the judiciary.
O. A. Antoniuc
The findings indicate that analysis of the accumulated Georgia and Kazakhstan, as well as other postSoviet states, the experience of modernization policy of national judicial systems is very useful for the improvement of the domestic judicial system in the context of the proclaimed judicial reform. First it must ensure the restoration of the unity of the judiciary in the possibility of the existence of certain specialized vessels. Regarding the latter, it is interesting Kazakhstan practice, when the specialized courts are formed with the status of the regional or district court, without disrupting the unity of the judiciary, which is headed by the Supreme Court. Considerable interest may also be the creation of the courts of public councils to assess the ethical qualities of the candidates for judges, the introduction of the modelspeakers of judges, the development of pretrial (mediation and alternative (arbitration courts forms of dispute resolution.
Full Text Available This article aims at a consistent search of the opinions about the judicial police as one of the subjects, contained in the Albanian criminal procedural law. In article 30 of the Albanian Criminal Procedure Code, are sanctioned the functions, division, addiction and judicial police duties. In the initial phase, the preliminary investigations are the basis of criminal proceedings. This phase includes evidences that cannot be replicated, the security measures are set, it is performed the notice of suit and necessary datas are collected. Searching, tracking, capture and bringing before trial of the perpetrators is considered as one of the oldest activities of human being. The need to ensure these regulations and the aim to prevent the consequences of any criminal activity has forced societies and different states to establish special investigative bodies (investigation and to determine by time their rights and obligations. So judicial police organs were provided and charged with competences and legal responsibility for the detection, crime preventions and research, capturing and bringing before the court, individuals or groups who commit criminal activities. From a comparative overview of legislation of the judicial police in several countries around the world, it is shown that there is no extreme change in structures and organizational patterns of these bodies, missions, powers and responsibilities they exercise (Elezi, 1997, 13. Judicial police in Albania has also been and is one of the important subjects of the criminal proceedings. In the historical perspective these bodies have had mixed origins and nature, and in different times they were military or civilian institutions. In this context, main purpose of this paper is the analysis of judicial police in
Lysack, John T.; Soboleski, Don [Department of Diagnostic Radiology, Queen' s University, Kingston General Hospital, 76 Stuart Street, K7L 2V7, Kingston, Ont. (Canada)
We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)
Lysack, John T.; Soboleski, Don
We report a case of an otherwise healthy neonate diagnosed at birth with a classic metaphyseal lesion of the proximal tibia following external cephalic version for frank breech presentation and a subsequent urgent cesarean section. Although the classic metaphyseal lesion is considered highly specific for infant abuse, this case demonstrates the importance of obtaining a history of obstetric trauma for neonates presenting to the imaging department for suspected non-accidental injury. (orig.)
Subramaniam, Akila; Jauk, Victoria C; Figueroa, Dana; Biggio, Joseph R; Owen, John; Tita, Alan T N
Risk factors for post-cesarean wound infection, but not disruption, are well-described in the literature. The primary objective of this study was to identify risk factors for non-infectious post-cesarean wound disruption. Secondary analysis was conducted using data from a single-center randomized controlled trial of staple versus suture skin closure in women ≥24 weeks' gestation undergoing cesarean delivery. Wound disruption was defined as subcutaneous skin or fascial dehiscence excluding primary wound infections. Composite wound morbidity (disruption or infection) was examined as a secondary outcome. Patient demographics, medical co-morbidities, and intrapartum characteristics were evaluated as potential risk factors using multivariable logistic regression. Of the 398 randomized patients, 340, including 26 with disruptions (7.6%) met inclusion criteria and were analyzed. After multivariable adjustments, African-American race (aOR 3.9, 95% CI 1.1-13.8) and staple - as opposed to suture - wound closure (aOR 5.4, 95% CI 1.8-16.1) remained significant risk factors for disruption; non-significant increases were observed for body mass index ≥30 (aOR 2.1, 95% CI 0.6-7.5), but not for diabetes mellitus (aOR 0.9, 95% CI 0.3-2.9). RESULTS for composite wound morbidity were similar. Skin closure with staples, African-American race, and considering the relatively small sample size, potentially obesity are associated with increased risk of non-infectious post-cesarean wound disruption.
Latifnejad-Roudsari, Robab; Zakerihamidi, Maryam; Merghati-Khoei, Effat; Kazemnejad, Anoshirvan
Background: Data was reported in Iran in 2013 has shown that almost 42 percent of deliveries in public hospitals and 90 percent in private hospitals were carried out with cesarean section. This high rate of cesarean requires careful consideration. It seems that making decision for cesarean is done under the influence of cultural perceptions and beliefs. So, this study was conducted to explore pregnant women's preferences and perceptions regarding cesarean delivery. Materials and Methods: A focused ethnographic study was used. 12 pregnant women and 10 delivered women, seven midwives, seven gynecologist and nine non-pregnant women referred to the health clinics of Tonekabon, who selected purposively, were included in the study. To collect data semi-structured in-depth interviews and participant observation were used. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using thematic analysis and MAXQDA software. Results: Four themes emerged from the data including personal beliefs, fear of vaginal delivery, cultural norms and values and also social network. These concepts played main roles in how women develop meanings toward caesarean, which affected their perceptions and preferences in relation to caesarean delivery. Conclusion: Most of pregnant women believed that fear of vaginal delivery is a major factor to choose caesarean delivery. Hence, midwives and physicians could help them through improving the quality of prenatal care and giving them positive perception towards vaginal delivery through presenting useful information about the nature of different modes of delivery, and their advantages and disadvantages, as well as the alternative ways to control labor pain. PMID:25949249
Tully, Kristin P; Ball, Helen L
International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women's accounts of their experiences largely portrayed cesarean section as everything that they had wanted to avoid, but necessary given their situations. Contrary to popular suggestion, the data did not indicate impersonalized medical practice, or that cesareans were being performed 'on request.' The categorization of cesareans into 'emergency' and 'elective' did not reflect maternal experiences. Rather, many unscheduled cesareans were conducted without indications of fetal distress and most scheduled cesareans were not booked because of 'choice.' The authoritative knowledge that influenced maternal perceptions of the need to undergo operative delivery included moving forward from 'prolonged' labor and scheduling cesarean as a prophylactic to avoid anticipated psychological or physical harm. In spontaneously defending themselves against stigma from the 'too posh to push' label that is currently common in the media, women portrayed debate on the appropriateness of cesarean childbirth as a social critique instead of a health issue. The findings suggest the 'need' for some cesareans is due to misrecognition of indications by all involved. The factors underlying many cesareans may actually be modifiable, but informed choice and healthful outcomes are impeded by lack of awareness regarding the benefits of labor on the fetal transition to extrauterine life, the maternal desire for predictability in their parturition and recovery experiences, and possibly lack of sufficient experience for
Tavares, Aida Isabel; Rocha, Tania
The aim of this work is to determine the demand factors for cesareans in Portugal. This work is exploratory and preliminary. Data is aggregated in NUTSII , for the period 2002-10. The number of cesareans performed is count data which requires the estimation of this panel data by a negative binomial with fixed effects. The main result is the evidence that there may be induced demand for cesareans in Portugal. Further research is needed.
Tully, Kristin P.; Ball, Helen L.
International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women’s accounts of their experiences largely portrayed cesarean section as everything that they had wanted to avoid, but necessary given their situations. Contrary to popular suggestion, the data did not indicate impersonalized medical practice, or that cesareans were being performed ‘on request.’ The categorization of cesareans into ‘emergency’ and ‘elective’ did not reflect maternal experiences. Rather, many unscheduled cesareans were conducted without indications of fetal distress and most scheduled cesareans were not booked because of ‘choice.’ The authoritative knowledge that influenced maternal perceptions of the need to undergo operative delivery included moving forward from ‘prolonged’ labor and scheduling cesarean as a prophylactic to avoid anticipated psychological or physical harm. In spontaneously defending themselves against stigma from the ‘too posh to push’ label that is currently common in the media, women portrayed debate on the appropriateness of cesarean childbirth as a social critique instead of a health issue. The findings suggest the ‘need’ for some cesareans is due to misrecognition of indications by all involved. The factors underlying many cesareans may actually be modifiable, but informed choice and healthful outcomes are impeded by lack of awareness regarding the benefits of labor on the fetal transition to extrauterine life, the maternal desire for predictability in their parturition and recovery experiences, and possibly lack
La Noue, George R.
This article describes the outcomes of the case "Fisher v. University of Texas at Austin," in which the plaintiff had accused the University of Texas (UT) of racial discrimination in the admission process. The author believes that the ruling of the court in this case makes it harder to hide race-based measures used in college admissions.…
Claudio Ladeira de Oliveira
Full Text Available In this paper I discuss the conflicting relationship between the “judicial activism” and representative democratic procedures. First, I discuss some definitions that enhance aspects “normative/prescriptive” of “activists” judicial positions and the functioning of “real existing” democratic institutions. Second, we discuss patterns of arguments that are used by courts to decide politically controversial issues as well as political and institutional factors that stimulate the occurrence of “activists” positions.
Stafford, R S
Nonclinical factors, including the setting in which health care takes place, influence clinical decisions. This research measures the independent effects of organizational and socioeconomic factors on repeat cesarean section use in California. Of 45,425 births to women with previous cesarean sections in 1986, vaginal birth after cesarean section occurred in 10.9%. Sizable nonclinical variations were noted. By hospital ownership, rates ranged from 4.9% (for-profit hospitals) to 29.2% (University of California). Variations also existed by hospital teaching level (nonteaching hospitals, 7.0%, vs formalized teaching hospitals, 23.3%); payment source (private insurance, 8.1%, vs indigent services, 25.2%); and obstetric volume (low-volume hospitals, 5.4%, vs high-volume hospitals, 16.6%). Multiple logistic regression demonstrated that these variables had independent effects after accounting for their overlapping influences and the effects of patient characteristics. The observed variations demonstrate the prominence of nonclinical factors in decision making and question the clinical appropriateness of current practice patterns.
Goldsmith, Tomer; Levy, Amalia; Sheiner, Eyal; Goldsmith, Tomer; Levy, Amalia; Sheiner, Eyal
The present study was aimed to investigate pregnancy outcome of patients with vaginismus, and specifically the relationship between vaginismus and cesarean delivery. A population based study comparing all pregnancies in patients with and without vaginismus was conducted. Patients lacking prenatal care were excluded from the analysis. Deliveries occurred during the years 1988-2007. A multivariate logistic regression model, with backward elimination, was constructed to find independent risk factors associated with vaginismus. During the study period there were 192,954 deliveries, of which 118 occurred in patients with vaginismus. Patients with vaginismus tended to be younger (26.04+/-4.89 vs. 28.61+/-5.83; p vaginismus. Patients with vaginismus had higher rates of infertility treatments (5.9%vs. 2.7%, odds ratio [OR] 2.3; 95% confidence interval [CI] 1.1-4.9; p = 0.04) and labor induction (37.3%vs. 27.4%, OR 1.6; 95% CI 1.1-2.3; p = 0.02), vacuum extraction (9.3%vs. 2.8%, OR 3.6, 95% CI 1.9-6.7; p vaginismus remained as an independent risk factor for cesarean delivery (OR 7.1; 95% CI 4.5-11.1; p Vaginismus is an independent risk factor for cesarean delivery.
Contag, Stephen A
We compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at >or=36 weeks\\' gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess (P = 0.35 and 0.78 for failure of descent and nonreassuring fetal status) or frequencies of pH below 7.0 (P = 0.73 and 0.34 for failure of descent and nonreassuring fetal status) among the three delivery methods. Birth outcomes and umbilical cord blood gas values were similar for those neonates with a forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. The occurrence of significant fetal acidemia was not different among the three delivery methods regardless of the indication.
Alanis, Mark C; Villers, Margaret S; Law, Tameeka L; Steadman, Elizabeth M; Robinson, Christopher J
The objective of the study was to determine predictors of cesarean delivery morbidity associated with massive obesity. This was an institutional review board-approved retrospective study of massively obese women (body mass index, > or = 50 kg/m(2)) undergoing cesarean delivery. Bivariable and multivariable analyses were used to assess the strength of association between wound complication and various predictors. Fifty-eight of 194 patients (30%) had a wound complication. Most (90%) were wound disruptions, and 86% were diagnosed after hospital discharge (median postoperative day, 8.5; interquartile range, 6-12). Subcutaneous drains and smoking, but not labor or ruptured membranes, were independently associated with wound complication after controlling for various confounders. Vertical abdominal incisions were associated with increased operative time, blood loss, and vertical hysterotomy. Women with a body mass index > or = 50 kg/m(2) have a much greater risk for cesarean wound complications than previously reported. Avoidance of subcutaneous drains and increased use of transverse abdominal wall incisions should be considered in massively obese parturients to reduce operative morbidity. Published by Mosby, Inc.
Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian
To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.
Senturk, Mehmet Baki; Cakmak, Yusuf; Atac, Halit; Budak, Mehmet Sukru
Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P0.05). In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of labor should take into consideration the patient’s preference, together with the proper setting. PMID:26203286
Chen, Cheng; Yan, Yan; Gao, Xiao; Xiang, Shiting; He, Qiong; Zeng, Guangyu; Liu, Shiping; Sha, Tingting; Li, Ling
Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother-infant pairs in three communities in Hunan, China. Data about participants' characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant's birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.
Full Text Available Los datos empíricos de juzgados y sistemas judiciales se analizan con mucha frecuencia tanto en estudios comparativos, como en estudios económicos y sociológicos, sin embargo, los agentes implicados en proyectos de reformas judiciales como jueces, profesores de derecho, funcionarios o políticos no hacen un uso adecuado de los mismos. Este artículo sugiere que esto tiene un origen estructural, que asigna roles sociales diferentes a estos actores. Una solución puede ser la creación de centros de investigación especializados. Una aproximación más amplia, plural y democrática es buscar la transparencia en internet, dando acceso al público general a todo tipo de documentos, incluyendo estadísticas judiciales y estudios empíricos. Se han visitado y categorizado en función de su contenido gran número de páginas web de juzgados, para conocer el nivel de transparencia judicial. Las primeras posiciones en cuanto al nivel de transparencia lo han obtenido algunas páginas anglosajonas, que ofrecían información legal, económica, organizacional y empírica, y que además ofrecían ayuda para utilizar estos datos. Sin embargo, este esfuerzo no alcanza su objetivo si la información no se utiliza. Si se quiere medir el uso real de los contenidos de las páginas judiciales no es suficiente con contar su número de visitas, sino que es necesario conocer más sobre las motivaciones que generan esas visitas. Afortunadamente, se ha encontrado un sitio web (mexicano que ofrece información sobre los visitantes: sus preocupaciones, su “historia” e incluso sus nombres y (en ocasiones su lugar de residencia. Estas peticiones se han evaluado cuidadosamente, y se analizan en este artículo. Se ha descubierto que hay una gran demanda de información empírica sobre los juzgados y las prácticas judiciales. La transparencia en internet parece ser una solución, aunque todavía se deben explorar las mejores formas de ofrecer la información judicial
Chen Yi; Xie Chunming; Yang Minling; Feng Duiping; Pang Ningdong; Cui Liping; Cui Jinxi; Liu Wenying
Objective: To assess the clinical value of uterine arterial embolization (UAE) in treating uterine scar pregnancy after cesarean section. Methods: A total of' 35 cases with cesarean scar pregnancy, admitted to authors' hospital during the period from Jan. 2007 to June 2011, were divided into two groups: embolization group (n=21) and non-embolization group (n=14). By using Seldinger technique, UAE was performed via the right femoral access and gelatin sponge particle was used as embolization agent to occlude the uterine artery. In embolization group, sixteen patients received uterine cavity curettage one or two days after UAE, while five patients received laparotomy or perineotomy surgery to remove the lesions after UAE. In non-embolization group, uterine cavity curettage was performed directly in 8 patients, local injection of' methotrexate followed by uterine cavity curettage was carried out in 3 patients, and direct laparotomy to remove the lesions was adopted in the remaining 3 patients. The blood loss during the procedure, the hospitalization days and the time for β-HCG levels falling to normal were documented. The results were compared between the two groups. Results: UAE was successfully accomplished in all the 21 patients of embolization group and the uterus was preserved in all patients. For the embolization group, the mean hospitalization time was (11.5±3.6) days, and the time for β-HCG levels falling to normal was (18.6±4.9) days. For the non-embolization group, the mean hospitalization time was(20.4±5.2)days, and the time for β-HCG levels falling to normal was (28.7±5.6)days. Hysterectomy had to be carried out in two patients of non-embolization group due to the massive bleeding occurred in therapeutic procedures. Conclusion: For the treatment of cesarean scar pregnancy, UAE is very effective and mini-invasive with high success rate. UAE can preserve the patient's reproductive function, and it also plays a significant role in preventing hemorrhage
Yang Kui; Yin Jun; Luo Jun; Jin Xueguang; Liu Zaijie; Liang Yong; Huang Lexiu
Objective: To investigate the clinical characteristics of cesarean section (C-section) complicating with DIC and evaluate the interventional embolization as a treatment of post-C-section hemorrhage. Methods: In total 12 cases of post-C-section massive hemorrhage and DIC were retrospectively studied. Results: Hemostasia was successfully obtained after intervention in all patients. Bleeding was immediately ceased after the procedure in 10 cases out of 12, and bleeding was significantly decreased after intervention, which stop gradually within 3 and 7 days in other 2 cases. Excellent prognosis was arcbieved in all cases. Conclusion: Post-C-section bleeding with DIC is characterized by massive blood loss and progressive deterioration of the patients condition. Interventional embolization provides a quick, thorough, lasting, safe and reliable control of the bleeding, with which uterectomy is able to be avoid. (authors)
Kelly de Souza Barbosa
Full Text Available Separation of powers is one of strongest aspects of contemporary constitutionalism, mostly to rationalize the exercise of state power. In Brazil, the 1988 Constitution provides as entrenchment clause to tripartition of powers. However, there is a change in paradigms, especially at the level of constitutional jurisdiction, through the phenomena of judicialization and judicial activism because the intervention of the Judiciary in the primary functions of other powers. Using deductive and descriptive method, bibliographical and documentary research, we tried to point out the harms that the invasive action of the Judiciary causes to the functional balance between the powers and democracy.
Melamed, Nir; Hadar, Eran; Keidar, Liron; Peled, Yoav; Wiznitzer, Arnon; Yogev, Yariv
objective: To assess the effect of the scheduled gestational age for a repeat planned cesarean section (CS) on the risk for adverse pregnancy outcome in women with two or more previous CS. A retrospective cohort study of all women after ≥2 previous CS who were scheduled for a repeat planned CS. Women were divided into two groups at which the planned CS was scheduled: 38-week group or 39-week group. Overall, 377 were enrolled, 264 (70.0%) and 113 (30.0%) in the 38-week and the 39-week groups, respectively. The rate of an unplanned CS was significantly higher in the 39-week versus the 38-week group (23.0% versus 13.3%, p = 0.02). A repeat planned CS scheduled to week 39 was associated with an increased risk of maternal adverse outcome (31.9% versus 21.6%, p = 0.03). There was no significant difference in the rate of adverse neonatal outcome between the two groups (20.8% versus 23.0%, p = 0.5). The lowest rate of any adverse outcome (maternal and/or neonatal) was observed when CS was scheduled to 38 + 1 weeks of gestation. In women after two cesarean sections, scheduling a planned CS at around 39 weeks compared with at around 38 weeks is associated with an increased risk for maternal adverse outcome with no apparent advantage in terms of neonatal outcome.
International Labour Review, 1982
Presents a selection of summaries of recent judicial decisions in a number of countries concerninq the application of general legal principles to contracts of employment, acquired rights, liability of employers and workers, access to employment, nature of the employment relationship, and more. (Editor/CT)
Klishas, Andrey A.
The paper explores Latin American countries legislation with the view to identify specific features of South American model of judicial review. The research methodology rests on comparative approach to analyzing national constitutions' provisions and experts' interpretations thereof. The constitutional provisions of Brazil, Peru, Mexico, and…
This PhD project explores the possibility of creating a normative way of assessing quality of the judicial organisation by arguing that legitimacy is related to the functioning of the organisation. This further leads to the idea that the judiciary can be held constitutionally accountable for its
Hasian, Marouf, Jr.; Croasmun, Earl
Investigates the possibility that judicial policymaking is responsive to the situational exigencies created in part through public discourse. Investigates the elite and public perspectives regarding the eugenics controversy in the 1920s to explore the emergent relationship between the public and technical spheres of argument. (SR)
... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Stays pending judicial review. 263.41 Section... SYSTEM RULES OF PRACTICE FOR HEARINGS Uniform Rules of Practice and Procedure § 263.41 Stays pending... the effectiveness of all or any part of its order pending a final decision on a petition for review of...
... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Reconsideration; stay pending... COMMISSION RULES OF PRACTICE Appeals to the Commission; Settlements § 10.106 Reconsideration; stay pending... operate to stay the effective date of the Commission's order. (b) Stay pending judicial appeal—(1...
Clark, Karen L.
This paper aims to provide support for post-secondary institutions' exploring and implementing restorative justice in their judicial practices. Although restorative principles have been employed successfully across the globe in criminal proceedings and K-12 education, most colleges and universities have not yet embraced this practice. By exploring…
In every society there is violation which implies its citizen not get proper social right, economical right and cultural right. Proper implementation and adoption of judicial enforcement can reduce this violation rate and established social peace. Step mentioned in the above might not perfect but it might be small starting and ensure social, culture & economical right for the people living in the society.
Dr. Loammi Wolf
The normative quality of pre-conviction equality is therefore much ..... not signal a relationship of subordination typical of an internal executive hierarchy. .... The Judicial Service Commission in South Africa usually consists of ...... he was sighted at an upmarket French restaurant where a lunch party was held to celebrate his.
Marlowe, Douglas B.; Festinger, David S.; Lee, Patricia A.; Dugosh, Karen L.; Benasutti, Kathleen M.
This article reports outcomes from a program of experimental research evaluating the risk principle in drug courts. Prior studies revealed that participants who were high risk and had (a) antisocial personality disorder or (b) a prior history of drug abuse treatment performed better in drug court when scheduled to attend biweekly judicial status…
... procedural, enforceable at law by a party against the Department of Justice, its Seismic Safety Coordinators... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Judicial review. 128-1... Regulations System (Continued) DEPARTMENT OF JUSTICE 1-INTRODUCTION 1.80-Seismic Safety Program § 128-1.8010...
E.A. Ontanu (Elena); M Velicogna (Marco); F. Contini (Francesco)
markdownabstractEfficiency is often considered a key component of any effective justice system, and a crucial drive for economic growth. A growing body of comparative studies explores how judicial reforms leading to a greater efficiency or effectiveness are positively correlated with economic growth
research on specific themes related with judicial reform. 1 Report and ... focused on legal education and law reform; the second, on basic needs legal aid; the third ... realities that brought about the challenges in achievement because the most .... (a) when the judiciary's public reputation for political impartiality and rectitude.
Jorge Baraona González
Full Text Available El presente trabajo se plantea el efecto que tiene una sentencia que se ha pronunciado sobre una separación judicial en la nueva Ley de Matrimonio Civil, de cara a la posibilidad de iniciar, fundado en los mismos hechos, un juicio de divorcio. El autor concluye que la sentencia judicial que decreta la separación tiene un efecto preclusivo sobre la futura acción de divorcio intentada por los mismos hechos. En el artículo se revisa la historia de la de aprobación de las normas y se analiza el panorama en derecho comparado, en países en que existe tanto separación como.This paper examines the effect of a judicial resolution that has accepted the separation, according to the new Ley de Matrimonio Civil, in relation with the possibility to begin a divorce trial in the future, pleading the same facts. The author concludes that the judicial resolution has precluded the divorce action supported in the same facts. The paper offers the approving history of the Act and a comparative law survey, in the countries that have in their marriage law, separation and divorce.
Full Text Available Concerns about gender and racial bias in the survey-based evaluations of judicial performance common in the United States have persisted for decades. Consistent with a large body of basic research in the psychological sciences, recent studies confirm that the results from these JPE surveys are systematically biased against women and minority judges. In this paper, we explain the insidious manner in which performance evaluations may be biased, describe some techniques that may help to reduce expressions of bias in judicial performance evaluation surveys, and discuss the potential problem such biases may pose in other common methods of performance evaluation used in the United States and elsewhere. We conclude by highlighting the potential adverse consequences of judicial performance evaluation programs that rely on biased measurements. Durante décadas ha habido una preocupación por la discriminación por género y racial en las evaluaciones del rendimiento judicial basadas en encuestas, comunes en Estados Unidos. De acuerdo con un gran corpus de investigación básica en las ciencias psicológicas, estudios recientes confirman que los resultados de estas encuestas de evaluación del rendimiento judicial están sistemáticamente sesgados contra las mujeres y los jueces de minorías. En este artículo se explica la manera insidiosa en que las evaluaciones de rendimiento pueden estar sesgadas, se describen algunas técnicas que pueden ayudar a reducir las expresiones de sesgo en los estudios de evaluación del rendimiento judicial, y se debate el problema potencial que estos sesgos pueden plantear en otros métodos comunes de evaluación del rendimiento utilizados en Estados Unidos y otros países. Se concluye destacando las posibles consecuencias adversas de los programas de evaluación del rendimiento judicial que se basan en mediciones sesgadas. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2533937
Full Text Available Gustavo F Gonzales,1–2 Vilma L Tapia,2 Alfredo L Fort,3 Ana Pilar Betran31Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, 2Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru; 3Department of Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandAbstract: A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P < 0.01. The rate of stillbirths was lower with cesarean than vaginal deliveries (P < 0.01. On the other hand, and as expected, the rates for preterm births, twin pregnancies, and preeclampsia were higher in women who delivered by cesarean section (P < 0.01. More importantly, the rate of maternal mortality was 5.5 times higher in the cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes.Keywords: elective cesarean, emergency cesarean, geographical regions, cesarean rates over time, adverse outcomes, developing country
Full Text Available Offer Erez1, Lena Novack2, Vered Kleitman-Meir1, Doron Dukler1, Idit Erez-Weiss3, Francesca Gotsch4, Moshe Mazor11Department of Obstetrics and Gynecology, Soroka University Medical Center, 2Department of Epidemiology, 3Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 4Obstetrics and Gynecology Departement, Policlinico GB Rossi Azienda Ospedaliera Universitaria Integrata Verona, ItalyPurpose: To determine the effects of vaginal birth after cesarean (VBAC versus repeated cesarean sections (RCS after a primary cesarean section (CS, on the rate of intraoperative and postpartum maternal morbidity.Patients and methods: This is a retrospective population-based cohort study. During the study period (1988–2005 there were 200,012 deliveries by 76,985 women at our medical center; 16,365 of them had a primary CS, of which 7429 women delivered a singleton infant after the primary CS, met the inclusion criteria, were included in our study, and were followed for four consecutive deliveries. Patients were divided into three study groups according to the outcome of their consecutive delivery after the primary CS: VBAC (n = 3622, elective CS (n = 1910, or an urgent CS (n = 1897. Survival analysis models were used to investigate the effect of the urgency of CS and the numbers of pregnancy predating the primary CS on peripartum complications.Results: Women who failed a trial of labor had a higher rate of uterine rupture than those who had a VBAC. Patients who delivered by CS had a higher rate of endometritis than those giving birth vaginally. The rate of cesarean hysterectomy and transfer to other departments increased significantly at the fourth consecutive surgery (P = 0.02 and P = 0.003, respectively. VBAC was associated with a 55% reduction in the risk of intrapartum complications in comparison to a planned CS (hazard ratio [HR] 0.45; 95% confidence interval [CI]: 0.22–0.89. A greater
Conclusion: Multiple repeated cesarean sections increase the risks for operative complications and poor perinatal outcomes. Patients must be informed about the related risks of multiple repeated cesarean sections and tubal ligation needs to be encouraged.
Full Text Available This article discusses to what extent and how the European Court of Human Rights (ECtHR has initiated and engaged in domestic judicial reforms. It shows that the judgments of the Strasbourg Court, rather than having effects only with respect to the individual whose rights have been violated, have much deeper structural effects in the design and operation of domestic judicial systems. This article argues that this phenomenon goes rather unnoticed, but it has deep implications for both the developing and developed European democracies. To demonstrate this phenomenon, this article assesses the impact of the ECtHR on three judicial design issues. First, it illustrates how the ECtHR has challenged the role of the advocates general. Second, it explains how the ECtHR has gradually curbed the jurisdiction of military courts both over civilians and over military officers, which has brought these courts to the brink of their abolition. Finally, it outlines how the ECtHR in its judgments regarding the disciplining of judges empowers the judiciary at the expense of other political institutions within the State. Based on the analysis of these three judicial design issues, we conclude that the Strasbourg Court is affecting the internal architecture of domestic judiciaries as it gradually endorses the unification of court administration and changes the power structures within the judiciary.
Gar Yein Ng
Full Text Available This commentary examines the contribution in this edition by Roach Anleu & Mack, based on arguments that reducing judicial performance evaluation (ergo any professional performance to that which is easily measurable removes the human aspect of that performance, and is therefore less accurate. Here, “measurable” is meant as focusing only on the “outward performance”, “interaction with stakeholders” and how judges perform in relation to numbers of cases. Compared to such organisational standards, judicial codes of ethics or other written codes reflect the more traditional values of the judiciary, such as independence and impartiality. This can be seen e.g. in the experiences of the Organisation for Security and Cooperation in Europe in supporting the use of judicial performance standards. The argument in the paper, supported by this commentator, is that such exercises are superficial and more depth is needed to capture the entirety of the judicial experience using the model presented. Este comentario analiza el artículo de Roach Anleu y Mack en este número, en base a los argumentos de que limitar la evaluación del rendimiento judicial (ergo cualquier rendimiento profesional a lo que es fácilmente medible elimina el aspecto humano de ese rendimiento, y es por lo tanto menos preciso. Aquí, por “medible” se entiende lo que está centrado únicamente en el “rendimiento exterior”, la “interacción con los interesados” y el rendimiento de los jueces en relación con el número de casos. En comparación con estas normas de organización, los códigos judiciales de ética u otros códigos escritos reflejan los valores más tradicionales de la judicatura, como la independencia o imparcialidad. Esto puede verse, por ejemplo, en las experiencias de la Organización para la Seguridad y la Cooperación en Europa en apoyar el uso de las normas de rendimiento judicial. El argumento del artículo, apoyado por esta autora, es que estos
... Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT CONTACT WITH PERSONS IN THE COMMUNITY Contact With News Media § 540.61 Authorization. (a) A news media representative... institution. (c) A representative of the news media is requested to provide the Bureau of Prisons an...
Maaløe, Nanna; Bygbjerg, Ib Christian; Onesmo, Rwakyendela
To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice.......To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice....
Turner, Michael J
OBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+\\/-2.6% (n=9337) and 13.8+\\/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+\\/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.
Jeanne M. Marrazzo
Full Text Available Objective: The purpose of this study was to determine whether the proportion of cesarean deliveries in pregnant women with a history of genital herpes and no active lesions at birth is higher than that in women with no history of genital herpes, and to determine whether this risk was modified by birth facilities' underlying prevalence of cesarean delivery.
Verhoeven, Corine J.; van Uytrecht, Cedric T.; Porath, Martina M.; Mol, Ben Willem J.
Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the
Hutton, E.K.; Kornelsen, J.
Background: The proportion of cesarean sections is increasing in Canada overall and in British Columbia in particular. It has been suggested that this increase is partially the result of women requesting the procedure, although the prevalence of patient-initiated elective cesarean section is
To assess obstetricians' perceptions surrounding cesarean delivery rates in Turkey. The present cross-sectional descriptive study was performed between May 1 and June 30, 2016. Practicing obstetricians with contact details known by the researchers and those attending a conference in Turkey were asked to complete a self-administered questionnaire that collected demographic data and information on participants' opinions, beliefs, knowledge, attitudes, and practices related to cesarean delivery. There were 100 obstetricians who responded to the survey. Awareness of high cesarean delivery rates was reported by 96 (96%) participants and 95 (95%) respondents said they were supportive of efforts to reduce it. There were 60 (60%), 83 (83%), and 100 (100%) participants aware of associations between high cesarean delivery rates and increased maternal and infant mortality; increased risk of uterine rupture; and increased risk of placenta previa, placenta accreta, and emergency cesarean hysterectomy, respectively. The most commonly reported reason for high cesarean delivery rates was high compensation costs during medical litigation legal proceedings, reported by all 100 (100%) participants. Participants were generally aware of the risks associated with high cesarean delivery rates. The results suggest that the greatest concern among obstetricians who perform cesarean deliveries was malpractice litigation. © 2017 International Federation of Gynecology and Obstetrics.
Seligman, K; Ramachandran, B; Hegde, P; Riley, E T; El-Sayed, Y Y; Nelson, L M; Butwick, A J
Compared to vaginal delivery, women undergoing cesarean delivery are at increased risk of postpartum hemorrhage. Management approaches may differ between those undergoing prelabor cesarean delivery compared to intrapartum cesarean delivery. We examined surgical interventions, blood component use, and maternal outcomes among those experiencing severe postpartum hemorrhage within the two distinct cesarean delivery cohorts. We performed secondary analyses of data from two cohorts who underwent prelabor cesarean delivery or intrapartum cesarean delivery at a tertiary obstetric center in the United States between 2002 and 2012. Severe postpartum hemorrhage was classified as an estimated blood loss ≥1500mL or receipt of a red blood cell transfusion up to 48h post-cesarean delivery. We examined blood component use, medical and surgical interventions and maternal outcomes. The prelabor cohort comprised 269 women and the intrapartum cohort comprised 278 women. In the prelabor cohort, one third of women received red blood cells intraoperatively or postoperatively, respectively. In the intrapartum cohort, 18% women received red blood cells intraoperatively vs. 44% postoperatively (Pcesarean delivery had the highest rates of morbidity, with 18% requiring hysterectomy and 16% requiring intensive care admission. Our findings provide a snapshot of contemporary transfusion and surgical practices for severe postpartum hemorrhage management during cesarean delivery. To determine optimal transfusion and management practices in this setting, large pragmatic studies are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Background: The relationship between perinatal outcome and anesthetic technique for preterm cesarean sections has not been explored in South Eastern, Nigeria. Objective: The objective of the following study is to evaluate perinatal outcome in preterm cesarean sections conducted under general anesthesia (GA) and ...
Schutte, Joke M.; Steegers, Eric A. P.; Santema, Job G.; Schuitemaker, Nico W. E.; Van Roosmalen, Jos
Background and methods. The cesarean section rate for term singleton breech babies in the Netherlands rose from 57 to 81% after the Term Breech Trial in 2000. The Dutch Maternal Mortality Committee registered and evaluated maternal mortality due to elective cesarean section for breech. Results. Four
Verhoeven, C. J. M.; Oudenaarden, A.; Hermus, M. A. A.; Porath, M. M.; Oei, S. G.; Mol, B. W. J.
Objective Models for the prediction of Cesarean delivery after induction of labor can be used to improve clinical decision-making. The objective of this study was to validate two existing models, published by Peregrine et al. and Rane et al., for the prediction of Cesarean section after induction of
Rietveld, A. L.; Teunissen, P. W.; Kazemier, B. M.; de Groot, C. J. M.
OBJECTIVE: The objective of this study is to investigate the association between interpregnancy interval and success of vaginal birth after cesarean. STUDY DESIGN: Retrospective 10-year cohort study of pregnant women with one prior cesarean, who opted for trial of labor (n = 36 653). Interpregnancy
Gonzales, Gustavo F; Tapia, Vilma L; Fort, Alfredo L; Betran, Ana Pilar
A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P cesarean than vaginal deliveries (P cesarean section (P cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes. PMID:24124393
Lydon-Rochelle, Mona T; Gardella, Carolyn; Cárdenas, Vicky; Easterling, Thomas R
National surveillance estimates reported a troubling 63 percent decline in the rate of vaginal birth after cesarean delivery (VBAC) from 1996 (28.3%) to 2003 (10.6%), with subsequent rising rates of repeat cesarean delivery. The study objective was to examine patterns of documented indications for repeat cesarean delivery in women with and without labor. We conducted a population-based validation study of 19 nonfederal short-stay hospitals in Washington state. Of the 4,541 women who had live births in 2000, 11 percent (n = 493) had repeat cesarean without labor and 3 percent (n = 138) had repeat cesarean with labor. Incidence of medical conditions and pregnancy complications, patterns of documented indications for repeat cesarean delivery, and perioperative complications in relation to repeat cesarean delivery with and without labor were calculated. Of the 493 women who underwent a repeat cesarean delivery without labor, "elective"(36%) and "maternal request"(18%) were the most common indications. Indications for maternal medical conditions (3.0%) were uncommon. Among the 138 women with repeat cesarean delivery with labor, 60.1 percent had failure to progress, 24.6 percent a non-reassuring fetal heart rate, 8.0 percent cephalopelvic disproportion, and 7.2 percent maternal request during labor. Fetal indications were less common (5.8%). Breech, failed vacuum, abruptio placentae, maternal complications, and failed forceps were all indicated less than 5.0 percent. Women's perioperative complications did not vary significantly between women without and with labor. Regardless of a woman's labor status, nearly 10 percent of women with repeat cesarean delivery had no documented indication as to why a cesarean delivery was performed. "Elective" and "maternal request" were common indications among women undergoing repeat cesarean delivery without labor, and nearly 10 percent of women had undocumented indications for repeat cesarean delivery in their medical record
Ana Tereza Lemus Nelson.
Full Text Available In this article the author argues that the scant existence of state agencies equipped to carry out legal actions in Brazil - described by Guillermo O’Donnell as the inoperance of accountability - is attributable to the weakness of the state of law in this country. The implications of a weak state of law for the quality and sustainability of democracy in Brazil are analyzed in two of the most grave cases of judicial impunity: racial discrimination and public security.
Full Text Available Shan-rong Shu, Xin Luo, Zhi-xin Wang, Yu-hong Yao Department of Obstetrics and Gynecology, The First Affiliated Hospital of JiNan University, HuangPu Road West, Guangzhou, People’s Republic of China Abstract: Pregnancy in a cesarean scar is the rarest form of an ectopic pregnancy. The treatment for cesarean scar pregnancy mainly includes systemic methotrexate and uterine artery embolization. Here, we reported a case of cesarean scar pregnancy treated by curettage and aspiration guided by laparoscopy. The treatment plan included two phases. Three days after a combination of methotrexate and mifepristone was administered, the gestational sac was removed under laparoscopy, which enabled a successful treatment for the unruptured ectopic pregnancy in a previous cesarean scar and made it possible to preserve the reproductive capability of the patient. Keywords: cesarean scar pregnancy, laparoscopy, curettage and aspiration
Kozhimannil, Katy Backes; Law, Michael R.; Virnig, Beth A.
Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteen-fold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordination of maternity care, more data collection and measurement, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting. PMID:23459732
... STATES FOR THE EDUCATION OF CHILDREN WITH DISABILITIES Procedural Safeguards Due Process Procedures for Parents and Children Discipline Procedures § 300.535 Referral to and action by law enforcement and... education and disciplinary records of the child are transmitted for consideration by the appropriate...
Defline, A; Obadia, M; El Djerbi, A; Plevy, P; Lepercq, J
The doctor-lawyer perspective that we discuss is a maternal refusal to consent to a cesarean delivery for a fetal indication in June 2011. Despite repeated information of the risks during a three-week hospitalization for pre-eclampsia, after being assured of the proper understanding of the seriousness of the situation by the patient and spouse, and after consideration to transfer to another hospital, the reiterated refusal led to a late fetal extraction resulting in term stillbirth. Copyright © 2013. Published by Elsevier Masson SAS.. All rights reserved.
Qvist, N; Storm, K; Holmskov, A
In a prospective randomized study of 39 consecutive cesarean sections, 20 patients received cimetidine 400 mg intramuscularly as a pre-anesthetic, an 19 control patients were given NaCl. No perinatal effects on the infants were observed by cardiotocography before delivery, and K, Na, pH, PCO2, HC...... with uncomplicated pregnancies, cimetidine was found to cross the placenta at a maternal/cord blood ratio of 3:1. The drug could not be detected in any of the infants 2 hours after delivery....
... litigation or other judicial process. 5.8 Section 5.8 Emergency Management and Assistance FEDERAL EMERGENCY... Provisions § 5.8 Records involved in litigation or other judicial process. Where there is reason to believe that any records requested may be involved in litigation or other judicial process in which the United...
... 25 Indians 1 2010-04-01 2010-04-01 false Flight to avoid prosecution or judicial process. 11.438... OFFENSES AND LAW AND ORDER CODE Criminal Offenses § 11.438 Flight to avoid prosecution or judicial process... Offenses exercises jurisdiction for the purpose of avoiding arrest, prosecution or other judicial process...
... permitting process. A State will meet this standard if State law allows an opportunity for judicial review... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Judicial review of approval or denial... (CONTINUED) WATER PROGRAMS STATE PROGRAM REQUIREMENTS State Program Submissions § 123.30 Judicial review of...
Guise, Jeanne-Marie; Denman, Mary Anna; Emeis, Cathy; Marshall, Nicole; Walker, Miranda; Fu, Rongwei; Janik, Rosalind; Nygren, Peggy; Eden, Karen B; McDonagh, Marian
To systematically review the evidence about maternal and neonatal outcomes relating to vaginal birth after cesarean (VBAC). Relevant studies were identified from multiple searches of MEDLINE, DARE, and the Cochrane databases (1980 to September 2009) and from recent systematic reviews, reference lists, reviews, editorials, Web sites, and experts. Inclusion criteria limited studies to the English-language and human studies conducted in the United States and developed countries specifically evaluating birth after previous cesarean delivery. Studies focusing on high-risk maternal or neonatal conditions, including breech vaginal delivery, or fewer than 10 patients were excluded. Poor-quality studies were not included in analyses. We identified 3,134 citations and reviewed 963 articles for inclusion; 203 articles met the inclusion criteria and were quality rated. Overall rates of maternal harms were low for both trial of labor and elective repeat cesarean delivery. Although rare in both elective repeat cesarean delivery and trial of labor, maternal mortality was significantly increased for elective repeat cesarean delivery at 0.013% compared with 0.004% for trial of labor. The rates of maternal hysterectomy, hemorrhage, and transfusions did not differ significantly between trial of labor and elective repeat cesarean delivery. The rate of uterine rupture for all women with prior cesarean was 0.30%, and the risk was significantly increased for trial of labor (0.47% compared with 0.03% for elective repeat cesarean delivery). Perinatal mortality was also significantly increased for trial of labor (0.13% compared with 0.05% for elective repeat cesarean delivery). Overall the best evidence suggests that VBAC is a reasonable choice for the majority of women. Adverse outcomes were rare for both elective repeat cesarean delivery and trial of labor. Definitive studies are lacking to identify patients who are at greatest risk for adverse outcomes.
Clarke, S C; Taffel, S M
There is wide variation among states in rates of cesarean and vaginal births after cesarean (VBAC) deliveries. In general, states in the South have the highest cesarean rates, states in the West have the lowest, and states in the Northeast and Midwest are intermediate. Louisiana had the highest overall rate in 1993 (27.7 per 100 births) while Alaska had the lowest rate (15.2). The majority of states had declines in their cesarean rate between 1989 and 1993. Patterns in primary cesarean rates are similar to those of the overall rate-states in the South generally have the highest rates while states in the West have the lowest rates. Primary cesarean rates ranged between a high of 19.6 in Louisiana to a low of 10.6 in Wisconsin. In general, states with low cesarean rates have among the highest rates of VBAC delivery. Alaska had the highest VBAC rate (40.0), which was almost quadruple the rate of Louisiana (11.2), the state with the lowest rate. Most states had substantial increases in VBAC rates between 1989 and 1993. When examining cesarean rates by maternal age and birth order, states with the highest overall rates also have among the highest age/birth order-specific rates. Cesarean rates were lowest for mothers under 25 years of age having a second or higher order birth in Alaska, 10.4, and highest for mothers 35 years of age or over having a first birth in Mississippi, 51.3. Standardized cesarean rates which were adjusted for differences between states in maternal age and birth order distributions did not diminish the variation among areas.
In 2011, one in three women who gave birth in the United States did so by cesarean delivery. Cesarean birth can be life-saving for the fetus, the mother, or both in certain cases. However, the rapid increase in cesarean birth rates from 1996 to 2011 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused. Variation in the rates of nulliparous, term, singleton, vertex cesarean births also indicates that clinical practice patterns affect the number of cesarean births performed. The most common indications for primary cesarean delivery include, in order of frequency, labor dystocia, abnormal or indeterminate (formerly, nonreassuring) fetal heart rate tracing, fetal malpresentation, multiple gestation, and suspected fetal macrosomia. Safe reduction of the rate of primary cesarean deliveries will require different approaches for each of these, as well as other, indications. For example, it may be necessary to revisit the definition of labor dystocia because recent data show that contemporary labor progresses at a rate substantially slower than what was historically taught. Additionally, improved and standardized fetal heart rate interpretation and management may have an effect. Increasing women's access to nonmedical interventions during labor, such as continuous labor and delivery support, also has been shown to reduce cesarean birth rates. External cephalic version for breech presentation and a trial of labor for women with twin gestations when the first twin is in cephalic presentation are other of several examples of interventions that can contribute to the safe lowering of the primary cesarean delivery rate.
Kaelin Agten, Andrea; Honart, Anne; Monteagudo, Ana; McClelland, Spencer; Basher, Basmy; Timor-Tritsch, Ilan E
To assess whether cesarean delivery changes the natural position of the uterus. In this retrospective Institutional Review Board-approved cohort study, we conducted a search of our university gynecologic ultrasonography (US) database. Patients with transvaginal US images before and after either vaginal or cesarean delivery between 2012 and 2015 were included. Women with prior cesarean delivery were excluded. Two readers independently measured antepartum and postpartum flexion angles between the longitudinal axis of the uterine body and the cervix. We calculated intraclass correlation coefficients to measure inter-reader agreement. Antepartum and postpartum uterine flexion angles were compared between patients with vaginal and cesarean delivery. We included 173 patients (107 vaginal and 66 cesarean delivery). The mean interval between scans ± SD was 18 ± 10 months. Inter-reader agreement for flexion angles was almost perfect (intraclass correlation coefficients: antepartum, 0.939; postpartum, 0.969; both P cesarean delivery (154.8° ± 45.7°) versus vaginal delivery (145.8° ± 43.7°; P = .216). Mean postpartum flexion angles were higher after cesarean delivery (180.4° ± 51.2°) versus vaginal delivery (152.8° ± 47.7°; P = .001. Differences in antepartum and postpartum flexion angles between cesarean and vaginal delivery were statistically significant (25.6° versus 7.0°; P = .027). Cesarean delivery can change the uterine flexion angle to a more retroflexed position. Therefore, all women with a history of cesarean delivery should undergo a transvaginal US examination before any gynecologic surgery or intrauterine device placement to reduce the possibility of surgical complications. © 2017 by the American Institute of Ultrasound in Medicine.
Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical
Full Text Available This article analyses the main World Trade Organization (WTO agreements: the 1994 GATT agreement and the agreements on the determination of the customs value and customs origin of goods. It also describes the problems involved in granting the direct effect of this external legislation in the Republic of Lithuania from the time of its accession to the WTO in 2001 and entry into the European Union (EU in 2004. The article seeks to answer the question of whether the external WTO legislation should be recognised as legal acts in the national legal system, with the capability for direct application in judicial proceedings. The article also considers whether individual persons can invoke the WTO agreements at a national level (in national courts to protect their legitimate rights and interests in international trade operations. In addition, it includes an analysis of practices followed by judicial authorities in the EU and countries in other regions, including the individual EU member states. The analysis leads to the conclusion that, unlike the case law of the Court of Justice of the European Union, the practices and experience of the Republic of Lithuania are essentially based on the provision that these sources of law could be directly applied at a national level in judicial cases related to the taxation of international trade operations. Analysis of the relevant issues is based on both theoretical (analysis and synthesis, systematic analysis and empirical methods (the statistical analysis of data, the evaluation and textual analysis of documents – in particular, decisions of national courts and the Court of Justice of the European Union (CJEU.
Carey, Hilary M
Interrogations and elections were two branches of Arabic judicial astrology made available in Latin translation to readers in western Europe from the twelfth century. Through an analysis of the theory and practice of interrogations and elections, including the writing of the Jewish astrologer Sahl b. Bishr, this essay considers the extent to which judicial astrology was practiced in the medieval west. Consideration is given to historical examples of interrogations and elections mostly from late medieval English manuscripts. These include the work of John Dunstaple (ca. 1390-1453), the musician and astrologer who is known have served at the court of John, duke of Bedford. On the basis of the relatively small number of surviving historical horoscopes, it is argued that the practice of interrogations and elections lagged behind the theory.
Mario Cajas Sarria
Full Text Available Cass Sustein Unstein es hoy en día uno de los principales expositores de la tesis del minimalismo judicial, metodología de adjudicación que puede ser utilizada por el máximo órgano de control constitucional cuando interpreta la Constitución. En este artículo se exponen las principales características y ventajas de esta metodología, así como una comparación con las otras formas de adjudicación presentes actualmente en el derecho estadounidense. Posteriormente, se analiza el uso dado al minimalismo judicial por la Corte Constitucional de Colombia en el control que ésta realiza a la legislación, prestando especial atención a los argumentos presentados por la Corte para declarar inconstitucional el estatuto antiterrorista del año 2003.
Full Text Available The basics of the judicial regime of Danube navigation, in the moern sens of the term, were inserted in the Peace Treaty in Paris, March 30, 1856, concluded at the end of Crimeea War. This judicial act of international law ended a situation in the area of the large European river where the rules were imposed by the big empires of Austria, Turkey and Russia, according to their interests. The rights and interests of the riverains such as the Romanian states, Serbia, Bulgari etc. were ignored and brutally violated. Until 1919, the European Danube Commission, institution created by the Paris Treaty, has contributed to the modernization of the lower Danube and development of navigation in this sector. This paper aims at clarifying to a certain extent the circumstances of the regulation of navigation during the reference period of time in this naval sector.
Daniela Aurelia Popa
Full Text Available Confronting with numerous problems related to moral judgment, the responsibility and irresponsibility in what concerns the vast domain of communication, we are interested in forming a correct and complete vision that crosses the judicial and deontological domain of the profession. The deontological norms are meant to guarantee, by their freely consented acceptance, the good fulfillment of the mission of the journalists, recognized as being indispensable for the god functioning of any human society. The laws do not expressly refer to the deontological norms, but these norms exist according to the law order and are necessary for its guarantee in this social context, which is chaotic from the point of view of the legislation in communication. The aspects analyzed here aremeant to indicate the manner in which passing from deontological norm to the judicial norm creates an external constraint for the communicator which brings more responsibility in view of avoiding the journalistic conflicts.
Full Text Available Implementation of the 'Checks and balances' principle as one of the milestones in modern democracies, demonstrates its full complexity when it comes to balancing guaranties of judicial independence and the need to prevent misinterpretation or abuse of the rights. Additional issue in that process is determination of the border line between constitutional and guaranties of judicial independence prescribed by law. Raising that issue opens various questions which go beyond the legal framework itself. It actually tackles the historical, political and cultural country background. Furthermore, if analyzed from the prospective of the requirements defined in the accession negotiation process with the EU, constitutional guaranties of (nonapplication of the EU standards might demotivate candidate countries in their efforts to achieve substantial reform results.
Background: Enzymatic wound debridement is an emerging concept in facilitating the wound healing process. Papaya has de-sloughing, antibacterial and wound healing properties. It has been used in African countries since centuries for different medicinal pur-poses. Apart from anecdotal reports and few studies on chronic ulcers and burns, no planned studies are available to support its action in postoperative wound infection.Objectives: To compare efficacy and safety of papaya dressing with conventional wound dressing with povidone iodine in post cesarean section gaped wounds. Setting: Gynecology Unit 3, Sir Ganga Ram Hospital Lahore - Pakistan, over a period of six months(June 2012 to Nov 2012). Study Design: Randomized, quasi experimental stu-dy. Materials and Methods: The study sample included 60 patients with post cesarean section gaped wounds. The sample was divided into two groups; thirty patients as Group A or the study group received Papaya dressing and rest of thirty patients as Group B or the control group received Povidone iodine dressing. Wounds were thoroughly washed with saline and then mashed unripe papaya was spread over the whole area of wound in the study group and povidone iodine in the control group. Wounds were covered with sterile bandage for at least 48 hours in study group and 24 hours in the control group. The process was repeated till a clean base of wound with healthy granulation tis-sue was achieved suitable for secondary suture. The efficacy parameters studied were the duration of time needed to develop healthy granulation tissue and total duration of hospital stay which were compared bet-ween the two groups. Safety factors studied were the adverse effects of medications used in the study. Results: Out of 1200 cesarean sections done during study period, sixty (5%) were gaped in the post-operative period. Out of 60, 55 (90%) were emergency and only 5 (10%) were elective cesarean sections. All the sixty patients with postoperative gaped
The Chicago Bar Association changed the wording of the questions it routinely asks judicial candidates for election and appointment to the bench. Prior to the change, the request for information was so broad that the bar association could learn the candidate's HIV status through a questionnaire that gave the result of the candidate's last physical examination. The new wording better reflects the spirit and intent of the Americans with Disabilities Act (ADA).
Emmanuel Jeuland; Anastasia Sotiropoulou
Communication has recently acquired a central role in the French judicial system. Being an integral part of the management of courts, it is crucial in building the image of justice, as it can affect procedural principles, in particular, the principles of impartiality and of reasonable time. A good image of justice promotes the appearance of efficiency and impartiality. Justice has not only to be fair, but also to be seen as such, according to the well-known proverb.
Full Text Available Communication has recently acquired a central role in the French judicial system. Being an integral part of the management of courts, it is crucial in building the image of justice, as it can affect procedural principles, in particular, the principles of impartiality and of reasonable time. A good image of justice promotes the appearance of efficiency and impartiality. Justice has not only to be fair, but also to be seen as such, according to the well-known proverb.
Abdulfatai O. Sambo; Hunud Abia Kadouf
The contemporary Arab world has witnessed uprisings and turmoil as a result of alleged power-overreaching by political elites. Consequently, people call for democracy with emphasis on constitutionalism, accountability and protection of human rights. Yet, the voice of the judiciary seems not to be heard in championing these values in many Muslim nations despite the clear roles Islam places on the judiciary regarding political matters. This paper therefore analyses the power of judicial review ...
Rafael Fernando dos Santos; Angelina Cortelazzi Bolzam
This article was elaborated in order to analyze issues relating to the judicialization of cases involving health, understanding health as a public policy aimed at to guarantee the fundamental right to it linked, that is, the concept of health that the authos intended to work is not far from that contained in the combined reading of Articles 6 and 196 of the Constitution, consecrators to be the health, universal right and duty of the state, guaranteed through social and economic policies aimed...
Alexandre Pedro Moura D’Almeida
Full Text Available The judiciary has excelled in the international and national scene, reaching role of great importance, thus creating opposition to the legislative and executive powers. The center of gravity of the sovereign power of the state moves toward the judiciary, that happens to have a more active role and controlling of the others powers, but also appears as a great defender of social and fundamental rights causes, seeking to make an effective constitution. Its great public notoriety has attracted great distrust of various sectors of society, especially by the two powers that have an increasing interference. Arises, therefore, a speech that the judiciary would be reversing into a big and uncontrollable power, increasing the suspicion that now it would be living in a real dictatorship of the judiciary through judicial activism. There is a growing concern with the expansion of activism and the role of the judiciary. The purpose of this work is to conceptualize and approach the judicial activism and the state of exception to search and reveal if there is any similarity, to then draw up a possible answer to the concern of forming a dictatorship of the judiciary. The state of exception is one of the rule of law paradoxes, while activism is a political manifestation of the judiciary. The similarity between the institutes appears as appalling in a dynamic expansion of political power of a state institution exercising judicial function, putting in check who would be the sovereign in a rule of law and democratic state.
... BACKGROUND CHECKS Private Security Officer Employment § 105.25 Authorized employer's responsibilities. An authorized employer is responsible for: (a) Executing and providing to the appropriate state agency the... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Authorized employer's responsibilities...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Delegation of authority. 804.2 Section... COLUMBIA ACCEPTANCE OF GIFTS § 804.2 Delegation of authority. The Director of CSOSA hereby delegates to the... train defendants in accordance with the requirements of this part. This delegation of authority may not...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Authority to conduct autopsies. 549.80... MEDICAL SERVICES Authority To Conduct Autopsies § 549.80 Authority to conduct autopsies. (a) The Warden may order an autopsy and related scientific or medical tests to be performed on the body of a deceased...
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Authority to approve a marriage. 551.11... MISCELLANEOUS Marriages of Inmates § 551.11 Authority to approve a marriage. (a) The Warden may approve the marriage of a federal inmate confined in a federal institution. This authority may not be delegated below...
Haas, David M; Morgan, Sarah; Contreras, Karenrose
Cesarean delivery is one of the most common surgical procedures performed by obstetricians. Infectious morbidity after cesarean delivery can have a tremendous impact on the postpartum woman's return to normal function and her ability to care for her baby. Despite the widespread use of prophylactic antibiotics, postoperative infectious morbidity still complicates cesarean deliveries. To determine if cleansing the vagina with an antiseptic solution before a cesarean delivery decreases the risk of maternal infectious morbidities, including endometritis and wound complications. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 July 2014). We included randomized and quasi-randomized trials assessing the impact of vaginal cleansing immediately before cesarean delivery with any type of antiseptic solution versus a placebo solution/standard of care on post-cesarean infectious morbidity. We independently assessed eligibility and quality of the studies. Five trials randomizing 1946 women (1766 analyzed) evaluated the effects of vaginal cleansing (all with povidone-iodine) on post-cesarean infectious morbidity. The risk of bias was generally low, with the quality of most of the studies being high. Vaginal preparation immediately before cesarean delivery significantly reduced the incidence of post-cesarean endometritis from 7.2% in control groups to 3.6% in vaginal cleansing groups (average risk ratio (RR) 0.39, 95% confidence interval (CI) 0.16 to 0.97, five trials, 1766 women). The risk reduction was particularly strong for women with ruptured membranes (1.4% in the vaginal cleansing group versus 15.4% in the control group; RR 0.13, 95% CI 0.02 to 0.66, two trials, 148 women). No other outcomes realized statistically significant differences between the vaginal cleansing and control groups. No adverse effects were reported with the povidone-iodine vaginal cleansing.The quality of the evidence using GRADE was low for post-cesarean endometritis
Chu, J Y; Zhang, L; Zhang, Y J; Yang, M J; Li, X W; Sun, L L
Objective: To evaluate the effect of breast massage at different time in the early period on maternal lactation after cesarean section. Methods: 80 women delivered by cesarean section were randomly selected from maternity ward of a hospital in Shandong province during Jan. 2013 to Jan. 2015; which were divided into four groups, with 20 patients in each. Three groups received 3 times of breast massage every 24 hoursbeginning from 2, 12 and 24 h after cesarean section, respectively. The control group didn't receive any breast massage. The starting time and status of lactation were observed and recorded after cesarean section. 5 ml venous blood sample was drawn from each patient respectively at 2 h before cesarean, 6, 12, 24, 48 and 72 h after cesarean to test the level of serum prolactin. The lactation status of each group was compared. Results: The P (50) ( P (25)- P (75)) of starting time of lactation of the three massage groups and control group were 3 (2-6) h, 4 (2-8) h, 4 (3-12) h and 4 (2-12) h, respectively, whose differences showed no statistical significance ( H =3.32, P= 0.345).The number of delivered women with adequate lactation 24 hours after cesarean was 10 in the group who received massage beginning from 2 h after cesarean; while the number was only 2 in the control group. The number of delivered women with adequate lactation 48 hours after cesarean was 18 in the group who received massage beginning from 2 h after cesarean; while the number was 8 in the control group. The differences showed statistical significances ( P values were 0.021 and 0.008, respectively). The serum prolactin level in the group of delivered women who received massage from 2 h after cesarean was separately (195.9±78.5), (176.0±96.5), (216.4±110.0), (190.0±56.8) and (184.8±69.6) μg/L at 2, 12, 24, 48 and 72 h after cesarean, which were significantly higher than those in the control group (which were (128.8±40.6), (127.3±66.8), (162.2±58.8), (145.1±64.7) and (141.7±49
Full Text Available This article identifies the main variables that explain judicial corruption in Chile, Peru, and Ecuador. Improving the current methodological strategies used to measure judicial corruption and incorporating endogenous and exogenous variables in the model, this article argues that legal training of the judges, respect for the judicial career, and the fragmentation of political power explain different degrees of judicial corruption. Through a comparative diachronic and synchronic research design of Chile, Peru and Ecuador, the article shows institutional designs with more legal steps will be more inclined to illegal payments or other types of judicial corruption.
Estefania Maria de Queiroz Barboza
Full Text Available Resumo: No presente artigo examinaram-se as origens históricas do judicial review nos Estados Unidos da América desde o caso Marbury v. Madison até a Corte Burger, bem como os reflexos de sua concepção no chamado “ativismo judicial” norte-americano, o qual acabou por priorizar o papel da jurisdição constitucional na proteção dos direitos fundamentais garantidos na Constituição, mesmo que isso implicasse enfrentar questões tipicamente políticas. Ou seja, apresentaram-se casos nos quais a Suprema Corte atuou de forma ativista especialmente na proteção de direitos fundamentais, embora em outros momentos tenha atuado justamente no sentido contrário, como na Era Lochner, numa postura conservadora em relação à proteção de direitos. Palavras-chave: Ativismo judicial. Suprema Corte. Estados Unidos. Judicial Review.
Kabiri, Doron; Elram, Tamar; Aboo-Dia, Mushira; Elami-Suzin, Matan; Elchalal, Uriel; Ezra, Yossef
To estimate the association between time of delivery after external cephalic version at term and the risk for cesarean delivery. This retrospective cohort study included all successful external cephalic versions performed in a tertiary center between January 1997 and January 2010. Stepwise logistic regression was used to calculate the odds ratio (OR) for cesarean delivery. We included 483 external cephalic versions in this study, representing 53.1% of all external cephalic version attempts. The incidence of cesarean delivery for 139 women (29%) who gave birth less than 96 hours from external cephalic version was 16.5%; for 344 women (71%) who gave birth greater than 96 hours from external cephalic version, the incidence of cesarean delivery was 7.8% (P = .004). The adjusted OR for cesarean delivery was 2.541 (95% confidence interval 1.36-4.72). When stratified by parity, the risk for cesarean delivery when delivery occurred less than 96 hours after external cephalic version was 2.97 and 2.28 for nulliparous and multiparous women, respectively. Delivery at less than 96 hours after successful external cephalic version was associated with an increased risk for cesarean delivery. III.
Kisa, Sezer; Zeyneloğlu, Simge
This study was conducted, in order to determine the opinions of women who had a cesarean delivery and the problems that they faced in the postpartum period. This descriptive study was conducted with 337 women who delivered babies by cesarean section. The data were collected using a semi-structured questionnaire. The results of the study showed that 53.4% of women underwent cesarean delivery for the first time, and 83.1% said that it was the obstetrician's decision to have a cesarean delivery. More than half of the women (61.1%) had a negative experience with cesarean delivery due to postpartum pain (44.7%) and inability to care for their infant (35.9%). The most common problems associated with cesarean delivery were postpartum pain (96.1%), back pain (68.2%), problems passing gas (62.0%), bleeding (56.1%), breastfeeding problems (49.6%) and limitation of movement (43.6%) respectively. Understanding the the opinions and problems of women towards cesarean delivery assists healthcare professionals in identifying better ways to provide appropriate care and support. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Objective: To explore and analyze the indications and causes of cesarean section on Pemba island of Zanzibar in Africa to improve the quality of obstetrics. Methods: 564 patients performed cesarean section in Abdulla Mzee Hospital of Pemba from January, 2008 to December, 2011 were selected, and statistics was conducted by the method of retrospective analysis. Results: The rate of cesarean section in Abdulla Mzee Hospital of Pemba was 10.01%. The primary causes of cesarean section included cephalopelvic disproportion (27.13%, scar uterus (23.40%, preeclampsia and eclampsia (13.30%, fetal distress in uterus (9.40%, fetal factors (9.75% and complication of pregnancy (6.91%. Conclusion: Cesarean section plays a great role in the treatment of dystocia, some complications of pregnancy and reducing the mortality of pregnant women and perinatal infants, but in the area with relatively undeveloped medical conditions in Africa, cesarean section still takes great risks. Unnecessary cesarean section cannot reduce the incidence of postpartum hemorrhage and neonatal morbidity. The local medical staff should improve the midwifery technique, establish and perfect the formal antenatal examination system to improve the quality of maternity.
Soltsman, Sofia; Perlitz, Yuri; Ben Ami, Moshe; Ben Shlomo, Izhar
The cornerstone of concerns over trial of labor after cesarean (TOLAC) is the risk of uterine rupture. The purpose of this study was to document the rate of uterine rupture during TOLAC and to delineate its severity and consequences. We retrospectively collected the data on vaginal and cesarean deliveries after a previous cesarean section with specific emphasis on uterine rupture and dehiscence in our center from 2006 through 2013. 22,670 deliveries were registered, with 18.2% rate of cesarean section. 2890 women had a single cesarean scar; of them 1206 delivered vaginally and 194 were re-operated during unsuccessful TOLAC. Seven cases of uterine rupture and 16 cases of dehiscence were recorded. There were no maternal, intrapartum or neonatal deaths, and no cesarean hysterectomy. There was one re-laparotomy, one ICU admission, and one blood transfusion; one neonate was admitted to NICU. TOLAC was successful in 86.1% of cases. Cautious selection and close monitoring of candidates are the cornerstones of successful management of TOLAC. Readily available facilities for emergency cesarean delivery and concerted obstetrical team can save the mother and child from catastrophic complications.
Objectives. I examined the relationship between insurance coverage, which may influence physician incentives and maternal choices, and cesarean delivery before labor. Methods. I analyzed hospital discharge data for mothers without previous cesarean deliveries in New Jersey between 2004 and 2007, with adjustment for maternal age, race, marital status, and maternal, fetal, and placental conditions. Results. Nearly 1 in 7 women (13.9%) had a cesarean delivery without laboring. Insurance status was strongly associated with cesarean birth. Women insured by Medicaid (adjusted relative risk [ARR] = 0.88; 95% confidence interval [CI] = 0.84, 0.91) or self-paying (ARR = 0.81; 95% CI = 0.78, 0.85) had a significantly lower likelihood, and women insured by BlueCross (ARR = 1.06; 95% CI = 1.03, 1.09) or standard commercial plans (ARR = 1.06; 95% CI = 1.02, 1.10) had a significantly higher likelihood of cesarean delivery than did women insured by commercial health maintenance organizations. These associations persisted in subsets restricted to lower-risk women and in qualitative sensitivity analyses for a hypothetical single, binary, unmeasured confounder. Conclusions. Insurance status has a small, independent impact on whether a woman without a previous cesarean delivery proceeds to labor or has a cesarean delivery without labor. PMID:21940911
Gonzalez Fiol, A; Meng, M-L; Danhakl, V; Kim, M; Miller, R; Smiley, R
Knowledge of hospital-specific average cesarean delivery operative times, and factors influencing length of surgery, can serve as a guide for anesthesiologists when choosing the optimal anesthetic technique. The aim of this study was to determine operative times and the factors influencing those times for cesarean delivery. We conducted a retrospective review of all 1348 cesarean deliveries performed at an academic hospital in 2011. The primary outcome was mean operative time for first, second, third and fourth or more cesarean deliveries. The secondary goal was to identify factors influencing operative time. Variables included age, body mass index, previous surgery, gestational age, urgency of cesarean delivery, anesthesia type, surgeon's seniority, layers closed, and performance of tubal ligation. Mean (standard deviation) operative times for first (n=857), second (n=353), third (n=108) and fourth or more (n=30) cesarean deliveries were 56 (19), 60 (19), 69 (28) and 82 (31) minutes, respectively (P cesarean delivery or the presence of other factors that could increase operative time may warrant catheter-based anesthetic techniques or the addition of adjunctive medications to prolong spinal anesthetic block. Institutional and individual surgeon factors may play an even more important role in determining surgical time. Copyright © 2018 Elsevier Ltd. All rights reserved.
Krispin, Eyal; Hiersch, Liran; Wilk Goldsher, Yulia; Wiznitzer, Arnon; Yogev, Yariv; Ashwal, Eran
To estimate the effect of prior successful vaginal birth after cesarean (VBAC) on the rate of uterine rupture and delivery outcome in women undergoing labor after cesarean. A retrospective cohort study of all women attempting labor after cesarean delivery in a university-affiliated tertiary-hospital (2007-2014) was conducted. Study group included women attempting vaginal delivery with a history of cesarean delivery and at least one prior VBAC. Control group included women attempting first vaginal delivery following cesarean delivery. Primary outcome was defined as the rate of uterine rupture. Secondary outcomes were delivery and maternal outcomes. Of 62,463 deliveries during the study period, 3256 met inclusion criteria. One thousand two hundred and eleven women had VBAC prior to the index labor and 2045 underwent their first labor after cesarean. Women in the study group had a significantly lower rate of uterine rupture 9 (0.7%) in respect to control 33 (1.6%), p = .036, and had a higher rate of successful vaginal birth (96 vs. 84.9%, p cesarean, prior VBAC appears to be associated with lower rate of uterine rupture and higher rate of successful vaginal birth.
In this contribution the author develops an argumentation model for the reconstruction of weighing and balancing on the basis of teleological-evaluative considerations. The model is intended as a heuristic and critical tool for the rational reconstruction of the justification of judicial decisions.
Hehir, Mark P; Ananth, Cande V; Siddiq, Zainab; Flood, Karen; Friedman, Alexander M; D'Alton, Mary E
Cesarean delivery has increased steadily in the United States over recent decades with significant downstream health consequences. The World Health Organization has endorsed the Robson Ten Group Classification System (TGCS) as a global standard to facilitate analysis and comparison of cesarean delivery rates. Our objective was to apply the TGCS to a nationwide cohort in the United States over a 10-year period. This population-based analysis applied the TGCS to all births in the United States from 2005-2014, recorded in the 2003-revised birth certificate format. Over the study 10-year period 27,044,217 deliveries met inclusion criteria. Five parameters (parity including previous cesarean, gestational age, labor onset, fetal presentation and plurality), identifiable on presentation for delivery, were used to classify all women included into one of ten groups. The overall cesarean rate was 31.6%. Group 3 births (singleton, term, cephalic multiparas in spontaneous labor) were most common, while Group 5 births (those with a previous cesarean) accounted for the most cesarean deliveries increasing from 27% of all cesareans in 2005-06 to over 34% in 2013-14. Breech pregnancies (Groups 6 and 7) had cesarean rates above 90%. Primiparous and multiparous women who had a prelabor cesarean [Groups 2(b) and 4(b)] accounted for over one quarter of all cesarean deliveries. Women with a previous cesarean delivery represent an increasing proportion of cesarean deliveries. Use of the Robson criteria allows standardised comparisons of data and identifies clinical scenarios driving changes in cesarean rates. Hospitals and health organisations can use the TGCS to evaluate quality and processes associated with cesarean delivery. Copyright © 2018 Elsevier Inc. All rights reserved.
Saleh, Ahmed M; Dudenhausen, Joachim W; Ahmed, Badreldeen
Rates of cesarean sections have been on the rise over the past three decades all over the world, despite the ideal rate of 10-15% that had been set by the World Health Organization (WHO) in 1985, in Fortaleza, Brazil. This epidemic increase in the rate of cesarean delivery is due to many factors which include, cesarean delivery on request, advanced maternal age at first pregnancy, decrease in number of patients who are willing to try vaginal birth after cesarean delivery, virtual disappearance of vaginal breech delivery, perceived increase in the weight of the fetus and increase in the number of women with chronic medical conditions such as Diabetes Mellitus and congenital heart disease in the reproductive age. There is no doubt that cesarean delivery is a safe procedure and it is getting safer and safer for many reasons. However, like all other surgical procedures it is not without risks both to the mother and the new born. There is a substantial increase in the incidence of morbidly adherent placenta and the risk of scar pregnancy. In the Middle East and many African and Asian countries women tend to have large families. The number of previous cesarean section deliveries is directly proportional to the risk of developing morbidly adherent placenta. Morbidly adherent placenta is the most common cause of emergency postpartum hysterectomy, which is often associated with multiple surgical complications, severe maternal morbidity and mortality. The increased rates of cesarean sections lead to increased rates of scar pregnancies, which can have lethal consequences. Cesarean delivery has a negative impact on the infant immune system. This effect on the infant led to the introduction of a new concept called "Vaginal seeding". This refers to the practice of transferring some maternal vaginal fluid to the infant born via cesarean section in an effort to enhance its immune system.
Currently, prophylactic elective cesarean to prevent incontinence is being promoted without robust evidence supporting it, this has created confusion among health personnel [corrected]. Past research centered on defining the damaging effect of vaginal birth on continence whilst the limited research on elective cesarean considered it protective. Cesarean delivery has economic, obstetric, gynecological and psychosocial consequences, but incontinence is not uncommon with a persistent morbidity. There is confusion among health personnel about advocating elective cesarean delivery to prevent incontinence. Reviewing current research would facilitate obstetric thinking. Multiplanar endosonography and three-dimensional magnetic resonance imaging scanning are reportedly better in delineating structural alterations in the continence mechanism following vaginal birth and could be applied to postcesarean incontinence. Incontinence can follow vaginal or elective cesarean delivery and the severity following either mode is comparable. Urinary incontinence can resolve, persist or start de novo and the primiparous prevalence is similar following cesarean or vaginal birth. Transient anal incontinence can manifest during pregnancy. Paradoxically, pelvic floor strengthening exercises are beneficial for pregnancy-related incontinence, yet urinary incontinence occurs in nulliparas notwithstanding a strong pelvic floor. Improved imaging techniques should promote a better understanding of postcesarean incontinence. Since severe incontinence can occur after elective cesarean, its reportedly preventative role deserves more scrutiny. When incontinence occurs without labor, it is transient or shows exercise-related improvement; the role of elective cesarean delivery seems tenuous and needs careful evaluation. Current evidence does not support the routine use of elective cesarean to prevent incontinence so the delivery mode should continue to be dictated by obstetric considerations.
Kjerulff, Kristen H; Attanasio, Laura B; Edmonds, Joyce K; Kozhimannil, Katy B; Repke, John T
Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. A prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted. We used nested logistic regression models and multiple mediational analyses to investigate the role of three groups of variables in explaining the association between labor induction and unplanned cesarean delivery-the confounders of maternal characteristics and indications for induction, and the mediating (intrapartum) factors-including cervical dilatation, labor augmentation, epidural analgesia, dysfunctional labor, dystocia, fetal intolerance of labor, and maternal request of cesarean during labor. More than a third of the women were induced (34.3%) and 24.8% underwent cesarean delivery. Induced women were more likely to deliver by cesarean (35.9%) than women in spontaneous labor (18.9%), unadjusted OR 2.35 (95% CI 1.97-2.79). The intrapartum factors significantly mediated the association between labor induction and cesarean delivery (explaining 76.7% of this association), particularly cervical dilatation <3 cm at hospital admission, fetal intolerance of labor, and dystocia. The indications for labor induction only explained 6.2%. Increased risk of cesarean delivery after labor induction among nulliparous women is attributable mainly to lower cervical dilatation at hospital admission and higher rates of labor complications. © 2017 Wiley Periodicals, Inc.
Li, Xiaoxi; Duan, Hongjun; Zuo, Mingzhang
Dwarfism is characterized by short stature. Pregnancy in women with dwarfism is uncommon and cesarean section is generally indicated for delivery. Patients with dwarfism are high-risk population for both general and regional anesthesia, let alone in an emergency surgery. In this case report we present a 27-year-old Chinese puerpera with dwarfism who underwent emergency cesarean section under combined spinal and epidural anesthesia. It is an original case report, which provides instructive significance for anesthesia management especially combined spinal and epidural anesthesia in this rare condition. There was only one former article that reported a puerpera who underwent combined spinal and epidural anesthesia for a selective cesarean section.
Salman, Lina; Aharony, Shachar; Shmueli, Anat; Wiznitzer, Arnon; Chen, Rony; Gabbay-Benziv, Rinat
Urinary bladder injury is a rare complication during cesarean delivery. Little is known on maternal outcome following this injury. To evaluate short and long-term maternal outcome following bladder injury during cesarean delivery. A retrospective case series of all pregnancies complicated by full-thickness bladder injury during cesarean delivery in a single university affiliated tertiary medical center (August 2007-June 2016). Data on demographics, labor and surgery parameters, postpartum sequelae, and cystography were collected and reviewed by study personnel. Short-term maternal outcome included catheterization period, cystography results (if performed), any febrile illness and/or need for second operation prior to maternal discharge. Long term maternal outcome was obtained by searching our urology departmental and ambulatory database for follow up for all women. Univariate analysis was used to compare maternal outcome following first or repeat cesarean delivery. Of 17,326 cesarean deliveries performed during study period, 81 (0.47%) were complicated by bladder injury. Of them, 8 cases (9.9%) occurred during primary cesarean delivery (overall risk in primary cesarean 0.07%). Of the other 73 cases that followed repeated cesarean, adhesions were documented in 55 (75.3%) of them. Six cases (8.2%) had placenta accreta. Bladder injury occurred at peritoneal entry in 55 (67.9%) cases, and involved the bladder dome in 49 (60.5%) of them. Injury was diagnosed during cesarean delivery in all but 3 women, in whom abdominal pain and bloating prompted evaluation on first to third postoperative day. All 3 underwent re-laparotomy with bladder closure without further adverse sequelae. Cystography was performed in 35 patients on median postoperative day 8 (6-11 days). Eleven patients had abnormal findings as follows: 5 urinary leakage, 4 bladder wall irregularity and two urinary reflux. Two of the 11 patients (18%) required additional interventions: One patient required
Gu Weijin; Wang Haiyun; Wan Jun; Zhang Lei; Wang Ying; Wang Wei; Ji Fang; Ji Lihua
Objective: To investigate the effective dose of methotrexate (MTX) via intra-arterial infusion for the treatment of cesarean scar pregnancy. Methods: Thirty-six cases of incisional scar pregnancy at the gestational age of 5-9 weeks received bilateral uterine arterial infusion of MTX. According to the dose of MTX used, the patients were randomly and equally divided into four groups with MTX dose of 60, 100, 150 and 200 mg respectively. After the perfusion was completed the embolization of both uterine arteries with Gelfoam was carried out until the uterine arteries were no longer visualized on DSA. Uterine curettage was conducted within 1-7 days after the treatment. Results: In one week after the procedure, the difference in the decreasing rate of serum β-HCG and progesterone between group 60 mg and group 200 mg was of statistical significance (P 0.05). The hospitalization days of group 60 mg was the longest, while that of group 200 mg was the shortest. Conclusion: The recommended dose of MTX used via intra-arterial infusion in treating cesarean scar pregnancy is 200 mg. The interventional procedure can kill the embryo tissue and quickly lower the serum β-HCG and progesterone levels,it can also shorten the patient's hospitalization time. (authors)
Trajetória da revisão judicial no desenho constitucional brasileiro: tutela, autonomia e judicialização The trajectory of judicial review in the brazilian constitutional design: tutelage, autonomy and judicialization
Full Text Available As instituições judiciárias ficaram por muito tempo na sombra dos fenômenos e da teoria política estudadas na América Latina. Neste texto trago algumas reflexões em torno de uma dessas instituições, a revisão judicial. A ideia central é demonstrar a trajetória deste instrumento jurídico que se tornou uma peça chave no entendimento da judicialização da política no Brasil. Neste sentido, tentaremos mapear os fatores que potencializam a judicialização da política tomando como pano de fundo a evolução das instituições judiciais brasileiras no período republicano, especificamente as instituições responsáveis pela revisão judicial.The judicial institutions remained for a long time in the shadow of the political phenomena and theory in Latin America. This article presents some thoughts on one of these institutions, the judicial review. The main idea is to demonstrate the trajectory of this legal instrument that has become a key piece to understand the judicialization of politics in Brazil. In this sense, the paper tries to identify the factors that lead to the judicialization of politics, considering as background the evolution of the judicial institutions in Brazil during the republican period, and in particular the institutions responsible for the judicial review.
Kristensen, Kim; Henriksen, Lonny
colitis and celiac disease, whereas children delivered by elective CS had an increased risk of lower respiratory tract infection and juvenile idiopathic arthritis. The effect of elective CS was higher than the effect of acute CS on the risk of asthma. CONCLUSION: Children delivered by CS are at increased......BACKGROUND: Earlier studies have shown that delivery by cesarean section (CS) is associated with an increased risk of disease associated with immune function in the offspring, but these studies have generally not discriminated between the effect of acute and elective CS. OBJECTIVE: We sought...... to further explore these associations using discrimination between the effects of acute versus elective CS. METHODS: We performed a population- and national register-based cohort study including all children born in Denmark from January 1997 through December 2012. Hazard ratios for diseases associated...
Mehryar Taghavi Gilani
Full Text Available Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.
Gilani, Mehryar Taghavi; Zirak, Nahid; Razavi, Majid
Magnesium sulfate is used frequently in the operation room and risks of wrong injection should be considered. A woman with history of pseudocholinesterase enzyme deficiency in the previous surgery was referred for cesarean operation. Magnesium sulfate of 700 mg (3.5 ml of 20% solution) was accidentally administered in the subarachnoid space. First, the patient had warm sensation and cutaneous anesthesia, but due to deep tissue pain, general anesthesia was induced by thiopental and atracurium. After the surgery, muscle relaxation and lethargy remained. At 8-10 h later, muscle strength improved and train of four (TOF) reached over 0.85, and then the endotracheal tube was removed. The patient was evaluated during the hospital stay and on the anesthesia clinic. No neurological symptoms, headache or backache were reported. Due to availability of magnesium sulfate, we should be careful for inadvertent intravenous, spinal and epidural injection; therefore before injection must be double checked.
Fornet, I; Morillas, P; López, M A; Palacio, F J; Aguilar, J M; Mesa, J L
Coffin-Siris syndrome is a rare genetic disease characterized by coarse facial features, sparse scalp hair, hirsutism, hypoplasia of the distal phalanges, hypoplastic nail in the fifth digit, and mental retardation and delayed growth evident in both weight and height. Most cases are sporadic, but the possibility of recessive or dominant autosomal inheritance has been suggested. Facial abnormalities that make intubation difficult and mental retardation that interferes with cooperation are aspects of this disease that can affect the choice of type of anesthesia. We report the case of a parturient with Coffin-Siris syndrome who refused epidural analgesia for labor pain and for whom the obstetrician later decided that an emergency cesarean was necessary due to fetal distress.
Gianluca Raffaello Damiani
Full Text Available A careful management of hepatic capsular rupture, with massive hemoperitoneum which occurred 14 hours after an emergency cesarean section at 36 weeks of gestation, is meticulously reported. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 53 days and 4 laparotomies and an unsuccessful attempt of superselective artery embolization. Ultrasound after 40 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we believe necessary to report our experience, reinforcing the importance of the postsurgery management.
Full Text Available Pheochromocytoma (PCC is a rare cause of hypertension during pregnancy [1:54000 pregnancies]. Fetomaternal morbidity and mortality is about 58% if the diagnosis is missed. Administration of anesthesia to patients with PCC is challenging. Associated pregnancy adds to the problems. This is a case report of a patient having PCC diagnosed at 26 weeks of gestation. With medical management pregnancy was continued till 34 weeks. She was posted for cesarean section and resection of PCC. Patient underwent surgery lasting for 7 h due to inferior vena cava tear and had stormy intra as well as postoperative course. Mother and baby had uneventful recovery due to continuous invasive monitoring and a good teamwork, despite limited anesthetic resources.
Fabbri, Daniele; Monfardini, Chiara; Castaldini, Ilaria; Protonotari, Adalgisa
Physicians are often alleged responsible for the manipulation of delivery timing. We investigate this issue in a setting that negates the influence of financial incentives on physician's behavior. Working on a sample of women admitted at the onset of labor in a big public hospital in Italy we estimate a model for the exact time of delivery as driven by individual Indication to Cesarean Section (ICS) and covariates. We find that ICS does not affect the day of delivery but leads to a circadian rhythm in the likelihood of delivery. The pattern is consistent with the postponement of high ICS deliveries in the late night\\early morning shift. Our evidence hardly supports the manipulation of timing of births as driven by medical staff's "demand for leisure". Physicians seem to manipulate the exact timing of delivery to reduce exposure to risk factors extant during off-peak periods. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Luisa Fernanda García López
Full Text Available The constitutionalization of law in Colombia is due to an active participation of the judge, in particular, of the constitutional judge. The judicial precedent source of law is an example of the inclusion of the judge on the constitutional stage as guarantor of democracy and law. The democratic ideal irreversibly includes the constitutional judge and his interpretations. The overinterpretation of law answers to a broad interpretation of the Constitution and to a building of norms that contribute something to fill the gaps in the law. Thus eoconstitutionalism is constitutionalizing the juridical order.
The intersection of law and science, particularly in relation to causality and the legal concept of causation, were of considerable interest to Sir Owen Dixon. In this article, revisiting Dixon's 1933 lecture "Science and Judicial Proceedings", the Chief Justice refers to Dixon's deep interest in science and the issues to which it can give rise in legal proceedings. The 1933 lecture followed shortly after the judgment of the High Court in Australian Knitting Mills Ltd v Grant (1933) 50 CLR 387 which involved consideration of expert testimony and causal connections between product characteristics and personal injury to the consumer.
Full Text Available BACKGROUND: The advances in surgical techniques and immunosuppression have improved results in organ transplantation which enabled pregnancies following the return of good health and normal endocrine function. Reports about the anesthetic management of renal transplant recipient (RTR during cesarean section (C/S were not found in the literature. The aim of this study is to present our experience in RTRs during C/S. MATERIALS-METHODS: Retrospect ive data regarding RTRs who underwent C/S among 1645 renal transplantations at Baskent Univer sity Hospital in Ankara between January 1977 and Decem ber 2007 have been collected from hospital records. RESULTS: Eleven live births occured from ten RTRs. Two of them from vaginal delivery and 9 from C/S. The mean maternal age was 28 ± 4.6 years. The time from transplantation to conception was 41.1 ± 30.4 months. The mean gestational age was 33.5 ± 3.6 weeks and all recipients were maintained on cyclosporine, azathioprine and corticosteroids before and during pregnancy for immunosuppression. Five C/Ss were performed under general anesthesia whereas spinal anesthesia was used in 4 patients. Renal function tests were stable in all of the patients and we did not observe any acute rejection. The mean birth weight was 1945 ± 689 gr. There were 7 premature and 7 low birth weight among 11 newborns. CONCLUSION: General and regional anesthesia can be safely used during cesarean delivery of the RTRs without increased risk of graft loses. Prematurity and low birth weight was mainly due to the cytotoxic drugs for immunosuppression. Perioperative management of RTRs should be handled by a team including anesthesiologists.
Vecino-Ortiz, Andres I; Bardey, David; Castano-Yepes, Ramon
To assess the issue of hospital variations in Colombia and to contribute to the methodology on health care variations by using a model that clusters the variance between hospitals while accounting for individual-level reimbursement rates and objective health-status variables. We used data on all births (N = 11,954) taking place in a contributory-regimen insurer network in Colombia during 2007. A multilevel logistic regression model was used to account for the share of unexplained variance between hospitals. In addition, an alternative variance decomposition specification was further carried out to measure the proportion of such unexplained variance due to the region effect. Hospitals account for 20% of the variation in performing cesarean sections, whereas region explains only one-third of such variance. Variables accounting for preferences on the demand side as well as reimbursement rates are found to predict the probability of performing cesarean sections. Hospital variations explain large variances within a single-payer's network. Because this insurer company is highly regarded in terms of performance and finance, these results might provide a lower bound for the scale of hospital variation in the Colombian health care market. Such lower bound provides guidance on the relevance of this issue for Colombia. Some factors such as demand-side preferences and physician reimbursement rates increase variations in health care even within a single-payer network. This is a source of inefficiencies, threatening the quality of health care and financial sustainability. The proposed methodology should be considered in further research on health care variations. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Borges, João Bosco Ramos; Guarisi, Telma; Camargo, Ana Carolina Marchesini de; Gollop, Thomaz Rafael; Machado, Rogério Bonassi; Borges, Pítia Cárita de Godoy
To assess the prevalence of stress urinary incontinence, urge incontinence and mixed urinary incontinence among women residing in the city of Jundiaí (São Paulo, Brazil), and the relation between the type of incontinence and the obstetric history of these women. A cross-sectional community-based study was conducted. A total of 332 women were interviewed; they were seen for whatever reason at the public primary healthcare units of the city of Jundiaí, from March 2005 to April 2006. A pre-tested questionnaire was administered and consisted of questions used in the EPINCONT Study (Epidemiology of Incontinence in the County of Nord-Trondelag). Statistical analysis was carried out using the χ2 test and odds ratio (95%CI). Urinary incontinence was a complaint for 23.5% of the women interviewed. Stress urinary incontinence prevailed (50%), followed by mixed urinary incontinence (35%) and urge incontinence (15%). Being in the age group of 35-64 years, having a body mass index of 30 or greater and having had only vaginal delivery or cesarean section, with uterine contraction, regardless of the number of pregnancies, were factors associated with stress urinary incontinence. However, being in the age group of 55 or older, having a body mass index of 30 or greater and having had three or more pregnancies, only with vaginal deliveries, were factors associated with mixed urinary incontinence. One third of the interviewees complained of some type of urinary incontinence, and half of them presented stress urinary incontinence. Cesarean section, only when not preceded by contractions, was not associated with stress urinary incontinence. The body mass index is only relevant when the stress factor is present.
Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Manuck, Tracy A; Boggess, Kim A; Stamilio, David M
Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics. Results Of 41,262 maternal-neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m(2), 12% had BMI of 40 to 49.9 kg/m(2), and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59-2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59-2.73) neonatal morbidity. Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Full Text Available We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO (as a bridge to recovery or bridge to salvage was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.
Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M
Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible
Glavind, Julie; Madsen, Lene Duch; Uldbjerg, Niels
Objectives: To compare the residual myometrial thickness and the size of the cesarean scar defect after one- and two layer uterotomy closure. Methods: From July 2010 a continuous two-layer uterotomy closure technique replaced a continuous one-layer technique after cesarean delivery...... at the Department of Obstetrics and Gynecology at Aarhus University Hospital. A total of 149 consecutively invited women (68 women with one-layer and 81 women with two-layer closure) had their cesarean scar examined with 2D transvaginal sonography (TVS) 6-16 months post partum. Inclusion criteria were non......-pregnant women with one previous elective cesarean, no post-partum uterine infection or uterine re-operation, and no type 1 diabetes. Scar defect width, depth, and residual myometrial thickness were measured on the sagittal plane, and scar defect length was measured on the transverse plane. Results: The median...
Hitti, Jane; Walker, Suzan; Benedetti, Thomas J
Hospitals and providers are increasingly held accountable for their cesarean delivery rates. In the perinatal quality improvement arena, there is vigorous debate about whether all hospitals can be held to the same benchmark for an acceptable cesarean rate regardless of patient acuity. However, the causes of variation in hospital cesarean delivery rates are not well understood. We sought to evaluate the association and temporal trends between severity of illness at admission and the primary term singleton vertex cesarean delivery rate among hospitals in Washington State. We hypothesized that hospitals with higher patient acuity would have higher cesarean delivery rates and that this pattern would persist over time. In this cross-sectional analysis, we analyzed aggregate hospital-level data for all nonmilitary hospitals in Washington State with ≥100 deliveries/y during federal fiscal years 2010 through 2014 (287,031 deliveries). Data were obtained from the Washington State Comprehensive Hospital Abstract Reporting System, which includes inpatient demographic, diagnosis, procedure, and discharge information derived from hospital billing systems. Age, admission diagnoses and procedure codes were converted to patient-level admission severity-of-illness scores using the All Patient Refined Diagnosis Related Groups classification system. This system is widely used throughout the United States to adjust hospital data for severity of illness. Mean admission hospital-level severity-of-illness scores were calculated for each fiscal year among the term singleton vertex population with no history of cesarean delivery. We used linear regression to evaluate the association between hospital admission severity of illness and the primary term singleton vertex cesarean delivery rate, calculated Pearson correlation coefficients, and compared regression line slopes and 95% confidence intervals for each fiscal year. Hospitals were diverse with respect to delivery volume, level of care
Druzin, Maurice L; El-Sayed, Yasser Y
Cesarean section rates are rising in the United States and were at an all time high of 29 percent in 2004. Within this context, the issue of cesarean section on maternal request has been described as being part of a "perfect storm" of medical, legal and personal choice issues, and the lack of an opposing view. An increasing cesarean section rate adds an economic burden on already highly stressed medical systems. There is an incremental cost of cesarean section compared to vaginal delivery. The issue of cost must also be considered more broadly. Rising cesarean section rates are associated with a longer length of stay and a higher occupancy rate. This high occupancy rate leads to the diversion of critical care obstetric transports and has dramatically reduced patient satisfaction. These diversions, and the resultant inability to provide needed care to pregnant women, represent a profound societal cost. These critical care diversions and reduced patient satisfaction also negatively impact a health care institution's financial bottom line and competitiveness. The impact of a rising cesarean section rate on both short and long-term maternal and neonatal complications, and their associated costs, must also be taken into account. The incidence of placenta accreta is increasing in conjunction with the rising cesarean section rate. The added costs associated with this complication (MRI, Interventional Radiology, transfusion, hysterectomy, and intensive care admission) can be prohibitive. It has also been demonstrated that infants born by scheduled cesarean delivery are more likely to require advanced nursery support (with all its associated expense) than infants born to mothers attempting vaginal delivery. The practice of maternal request cesarean section, with limited good data and obvious inherent risk and expense, is increasing in the USA. Patient autonomy and a woman's right to choose her mode of delivery should be respected. However, in our opinion, based on the
Dude, Annie M; Lane-Cordova, Abbi D; Grobman, William A
Approximately one third of all deliveries in the United States are via cesarean. Previous research indicates weight gain during pregnancy is associated with an increased risk of cesarean delivery. It remains unclear, however, whether and to what degree weight gain between deliveries (ie, interdelivery weight gain) is associated with cesarean delivery in a subsequent pregnancy following a vaginal delivery. The objective of the study was to determine whether interdelivery weight gain is associated with an increased risk of intrapartum cesarean delivery following a vaginal delivery. This was a case-control study of women who had 2 consecutive singleton births of at least 36 weeks' gestation between 2005 and 2016, with a vaginal delivery in the index pregnancy. Women were excluded if they had a contraindication to a trial of labor (eg, fetal malpresentation or placenta previa) in the subsequent pregnancy. Maternal characteristics and delivery outcomes for both pregnancies were abstracted from the medical record. Maternal weight gain between deliveries was measured as the change in body mass index at delivery. Women who underwent a subsequent cesarean delivery were compared with those who had a repeat vaginal delivery using χ 2 statistics for categorical variables and Student t tests or analysis of variance for continuous variables. Multivariable logistic regression was used to determine whether interdelivery weight gain remained independently associated with intrapartum cesarean delivery after adjusting for potential confounders. Of 10,396 women who met eligibility criteria and had complete data, 218 (2.1%) had a cesarean delivery in the subsequent pregnancy. Interdelivery weight gain was significantly associated with cesarean delivery and remained significant in multivariable analysis for women with a body mass index increase of at least 2 kg/m 2 (adjusted odds ratio, 1.53, 95% confidence interval, 1.03-2.27 for a body mass index increase of 2 kg/m 2 to gained 2 kg
Yuan, Changzheng; Gaskins, Audrey J; Blaine, Arianna I; Zhang, Cuilin; Gillman, Matthew W; Missmer, Stacey A; Field, Alison E; Chavarro, Jorge E
Cesarean birth has been associated with higher risk of obesity in offspring, but previous studies have focused primarily on childhood obesity and have been hampered by limited control for confounders. To investigate the association between cesarean birth and risk of obesity in offspring. A prospective cohort study was conducted from September 1, 1996, to December 31, 2012, among participants of the Growing Up Today Study, including 22 068 offspring born to 15 271 women, followed up via questionnaire from ages 9 to 14 through ages 20 to 28 years. Data analysis was conducted from October 10, 2015, to June 14, 2016. Birth by cesarean delivery. Risk of obesity based on International Obesity Task Force or World Health Organization body mass index cutoffs, depending on age. Secondary outcomes included risks of obesity associated with changes in mode of delivery and differences in risk between siblings whose modes of birth were discordant. Of the 22 068 offspring (20 950 white; 9359 male and 12 709 female), 4921 individuals (22.3%) were born by cesarean delivery. The cumulative risk of obesity through the end of follow-up was 13% among all participants. The adjusted risk ratio for obesity among offspring delivered via cesarean birth vs those delivered via vaginal birth was 1.15 (95% CI, 1.06-1.26; P = .002). This association was stronger among women without known indications for cesarean delivery (adjusted risk ratio, 1.30; 95% CI, 1.09-1.54; P = .004). Offspring delivered via vaginal birth among women who had undergone a previous cesarean delivery had a 31% (95% CI, 17%-47%) lower risk of obesity compared with those born to women with repeated cesarean deliveries. In within-family analysis, individuals born by cesarean delivery had 64% (8%-148%) higher odds of obesity than did their siblings born via vaginal delivery. Cesarean birth was associated with offspring obesity after accounting for major confounding factors. Although additional research is
Tully, Kristin P.; Ball, Helen L.
Background Breastfeeding outcomes are often worse after cesarean section compared to vaginal childbirth. Objectives This study characterizes mothers’ breastfeeding intentions and their infant feeding experiences after cesarean childbirth. Methods Data are from 115 mothers on a postnatal unit in Northeast England during February 2006 to March 2009. Interviews were conducted an average of 1.5 days (range 1–6 days) after the women underwent unscheduled or scheduled cesarean. Results Thematic analysis of the data suggested breastfeeding was mostly considered the “right thing to do,” preferable, natural, and “supposedly healthier,” but tiring and painful. Advantages of supplementation involved more satiated infants, feeding ease, and longer sleep bouts. The need for “thinking about yourself” was part of cesarean recovery. Infrequent feeding was concerning but also enabled maternal rest. Other breastfeeding obstacles were maternal mobility limitations, positioning difficulties, and frustration at the need for assistance. Participants were confused about nocturnal infant wakings, leading many to determine that they had insufficient milk. Mothers were surprised that sub-clinically poor infant condition was common following cesarean section. Some breastfeeding difficulty stemmed from “mucus” expulsion that had to occur before the infants could be “interested” in feeding. Women who cited motivations for breastfeeding that included benefit to themselves were more likely to exclusively breastfeed on the postnatal unit after their cesareans than those who reported infant-only motivations. Conclusions For the majority of mothers, breastfeeding after a cesarean is affected by interrelated and compounding difficulties. Provision of more relational breastfeeding information may enable families to better anticipate early feeding experiences after cesarean section childbirth. PMID:24252711
Tully, Kristin P.; Ball, Helen L.
International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women’s ...
Olapour, Alireza; Behaeen, Kaveh; Akhondzadeh, Reza; Soltani, Farhad; al Sadat Razavi, Forough; Bekhradi, Reza
Background Pain is a major problem in patients after cesarean and medication such as aromatherapy which is a complementary therapy, in which the essences of the plants oils are used to reduce such undesirable conditions. Objectives In this study, the effect of aromatherapy using Lavender (Lavandula) essential oil on cesarean postoperative pain was assessed. Materials and Methods In a triple blind, randomized placebo-controlled trial study, 60 pregnant women who were admitted to a general hosp...
Siavash Beiranvand; Morteza Noparast; Nasrin Eslamizade; Saeed Saeedikia
Spiritual elements play an important role in the recovery process from acute postoperative pain. This study was conducted to assess the effect of pray meditation on postoperative pain reduction and physiologic responds among muslim patients who underwent cesarean surgery under spinal anesthesia. This double-blinded randomized clinical trial study was conducted among muslim patients who underwent cesarean surgery under spinal anesthesia during 2011-2013 at tertiary regional and teaching hospit...
Horner-Johnson, Willi; Biel, Frances M; Darney, Blair G; Caughey, Aaron B
Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000-2010 (n = 4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Among all women giving birth, the proportion with a disability increased from 0.27% in 2000 to 0.80% in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95% CI = 2.25 = 2.99) in 2000 to 1.66 (95% CI = 1.51-1.81) in 2010. Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities. Copyright © 2017 Elsevier Inc. All rights reserved.
Alipour M; Soltani Gh; Zirak N; ParaviTorghabeh N; Peivandi Yazdi A
Objectives: Peri-operative aspiration of gastric contents is a problem that causes certain respiratory problems including ARDS. Prophylaxis against aspiration of gastric contents is performed routinely in elective surgeries, but there is rare evidence on the efficacy of this method in emergency cesarean section. Materials and Methods: This is a randomized, controlled, double-blinded clinical trial. 60 parturients undergoing emergency cesarean section were randomly assigned into three groups o...
Hee Young Cho
Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.
Kozhimannil, Katy Backes; Attanasio, Laura B; Johnson, Pamela Jo; Gjerdingen, Dwenda K; McGovern, Patricia M
Rising rates of labor induction and cesarean delivery, especially when used without a medical reason, have generated concern among clinicians, women, and policymakers. Whether employment status affects pregnant women's childbirth-related care is not known. We estimated the relationship between prenatal employment and obstetric procedures, distinguishing whether women reported that the induction or cesarean was performed for medical reasons. Using data from a nationally representative sample of women who gave birth in U.S. hospitals (n = 1,573), we used propensity score matching to reduce potential bias from nonrandom selection into employment. Outcomes were cesarean delivery and labor induction, with and without a self-reported medical reason. Exposure was prenatal employment status (full-time employment, not employed). We conducted separate analyses for unmatched and matched cohorts using multivariable regression models. There were no differences in labor induction based on employment status. In unmatched analyses, employed women had higher odds of cesarean delivery overall (adjusted odds ratio [AOR], 1.45; p = .046) and cesarean delivery without medical reason (AOR, 1.94; p = .024). Adding an interaction term between employment and college education revealed no effects on cesarean delivery without medical reason. There were no differences in cesarean delivery by employment status in the propensity score-matched analysis. Full-time prenatal employment is associated with higher odds of cesarean delivery, but this association was not explained by socioeconomic status and no longer existed after accounting for sociodemographic differences by matching women employed full time with similar women not employed during pregnancy. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Thornton, Patrick; McFarlin, Barbara L; Park, Chang; Rankin, Kristin; Schorn, Mavis; Finnegan, Lorna; Stapleton, Susan
High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth. We generated low-risk cohorts admitted in labor to hospitals (n = 2527) and birth centers (n = 8776) using secondary data obtained from the American Association of Birth Centers (AABC). All women received prenatal care in the birth center and midwifery care in labor, but some chose hospital admission for labor. Analysis was intent to treat according to site of admission in spontaneous labor. We used propensity score adjustment and multivariable logistic regression to control for cohort differences and measured effect sizes associated with setting. There was a 37% (adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 0.50-0.79) to 38% (adjusted OR, 0.62; 95% CI, 0.49-0.79) decreased odds of cesarean in the birth center cohort and a remarkably low overall cesarean rate of less than 5% in both cohorts. These findings suggest that low rates of cesarean in birth centers are not attributable to labor setting alone. The entire birth center care model, including prenatal preparation and relationship-based midwifery care, should be studied, promoted, and implemented by policy makers interested in achieving appropriate cesarean rates in the United States. © 2016 by the American College of Nurse-Midwives.
Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc (Dept. of Radiology and Medical Imaging, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)), email: email@example.com; Bourdel, Nicolas; Canis, Michel (Dept. of Obstetrics and Gynecology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France)); Charpy, Cecile (Dept. of Pathology, CHU Clermont-Ferrand, CHU Estaing, Clermont-Ferrand (France))
Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease
Da Ines, David; Montoriol, Pierre Francois; Petitcolin, Virginie; Garcier, Jean-Marc; Bourdel, Nicolas; Canis, Michel; Charpy, Cecile
Abdominal wall endometriosis is unusual and mostly occurs in scars following Cesarean section. Although malignant transformation is rare, it must be recognized in order to benefit from radical resection. We report a very rare case of mixed endometrioid and serous carcinoma developing in a Cesarean section endometriosis scar and the way we managed it using surgery and chemotherapy. 18-FDG PET-CT imaging was performed to correctly stage the disease
Qvist, N; Storm, K
Twenty patients undergoing cesarean section received cimethidine 400 mg intramuscularly as pre-anesthetic approximately 70 minutes prior to gastric aspiration. The average pH was 5.05, as against 2.97 in the control group (p less than 0.01). No significant reduction in the aspirated volumes...... in the infants. Hence, cimethidine is a safe and useful pre-anesthetic for patients undergoing cesarean section, irrespective of indication and, consequently, much to be preferred to oral antacids....
Rodriguez, Maria I; Say, Lale; Abdulcadir, Jasmine; Hindin, Michelle J
To compare primary indications for cesarean delivery among patients with different female genital mutilation (FGM) status. The present secondary analysis included data from women who underwent trial of labor resulting in cesarean delivery at 28 obstetric centers in six African countries between November 1, 2001, and March 31, 2003. Associations between cesarean delivery indications and FGM status were assessed using descriptive statistics and multivariable multinomial logistic regression. Data from 1659 women (480 patients with no type of FGM and 1179 patients with FGM [any type]) were included; cesarean delivery indications were collapsed into five categories (fetal indications, maternal factors, stage 1 arrest, stage 2 arrest, and other). The incidence of a clear medical indication for cesarean delivery did not differ between the groups (P=0.320). Among patients without a clear indication for cesarean delivery, women with FGM were more likely to have undergone cesarean delivery for maternal factors (adjusted relative risk ratio [aRRR] 3.92, 95% confidence interval [CI] 1.3-11.71), stage 1 arrest (aRRR 7.74, 95% CI 1.33-45.07), stage 2 arrest (aRRR 6.63, 95% CI 3.74-11.73), or other factors (aRRR 2.41, 95% CI 1.04-5.60) rather than fetal factors compared with women who had no type of FGM. Among women with unclear medical indications, FGM was associated with cesarean delivery being performed for maternal factors or arrest disorders. © 2017 World Health Organization; licensed by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
Schroeder, T; Kristensen, J K
We report a case of a vesicouterine fistula subsequent to delivery at cesarean section through the bladder. A first attempt to close the fistula failed but a second operation adhering to the general principles of fistula repair was successful.......We report a case of a vesicouterine fistula subsequent to delivery at cesarean section through the bladder. A first attempt to close the fistula failed but a second operation adhering to the general principles of fistula repair was successful....
Mascarello, Keila Cristina; Matijasevich, Alicia; Barros, Aluísio J D; Santos, Iná S; Zandonade, Eliana; Silveira, Mariângela Freitas
The current literature indicates increasing concern regarding the number of safe cesarean sections which a woman can undergo, mainly in face of the high cesarean section rates, which are growing in Brazil and worldwide. Aimed to describe the prevalence and associated factors of repeat cesarean section in a cohort of Brazilian women who had a cesarean section in the first birth. This is a prospective cohort study using data from the 2004 Pelotas Birth Cohort. The sample included 480 women who had their first delivery in 2004, regardless of the form of delivery, and who had a second delivery identified in the cohort's follow-ups (in 2005, 2006, 2008, and 2010). Descriptive, bivariate and multivariate analyses using Poisson regression with robust error variance were carried out. Among the women who underwent a cesarean section in their first delivery (49.47%), 87.44% had a second surgical delivery. The risk factors for repeat cesarean section included ages 21-34 (PR 1.67, CI 95% 1.07-2.60), not being seen by SUS (Public Healthcare System) in 2004 (PR 2.27, CI 95% 1.44-3.60), and the number of prenatal medical visits, i.e., women with ten or more visits were at 2.33 times higher risk (CI 95% 1.10-4.96) compared to those who had five or fewer visits. The proportion of cesarean sections both in the first and in the subsequent delivery is quite high. This high rate may compromise the reproductive future of the women who undergo consecutive cesarean sections with possible consequent complications and changes in care policies for pregnant women should be implemented.
Murthy, Karna; Grobman, William A; Lee, Todd A; Holl, Jane L
To estimate the association between changes in Illinois professional liability premiums for obstetrician-gynecologists and singleton primary cesarean delivery rates. Data from the National Center for Health Statistics were used to identify all singleton births between 37 weeks and 44 weeks of gestation occurring in Illinois from 1998 through 2003. Primary cesarean delivery rates for women delivered between 37 weeks and 44 weeks of gestation per 1,000 gravid women eligible to have a primary cesarean delivery were calculated for each Illinois county. The annual medical professional liability premium for each county in Illinois was represented by the reported professional liability insurance rate charges (adjusted to 2004 dollars) from the ISMIE Mutual Insurance Company. Separate analyses were conducted for nulliparous and multiparous women. The independent association between county-level primary cesarean delivery rates and the previous year's insurance premiums was evaluated using linear regression models. During the study period, 817,521 women were eligible for inclusion in the analysis. The county-level mean primary cesarean delivery rate increased from 126 to 163 per 1,000 (Pinsurance premiums also rose significantly (from $60,766 in 1997 to $83,167 in 2002, Pinsurance premium increase, the primary cesarean delivery rate increased by 15.7 per 1,000 for nulliparous women. This association also was evident for multiparous women, who had an increase in cesarean deliveries of 4.7 per 1,000 for every $10,000 increase. Higher rates of primary cesarean delivery are associated with increased medical professional liability premiums for obstetrician-gynecologists in Illinois. II.
Full Text Available O artigo pretende fornecer elementos para a análise da relação entre o fenômeno de internacionalização do direito e a emergência de modalidades de advogados engajados na representação judicial de causas coletivas. São analisadas duas dimensões: uma primeira expõe um panorama exploratório das causas coletivas no cenário nacional e internacional, pela catalogação das decisões judiciais na Corte Interamericana de Direitos Humanos e em tribunais brasileiros. Uma segunda dimensão de análise aborda, com base em entrevistas, casos representativos de promoção de causas coletivas nas décadas de 1990 e 2000. Essas duas dimensões permitem avançar a hipótese de que a redemocratização política nacional e a constituição de redes internacionais de circulação de causas políticas e jurídicas contribuem para a definição dos perfis de ativismo judicial legitimados no espaço jurídico em diferentes períodos.The article intends the analysis of the relation between the phenomenon of internationalization of Law and the emergency of modalities of lawyers engaged in the judicial representation of collective causes. Two dimensions are analyzed: the first one displays an exploratory panorama of the collective causes in the national and international scene, out of a survey of the profile of demands of the Inter-American Court of Human Rights and Brazilian courts. The second dimension approaches, from interviews, representative cases of promotion of collective causes in the decades of 1990 and 2000. These two dimensions allow to advance the hypothesis that the national political redemocratization and the constitution of international networks of circulation of political and legal causes contribute for the definition of the profiles of judicial activism legitimated in the legal space in different periods.
Claudia Maria Barbosa
Full Text Available Within the classical view of separation of powers, the judiciary originally occupied the weaker position. What is observed today, however, is a displacement of power from representative institutions to the judiciary, erecting a new kind of political regime that the Canadian political scientist Ran Hirschl called juristocracy. This paper intends to discuss this movement basing on the idea of hegemonic preservation, presented by Hirschl in his work Towards Juristocracy whose central hypothesis is that the political, economic and social elites voluntarily transfer power to the judiciary, when threatened of losing their hegemony in the political sphere. In Brazil, the 1988 Constitution turned the Supreme Court into one of the world's most powerful courts, which works at the same time as constitutional court, court of appeals and criminal court, responsible for deciding the most fundamental issues for brazilian society. We present at first, the examples used by Hirschl to illustrate his thesis about the judicial empowerment through constitutionalization, analyzing the political and economic changes in recent history of Israel, Canada, New Zealand and South Africa, followed by an analysis of the phenomenon in Brazil. We conclude that it is not possible to determine, in principle, the occurrence of hegemonic preservation in Brazil, but that Hirschl's analysis that offers an answer that challenges the traditional view on the judicialization of politics, contributes to the discussion and analysis of the phenomenon in Brazil.
Chieffi, Ana Luiza; Barata, Rita Barradas
The supply of medicines in response to court orders or injunctions has become a common practice in the State of São Paulo, Brazil. This 'judicialization' of the health system clashes with basic principles of the Brazilian Unified National Health System (SUS), such as equal opportunity to access health services. The aim of this paper is to analyze the legal action used to obtain medicines through the São Paulo State Health Department, from two main angles: judicialization of public policies and breach of the equity principle. This is a descriptive study of legal action taken to obtain medicines through the São State Health Department, as listed in the Electronic Court Docket System for the year 2006. Most cases were filed through private attorneys; 47% of the patients had obtained their prescriptions through private care; and 73% of the cases involved patients from the three wealthiest areas in the city of São Paulo. The data demonstrate that such legal action violates key principles of the SUS such as equity, thereby privileging individuals with higher purchasing power and more access to information.
Stewart, P J; Dulberg, C; Arnill, A C; Elmslie, T; Hall, P F
We carried out a chart review study to determine the rate of diagnosis of dystocia (abnormal progress) and the use of cesarean section to treat dystocia among 3887 primiparous women who gave birth to a single baby in the vertex presentation at four hospitals in Ottawa-Carleton in 1984. Of the 3740 women who had some labour 1127 (30.1%) were given a diagnosis of dystocia. Cesarean section for dystocia was done during all phases of labour (41% of procedures in the latent phase, 38% in the active phase and 21% in the second stage). The cesarean section rate varied among the hospitals from 11.8% to 19.6%. A total of 75% of the cesarean sections were for dystocia, disproportion or failed induction. The findings suggest that cesarean section is being done for disproportion without a trial of labour beyond the latent phase and for dystocia in the absence of fetal distress. If these practices were modified the cesarean section rate could be reduced from 16% to about 8%, the rate found in some other centres and that observed in Canada in the early 1970s. PMID:2302643
Doctor, Jason N.
Objectives. We studied if both observed and unobserved maternal health in African American women in hospitals or communities were associated with cesarean delivery of infants. Methods. We examined the relationship between African American race and cesarean delivery among 493 433 women discharged from 255 Californian hospitals in 2010 using administrative data; we adjusted for patient comorbidities and maternal, fetal, and placental risk factors, as well as clustering of patients within hospitals. Results. Cesarean rates were significantly higher overall for African American women than other women (unadjusted rate 36.8% vs 32.7%), as were both elective and emergency primary cesarean rates. Elevated risks persisted after risk adjustment (odds ratio generally > 1.27), but the prevalence of particular risk factors varied. Although African American women were clustered in some hospitals, the proportion of African Americans among all women delivering in a hospital was not related to its overall cesarean rate. Conclusions. To address the higher likelihood of elective cesarean delivery, attention needs to be given to currently unmeasured patient-level health factors, to the quality of provider–physician interactions, as well as to patient preferences. PMID:25790391
Ogunyemi, Dotun; McGlynn, Sara; Ronk, Anne; Knudsen, Patricia; Andrews-Johnson, Tonyie; Raczkiewicz, Angeline; Jovanovski, Andrew; Kaur, Sangeeta; Dykowski, Mark; Redman, Mark; Bahado-Singh, Ray
National efforts exist to safely reduce the rate of cesarean delivery, a major source of increased morbidity and healthcare costs. This is a report of a quality improvement study targeting reduction of primary cesarean deliveries. From March 2014 to March 2016, interventions included a nested case-control review of local risk factors, provider and patient education, multidisciplinary reviews based on published guidelines with feedback, provider report cards, commitment to labor duration guidelines, and a focus on natural labor. Primary outcomes were the total primary singleton vertex and the nulliparous term singleton vertex (NTSV) cesarean delivery rates. Secondary outcome measures were postpartum hemorrhage, chorioamnionitis, perineal laceration, operative delivery, neonatal intensive care unit (NICU) admission, stillbirth, and neonatal mortality. Statistical process control charts identified significant temporal trends. Control chart analysis demonstrated that the institutional cesarean delivery rate was due to culture and not "outlier" obstetricians. The primary singleton vertex cesarean rate decreased from 23.4% to 14.1% and the NTSV rate decreased from 34.5% to 19.2% (both p cesarean deliveries without increasing maternal or perinatal morbidity.
Rossen, Janne; Klungsøyr, Kari; Albrechtsen, Susanne; Løkkegård, Ellen; Rasmussen, Steen; Bergholt, Thomas; Skjeldestad, Finn E
Maternal age is an established risk factor for cesarean section; epidural analgesia and oxytocin augmentation may modify this association. We investigated the effects and interactions of oxytocin augmentation, epidural analgesia and maternal age on the risk of cesarean section. In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1]. In this case-control study the main exposure was maternal age; epidural analgesia, oxytocin augmentation, birthweight and time period were explanatory variables. Chi-square test and logistic regression were used to estimate associations and interactions. The cesarean section rate increased consistently with advancing maternal age, both overall and in strata of epidural analgesia and oxytocin augmentation. We observed strong interactions between maternal age, oxytocin augmentation and epidural analgesia for the risk of cesarean section. Women with epidural analgesia generally had a reduced adjusted odds ratio when oxytocin was used compared with when it was not used. In Norway, this applied to all maternal age groups but in Denmark only for women ≥30 years. Among women without epidural, oxytocin augmentation was associated with an increased odds ratio for cesarean section in Denmark, whereas no difference was observed in Norway. Oxytocin augmentation in nulliparous women with epidural analgesia is associated with a reduced risk of cesarean section in labor with spontaneous onset. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.
Wood, Stephen L; Tang, Selphee; Crawford, Susan
Cesarean delivery is being increasingly used by obstetricians for indicated deliveries in the second stage of labor. Unplanned extension of the uterine incision involving the cervix often occurs with these surgeries. Therefore, we hypothesized that cesarean delivery in the second stage of labor may increase the rate of subsequent spontaneous premature birth. We sought to determine if cesarean delivery in the late first stage of labor or in the second stage of labor increases the risk of a subsequent spontaneous preterm birth. We conducted a retrospective cohort study of matched first and second births from a large Canadian perinatal database. The primary outcomes were spontaneous premature birth cesarean delivery. The protocol and analysis plan was registered prior to obtaining data at Open Science Foundation. In total, 189,021 paired first and second births were identified. The risk of spontaneous preterm delivery cesarean delivery in the second stage of labor (relative risk, 1.57; 95% confidence interval, 1.43-1.73 and relative risk, 2.12; 95% confidence interval, 1.67-2.68, respectively). The risk of perinatal death in the second birth, excluding congenital anomalies, was also correspondingly increased (relative risk, 1.44; 95% confidence interval, 1.05-1.96). Cesarean delivery in second stage of labor was associated with a 2-fold increase in the risk of spontaneous preterm birth <32 weeks of gestation in a subsequent birth. This information may inform management of operative delivery in the second stage. Copyright © 2017 Elsevier Inc. All rights reserved.
incrementally shaping the law of EU external relations, and determining the manner in which the Union may enter into formal international relations. Understanding the Court’s importance in this field has been done time and again, but yet, consideration of the pre-ratification judicial review option, available...... for how ex ante judicial review can work in developing the Union into an even more enhanced global actor, through its own unique judicial order....
Bruijn, L Michelle; Vols, Michel; Brouwer, Jan G
A widespread sense of a failing criminal justice system and increased feelings of insecurity changed the response to crime into a culture of control, which is characterized by policies that punish and exclude. In the Netherlands, these influences can be witnessed in the war on drugs where local authorities use their administrative power to close homes involved in drug-related crime. Citizens can invoke judicial review over these administrative interferences by claiming that such closure results in an unfair balance between purposes, means and consequences. This paper assesses whether judicial review functions as a safety net against losing one's home due to drug-related crime. We used doctrinal legal research methods to examine the "law in the books" and empirical legal research methods to analyse the "law in action". We used a survey to investigate how often the drug-related closure power was used in 2015, and we statistically analysed all published case law of Dutch lower courts between 2007 and 2016. The scope of the closure power broadened over the years and our data show that local authorities fiercely make use of this instrument. In 41.4% of the cases, citizens are successful in fighting the closure. While scholarly literature indicates that judicial courts function as safeguards by questioning the proportionality of administrative action, raising a proportionality defence does not necessarily result in a more favourable outcome for citizens. In fact, raising a proportionality defence makes it more likely to result in dismissal of the appeal. The stretched scope of the drug-related closure power together with the relatively low success rate of citizens who fight the loss of their home and a seemingly meaningless proportionality check show no sign of a safety net against the loss of one's home at the suit of a local authority. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
La influencia del género en las decisiones de los tribunales: del paternalismo judicial a los papeles familiares The influence of the gender on judicial decision-making: from judicial paternalism to family roles
Andreia de Castro-Rodrigues
Full Text Available Recurriendo al concepto de género como objeto de análisis, este artículo realiza una retrospectiva sobre la evolución de la investigación sobre la influencia de factores extralegales en las decisiones judiciales, a través de la lectura de sus referencias bibliográficas más destacadas. En el caso concreto del género, esta evolución se caracteriza por una sofisticación crítica que provocó un cambio en las explicaciones asociadas a las diferencias encontradas en las sentencias atribuidas a hombres y mujeres. Esta transición parte de perspectivas simplistas relacionadas con una actitud paternalista por parte del sistema de justicia criminal, y evoluciona hasta perspectivas complejas y multifacéticas relacionadas con los diferentes papeles familiares ejercidos por hombres y mujeres.Using the concept of gender as an object of analysis, this article aims at having a retrospective description of the methodological and conceptual evolution regarding the influence of extralegal aspects on judicial decisions research through the most prominent authors. In the specific case of Gender, this evolution is characterized by a critical sophistication. The transition in the explanations in differential criminal sentences attributed to men and women evolved from a simplistic perspective linked to paternalism and chivalry hypothesis to more complex and multifaceted standpoints related to the different family roles exercised by men and women.
This article studies the impact of judicial reform in Mexico. It does so using a survey about crime victimization and perceptions of insecurity (Encuesta Nacional Sobre la Inseguridad [ENSI]) collected in 2005, 2008, and 2009 in 11 Mexican cities, 3 of which implemented the reform in 2007 and 2008. This analysis shows that judicial reform not only reduces victimization but also lowers perceptions of security. Although we find that judicial reform has a negative effect on trust in the local and federal police, judicial reform reduces the probability of being asked by the transit police for a bribe.
Patricia Fernandes Bega
Full Text Available The article is subject to study the Principle of Judicial Cooperation. The problem of research focuses on the conflict between the institution of bankruptcy and labor laws. The initial hypothesis is that the principle of protection to workers and the Judicial Recovery Institute reveal clash, contradiction and non-cooperation. In this way, the work seeks to demonstrate that the procedural rule of judicial cooperation brought about by the new CPC is an instrument of dialogue between material contradictions. The objective is to analyze the new civil procedure code and the difficulty to cooperate the irreconcilable. The method used was deductive.
Full Text Available BACKGROUND: Cesarean section is the only surgery for which we have nearly global population-based data. However, few surveys provide additional data related to cesarean sections. Given weaknesses in many health information systems, health planners in developing countries will likely rely on nationally representative surveys for the foreseeable future. The objective is to validate self-reported data on the emergency status of cesarean sections among women delivering in teaching hospitals in the capitals of two contrasting countries: Accra, Ghana and Santo Domingo, Dominican Republic (DR. METHODS AND FINDINGS: This study compares hospital-based data, considered the reference standard, against women's self-report for two definitions of emergency cesarean section based on the timing of the decision to operate and the timing of the cesarean section relative to onset of labor. Hospital data were abstracted from individual medical records, and hospital discharge interviews were conducted with women who had undergone cesarean section in two hospitals. The study assessed sensitivity, specificity, and positive predictive value of responses to questions regarding emergency versus non-emergency cesarean section and estimated the percent of emergency cesarean sections that would be obtained from a survey, given the observed prevalence, sensitivity, and specificity from this study. Hospital data were matched with exit interviews for 659 women delivered via cesarean section for Ghana and 1,531 for the Dominican Republic. In Ghana and the Dominican Republic, sensitivity and specificity for emergency cesarean section defined by decision time were 79% and 82%, and 50% and 80%, respectively. The validity of emergency cesarean defined by operation time showed less favorable results than decision time in Ghana and slightly more favorable results in the Dominican Republic. CONCLUSIONS: Questions used in this study to identify emergency cesarean section are promising
Easter, Sarah Rae; Robinson, Julian N; Carusi, Daniela; Little, Sarah E
The objective of this study was to test whether hospitals experienced in twin delivery have lower rates of cesarean delivery for twins. We divided obstetric hospitals in the 2011 National Inpatient Sample by quartile of annual twin deliveries and compared twin cesarean delivery rates between hospitals with weighted linear regression. We used Pearson's coefficients to correlate a hospital's twin cesarean delivery rate to its overall cesarean delivery and vaginal birth after cesarean (VBAC) rates. Annual twin delivery volume ranged from 1 to 506 across the 547 analyzed hospitals with a median of 10 and mode of 3. Adjusted rates of cesarean delivery were independent of delivery volume with a rate of 75.5 versus 74.8% in the lowest and highest volume hospitals ( p = 0.09 across quartiles). A hospital's cesarean delivery rate for twins moderately correlated with the overall cesarean rate ( r = 0.52, p < 0.01) and inversely correlated with VBAC rate ( r = - 0.42, p < 0.01). Most U.S. obstetrical units perform a low volume of twin deliveries with no decrease in cesarean delivery rates at higher volume hospitals. Twin cesarean delivery rates correlate with other obstetric parameters such as singleton cesarean delivery and VBAC rates suggesting twin cesarean delivery rate is more closely related to a hospital's general obstetric practice than its twin delivery volume. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Chi, Claudia; Pang, Deanette; Aris, Izzuddin M; Teo, Wei Ting; Li, Sarah Weiling; Biswas, Arijit; Yong, Eu Leong; Chong, Yap Seng; Tan, Kelvin; Kramer, Michael S
Rates of cesarean birth have continued to rise in many high-income countries. We examined the temporal trends and predictors of cesarean birth in Singapore. Linked hospitalization and Birth Registry data were used to examine all live births to Singaporean citizens and permanent residents between January 1, 2005 and December 31, 2014 (n = 342 932 births). We calculated cesarean rates and age-adjusted average annual percent change (AAPC) in those rates and used sequential multivariable regression modeling to assess the contribution of changes in predictors to the change in cesarean rates over time. The overall cesarean rate in Singapore rose from 32.2% in 2005 to 37.4% in 2014. Among singleton, cephalic, term pregnancies, the two major predictions of cesarean were nulliparity and previous cesarean, each accounting for just over one-third of all cesareans. Higher AAPC was observed in nulliparous women of Indian ethnicity (0.74% [95% confidence interval 0.68-0.80]) compared with Chinese (0.62% [0.60-0.65]) or Malay women (0.63% [0.59-0.68]), and in women who delivered in private hospitals (0.62% [0.60-0.64]) compared with those delivered under subsidized care in public hospitals (0.58% [0.52-0.63]). Parity and education had the largest influences on cesarean birth trend (attenuation of AAPC from 0.62% [0.59-0.66] to 0.39% [0.38-0.40] after adjustment). Cesarean birth has continued to rise at a steady rate in Singapore. Strategies to curb this temporal increase include avoidance of medically unnecessary primary cesarean and attempts at trial of labor and vaginal delivery among women with a history of prior cesarean. © 2018 Wiley Periodicals, Inc.
Sebastián Soto Velasco
Full Text Available El presente trabajo analiza las relaciones entre el Congreso Nacional y el Poder Judicial a través de dos instituciones existentes en nuestro ordenamiento: el proceso de nombramiento de Ministros de la Corte Suprema y los informes que esta última envía al Congreso Nacional en ciertos proyectos de ley. En el caso de las nominaciones de Ministros a la Corte Suprema se estudia como ha operado el sistema desde la incorporación del Senado en 1997 hasta el año 2005. Se analiza cómo la transparencia del proceso, la posibilidad de conocer la historia profesional del nominado y audiencias abiertas contribuirían a incentivar una decisión centrada en criterios de calidad. El documento también se centra en el contenido y la influencia de los informes que envía la Corte Suprema al Congreso Nacional con ocasión de la tramitación de proyectos de ley que contienen normas que modifican la organización o atribuciones de los tribunales de justicia. En esta instancia, permitir el acceso a los informes también tendría positivas consecuencias. En definitiva, aunque hay otras vías de comunicación entre el Congreso y el Poder Judicial, se profundiza únicamente en las mencionadas pues del estudio se concluye que ambas tenderían a aumentar el potencial que de suyo ya tienen si se incorpora apertura en los procesosThis paper analyzes the relationship between the Chilean Congress and Judicial power, focusing on two institutions: the nomination process to appoint Supreme Court justices and the reports that the Supreme Court is constitutionally obligated to send to the Congress when specific types of bills are introduced. The appointment of Supreme Court candidates is studied from the Senate's incorporation in the process from 1997 until 2005. The author states that a more transparent process, including the publication of the candidate's backgrounds and public hearings, would increase the incentives to nominate the most qualified candidates. The paper also
Dolf, Gaudenz; Gaillard, Claude; Russenberger, Jane; Moseley, Lou; Schelling, Claude
In the past 10 years, the frequency of unplanned cesarean sections in the Labrador Retriever breeding colony at Guiding Eyes for the Blind stayed around 10% (range 5% to 28%). To reduce the number of cesarean sections, factors influencing the occurrence of a cesarean section need to be known. The goal of this study was to identify factors that contribute to the decision to perform a cesarean section. Of the 688 Labrador Retriever litters whelped between 2003 and 2016, 667 litters had sufficient data and remained in the analysis. The target trait was ordinal with the three levels "normal whelping", "assisted whelping" and "cesarean section". A general ordinal logistic regression approach was used to analyze the data. Model selection with possible predictors resulted in a final model including weight of the dam, the weight of the heaviest puppy of a litter, the number of fetuses malpositioned and the quality of uterine contractions. Weight and size of a litter, parity, maternal inbreeding coefficient, whelping season, dam and sire were dropped from the model because they were not significant. The risk of a cesarean section was influenced by the combination of the weight of the dam and the weight of the heaviest puppy in the litter, as well as by the number of malpositioned fetuses and the quality of the contractions. Larger puppies increased the risk of cesarean section especially when the dam had a lighter weight. For dams weighing 23.6 kg and 32.8 kg the predicted probability of a cesarean section was low, with 0.06 and 0.02, respectively, when the heaviest puppy in a litter was light (0.42 kg), contractions were normal and no fetus was malpositioned. However, the probability of a cesarean section was much higher, ranging from 0.24 to 0.08, when the heaviest puppy in a litter was heavy (0.66 kg). Means to reduce the cesarean section frequency in this Labrador Retriever breeding colony should include genetic selection for ideal puppy weight. In addition, dams
Eldenburg, L; Waller, W S
This article contributes a decision-case mix model for analyzing variation in c-section rates. Like recent contributions to the literature, the model systematically takes into account the effect of case mix. Going beyond past research, the model highlights differences in physician decision making in response to obstetric factors. Distinguishing the effects of physician decision making and case mix is important in understanding why c-section rates vary and in developing programs to effect change in physician behavior. The model was applied to a sample of deliveries at a hospital where physicians exhibited considerable variation in their c-section rates. Comparing groups with a low versus high rate, the authors' general conclusion is that the difference in physician decision tendencies (to perform a c-section), in response to specific obstetric factors, is at least as important as case mix in explaining variation in c-section rates. The exact effects of decision making versus case mix depend on how the model application defines the obstetric condition of interest and on the weighting of deliveries by their estimated "risk of Cesarean." The general conclusion is supported by an additional analysis that uses the model's elements to predict individual physicians' annual c-section rates.
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Gröbner, Susanne N; Worst, Barbara C; Weischenfeldt, Joachim
In this Article, author Benedikt Brors was erroneously associated with affiliation number '8' (Department of Developmental Neurobiology, St Jude Children's Research Hospital, Memphis, Tennessee, USA); the author's two other affiliations (affiliations '3' and '7', both at the German Cancer Researc...
Author Details. Journal Home > Advanced Search > Author Details. Log in or Register to get access to full text downloads. ... An algorithm to retrieve Land Surface Temperature using Landsat-8 Dataset Abstract PDF. ISSN: 2225-8531.
Pearson, Greg A; MacKenzie, Ian Z
To observe the incidence of, indications for, and complications associated with second-stage cesarean delivery in 10-year intervals over 30 years. The present analysis of prospectively collected data compared cesarean deliveries during 1976, 1986, 1996, and 2006 at John Radcliffe Hospital in Oxford, UK (n=3222). Pregnancy, delivery, and neonatal details were reviewed. The proportion of deliveries by cesarean in the second stage of labor increased from 0.5% (22/4464) in 1976 to 2.1% (124/5998) in 2006 (Pcesarean deliveries during the second stage because of failed instrumental delivery also increased over the study period from 59.1% (13/22) in 1976 to 71.0% (88/124) in 2006. Compared with cesareans at other stages, uterine trauma (Pcesarean delivery. Neonates delivered by second-stage cesarean had lower Apgar scores (Pcesarean earlier in labor. A trend towards an increase in neonatal trauma with second-stage cesarean compared with cesarean delivery before labor or during the first stage did not reach statistical significance. The proportion of deliveries by cesarean in the second stage of labor increased; these deliveries were associated with greater maternal and neonatal morbidity, but were not influenced by the indication for cesarean. © 2017 International Federation of Gynecology and Obstetrics.
Full Text Available Chewing gum has been reported to enhance bowel function. However, the efficacy remains unclear for women undergoing cesarean delivery. The aim of this meta-analysis is to evaluate the efficacy of chewing gum for recovering intestinal function following cesarean delivery in the early postoperative period. Electronic databases including MEDLINE, EMBASE, Cochrane Library were searched to identify English language randomized controlled trials comparing chewing gum with other procedures for promoting the recovery of intestinal function after cesarean delivery. Two of the authors independently extracted data from the eligibility studies, and Review Manager Version 5.2 was used to pool the data. Finally, five randomized controlled trials involving 882 patients were included and all the trials were considered as at high risk of bias. The pooled findings showed that chewing gum after cesarean delivery can significantly shorten the time to first flatus [standardized mean difference (SMD = −0.73; 95% confidence interval (CI = −1.01 to −0.14; p < 0.001]; time to first hearing of normal intestinal sounds (SMD = −0.69; 95% CI = −1.20 to −0.17; p = 0.009; I² = 92%. Time to the first defecation (SMD = −0.53; 95% CI = −1.61 to −0.07; p = 0.07; I² = 92% and length of hospital stay (SMD = −0.59; 95% CI = −1.18 to 0.00; p = 0.05; I² = 93% were also reduced in the chewing gum group; however, these results were not statistically significant. The current evidence suggests that chewing gum has a positive effect on intestinal function recovery following cesarean delivery in the early postoperative period. However, more large-scale and high-quality randomized controlled trials are needed to confirm these results.
Kaelin Agten, Andrea; Cali, Giuseppe; Monteagudo, Ana; Oviedo, Johana; Ramos, Joanne; Timor-Tritsch, Ilan
The term cesarean scar pregnancy refers to placental implantation within the scar of a previous cesarean delivery. The rising numbers of cesarean deliveries in the last decades have led to an increased incidence of cesarean scar pregnancy. Complications of cesarean scar pregnancy include morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that cesarean scar pregnancies that are implanted within a dehiscent scar ("niche") behave differently compared with those implanted on top of a well-healed scar. To date there are no studies that have compared pregnancy outcomes between cesarean scar pregnancies implanted either "on the scar" or "in the niche." The purpose of this study was to determine the pregnancy outcome of cesarean scar pregnancy implanted either "on the scar" or "in the niche." This was a retrospective 2-center study of 17 patients with cesarean scar pregnancy that was diagnosed from 5-9 weeks gestation (median, 8 weeks). All cesarean scar pregnancies were categorized as either implanted or "on the scar" (group A) or "in the niche" (group B), based on their first-trimester transvaginal ultrasound examination. Clinical outcomes based on gestational age at delivery, mode of delivery, blood loss at delivery, neonate weight and placental histopathologic condition were compared between the groups with the use of the Mann-Whitney U test. Myometrial thickness overlying the placenta was compared among all the patients who required hysterectomy and those who did not with the use of the Mann-Whitney U test. Myometrial thickness was also correlated with gestational age at delivery with the use of Spearman's correlation. Group A consisted of 6 patients; group B consisted of 11 patients. Gestational age at delivery was lower in group B (median, 34 weeks; range, 20-36 weeks) than in group A (median, 38 weeks; range, 37-39 weeks; P=.001). In group A, 5 patients were delivered via cesarean delivery (with normal placenta), and
Marlowe, Douglas B.; Festinger, David S.; Lee, Patricia A.; Dugosh, Karen L.; Benasutti, Kathleen M.
This article reports outcomes from a program of experimental research evaluating the risk principle in drug courts. Prior studies revealed that participants who were high risk and had (a) antisocial personality disorder or (b) a prior history of drug abuse treatment performed better in drug court when scheduled to attend biweekly judicial status hearings in court. In contrast, participants who were low risk performed equivalently regardless of the court hearings schedule. This study prospectively matches drug court clients to the optimal schedule of court hearings based on an assessment of their risk status and compares outcomes to clients randomly assigned to the standard hearings schedule. Results confirmed that participants who were high risk and matched to biweekly hearings had better during-treatment outcomes than participants assigned to status hearings as usual. These findings provide confirmation of the risk principle in drug courts and yield practical information for enhancing the efficacy and cost-efficiency of drug courts. PMID:18174915
Full Text Available The sensational trial of Richard Bruno Hauptmann for the kidnapping and murder of Charles Lindberg’s young son in 1935 marked the starting point of the debate regarding the propriety of allowing cameras in courtrooms during judicial proceedings. This debate intensified during and following the 1994-1997 trial of O.J. Simpson. At issue is how a court must weigh the Sixth Amendment right of the accused to a public trial and the First Amendment right to a free press, as well as its own interest in preserving the dignity and decorum of the courtroom. This paper examines the history, Federal rules, seminal court cases, and California rules concerning cameras in the courtroom in the context of these important Constitutional issues. This research provides qualitative data from 208 California judges that help explain some of the thinking by those who are empowered to accept or reject requests to record court proceedings.
Langford, Peter E
Unlike previous studies of the development of reasoning about moral dilemmas, the 2 studies reported separated judicial reasoning (the application of rules) from legislative reasoning (the justification of rules), as well as attending to other aspects of context, using a modification of the weakly interpretive scoring method of Langford and D'Cruz. This assigns justifications to relatively simple conceptually defined categories. Findings were in accord with substantially modified versions of the views of Piaget and Kohlberg, according to which legislative reasoning can be divided into 3 main types of stages in the period 7-21 years: heteronomy (Piaget) or egocentrism (Kohlberg); local groups (attention to group interests, harmony, and reciprocity in local groups), wider groups (attention to these thing in wider groups). Findings contradicted Gibbs's theory.
Full Text Available This paper compares the framing of the coverage of judicial appointments in Israel in 2008 in two newspapers with nomination news from preceding years and to the patterns of press coverage in the U.S. A content analysis of 101 Supreme Court nomination articles indicated that unlike the political frame of American coverage, the press in Israel preserves its ostensible commitment to the professionalism of judges while linking the Supreme Court to political maneuvering in the selection of candidates. These findings are discussed within the context of the media's role in constructing judicial nominations as a debate about the role of the Supreme Court in Israeli society. Este artículo compara el marco de la cobertura de los nombramientos judiciales en Israel en 2008 en dos periódicos, con noticias de nombramientos de años anteriores y en los Estados Unidos, con los patrones de cobertura de prensa en los EE.UU. Un análisis de contenido de 101 artículos de nombramientos de la Corte Suprema indicó que, a diferencia del marco político de la cobertura de América, la prensa en Israel consierva su aparente compromiso con la profesionalidad de los jueces, a pesar de que relaciona la Corte Suprema con maniobras políticas en la selección de candidatos. Estos resultados se discuten en el contexto del papel de los medios de comunicación en la construcción de los nombramientos judiciales como un debate sobre el papel de la Corte Suprema en la sociedad israelí. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=2478756
Foda, Ashraf A; Abdel Aal, Ibrahim A
The objective of the study was to measure the copeptin levels in maternal serum and umbilical cord serum at cesarean section and vaginal delivery in normotensive pregnancy and pre-eclamptic women. This was a prospective study at Mansoura University Hospital, Egypt. Ninety cases were included. They were divided into six groups: (1) normal pregnancy near term, as a control group, (2) primiparas who had vaginal delivery, (3) primiparas who had vaginal delivery and mild preeclampsia, (4) elective repeat cesarean section, (5) intrapartum cesarean section for indications other than fetal distress, and (6) intrapartum cesarean section for fetal distress. Serum copeptin concentrations were quantified with an enzyme-linked immunosorbent assay (ELISA). Mean, standard deviation, and paired t-test were used to test for significant change in quantitative data. The vaginal delivery groups had higher levels of maternal serum copeptin than the elective cesarean section group (P<0.01). Higher maternal serum copeptin levels were found in cases with pre-eclampsia as compared with the normotensive cases. The maternal copeptin levels during intrapartum cesarean section were higher than that during elective repeat cesarean section. There was a significant correlation between maternal copeptin levels and the duration of the first stage. In the presence of fetal distress, umbilical cord serum copeptin levels were significantly higher than other groups. Vaginal delivery can be very painful and stressful, and is accompanied by a marked increase of maternal serum copeptin. Increased maternal levels of serum copeptin were found in cases with pre-eclampsia as compared with the normotensive cases, and it may be helpful in assessing the disease. Intrauterine fetal distress is a strong stimulus to the release of copeptin into the fetal circulation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
The influence of the type of institutional setting on cesarean delivery is well documented. However, the traditional boundaries between public and private providers have become increasingly blurred with the commercialization of the state health sector that allows providers to tailor the quantity and quality of care according to patients' ability to pay. This study examined wealth-related variations in cesarean rates in six lower- and upper-middle income countries: the Dominican Republic, Egypt, Guatemala, Jordan, Pakistan, and the Philippines. Demographic and Health Survey data and a hierarchical regression model were used to assess wealth-related variations in cesarean rates in government and private hospitals while controlling for a wide range of women's socioeconomic and risk profiles. The odds of undergoing a cesarean delivery were greater in private facilities than government hospitals by 58% in Jordan, 129% in Guatemala, and 262% and 279% in the Dominican Republic and Egypt, respectively. Additional analysis involving interactions between the type of facility and wealth quintiles indicated that wealthier women were more likely to undergo a cesarean birth in government hospitals than poorer women in all countries but the Dominican Republic and Guatemala. Moreover, in both Egypt and Jordan, differences in cesarean rates between government and private hospitals were smaller for the wealthier strata than for the nonwealthy. Large wealth-related variations in the mode of delivery across government and private hospitals suggest the need for well-developed guidelines and standards to achieve a more appropriate selection of cases for cesarean delivery. © 2018 Wiley Periodicals, Inc.
Hernández-Martínez, Antonio; Pascual-Pedreño, Ana I; Baño-Garnés, Ana B; Melero-Jiménez, María R; Tenías-Burillo, José M; Molina-Alarcón, Milagros
To develop a predictive model for risk of cesarean section in pregnant women after induction of labor. A retrospective cohort study was conducted of 861 induced labors during 2009, 2010, and 2011 at Hospital "La Mancha-Centro" in Alcázar de San Juan, Spain. Multivariate analysis was used with binary logistic regression and areas under the ROC curves to determine predictive ability. Two predictive models were created: model A predicts the outcome at the time the woman is admitted to the hospital (before the decision to of the method of induction); and model B predicts the outcome at the time the woman is definitely admitted to the labor room. The predictive factors in the final model were: maternal height, body mass index, nulliparity, Bishop score, gestational age, macrosomia, gender of fetus, and the gynecologist's overall cesarean section rate. The predictive ability of model A was 0.77 [95% confidence interval (CI) 0.73-0.80] and model B was 0.79 (95% CI 0.76-0.83). The predictive ability for pregnant women with previous cesarean section with model A was 0.79 (95% CI 0.64-0.94) and with model B was 0.80 (95% CI 0.64-0.96). For a probability of estimated cesarean section ≥80%, the models A and B presented a positive likelihood ratio (+LR) for cesarean section of 22 and 20, respectively. Also, for a likelihood of estimated cesarean section ≤10%, the models A and B presented a +LR for vaginal delivery of 13 and 6, respectively. These predictive models have a good discriminative ability, both overall and for all subgroups studied. This tool can be useful in clinical practice, especially for pregnant women with previous cesarean section and diabetes.
Kirane, Akhilesh G; Gaikwad, Nandkishor B; Bhingare, Prashant E; Mule, Vidya D
Better diagnosis and early referral due to increased health care coverage have increased the cesarean deliveries at tertiary-care hospitals of India. Improvements in the health care system raise many concerns and need of cross-checking system in place to counter the problems pertaining to patient education and participation of patient. While most of the cesarean sections are done in good faith for the patient, it does not escape the purview of consumer awareness and protection. This cross-sectional study was undertaken at a tertiary level government institution to understand the level of awareness of 220 patients regarding the various aspects of cesarean delivery which are essential for women to know before giving an informed consent. 71 % of the women had knowledge about the indication and need to do cesarean delivery. Of these, only one-third (25 % of total women) were properly explained about procedure and complications. Other demographic and social characteristics were also evaluated. While the health care schemes have had their improved results, the onus lies upon the caregivers to improve and maintain the quality of health care in these tertiary-care government hospitals in proportion to the increase in patient load. The results of this study highlight the need for proper counseling of patients regarding complications of cesarean section. The fact that only 25 % of total cases were explained proper procedure and complication as opposed to 71 % of patients having proper knowledge about the indication of cesarean section points out the lack of information in seemingly "informed" consent. To bring about awareness about the risks and complications of cesarean section, there is a need that patients be counseled during the antenatal visits, specifically when patients visit near term for antenatal check up.
Venkata Sujatha Vellanki
Full Text Available Venkata Sujatha Vellanki1, Sarath Babu Gillellamudi21Department of Obstetrics and Gynaecology 2Department of General Surgery Kamineni Institute of Medical Sciences, Sreepuram, Narketpally, Nalgonda, Andhra Pradesh, IndiaPurpose: Cesarean section is the most common surgery performed in obstetrics. Incorporating a simulation model into training provides a safe, low-stress environment in which students can gain skills and receive feedback. The purpose of this study was to determine the effectiveness of obstetrics simulator training for medical students doing their internship.Methods: Twenty-five students posted in the Department of Obstetrics and Gynecology received a formal lecture on cesarean section and demonstration of the procedure on a mannequin in the first week of their internship, The study group (n = 12 practiced their skills on an obstetrics simulator under the direct supervision of a faculty member. The control group received no simulator-based training (n = 13 or further instruction. All students were asked to complete a prevalidated questionnaire to assess their level of confidence in performing the procedure after the educational session.Results: Compared with their peers in the study, students in the simulator group were significantly more likely to define the steps of cesarean section (91% vs 61.5%, and were comfortable in assisting cesarean section (100% vs 46.15% as they were able to identify the layers of abdomen opened during cesarean section. All 12 students reported this as an excellent experience.Conclusion: We were able to construct an inexpensive cesarean section trainer that facilitates instruction in cesarean section technique in a low-stress environment.Keywords: simulation, obstetrics, medical students
Kourtis, Athena P.; Ellington, Sascha; Pazol, Karen; Flowers, Lisa; Haddad, Lisa; Jamieson, Denise J.
Objective To compare rates of complications associated with cesarean delivery in HIV-infected and HIV-uninfected women in the United States and to investigate trends in such complications across four study cycles spanning the implementation of HAART in the United States (1995–1996, 2000–2001, 2005–2006, 2010–2011). Design The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project is the largest all-payer hospital inpatient care database in the United States; when weighted to account for the complex sampling design, nationally representative estimates are derived. After restricting the study sample to women aged 15–49 years, our study sample consisted of approximately 1 090 000 cesarean delivery hospitalizations annually. Methods Complications associated with cesarean deliveries were categorized as infection, hemorrhage, or surgical trauma, based on groups of specific International Classification of Diseases 9th revision codes. Length of hospitalization, hospital charges, and in-hospital deaths were also examined. Results The rate of complications significantly decreased during the study periods for HIV-infected and HIV-uninfected women. However, rates of infectious complications and surgical trauma associated with cesarean deliveries remained higher among HIV-infected, compared with HIV-uninfected women in 2010–2011, as did prolonged hospital stay and in-hospital deaths. Length of hospitalization decreased over time for cesarean deliveries of HIV-infected women to a greater extent compared with HIV-uninfected women. Conclusion In the United States, rates of cesarean delivery complications decreased from 1995 to 2011. However, rates of infection, surgical trauma, hospital deaths, and prolonged hospitalization are still higher among HIV-infected women. Clinicians should remain alert to this persistently increased risk of cesarean delivery complications among HIV-infected women. PMID:25574961
Assawapalanggool, Srisuda; Kasatpibal, Nongyao; Sirichotiyakul, Supatra; Arora, Rajin; Suntornlimsiri, Watcharin
Organ/space surgical site infections (SSIs) are serious complications after cesarean delivery. However, no scoring tool to predict these complications has yet been developed. This study sought to develop and validate a prognostic scoring tool for cesarean organ/space SSIs. Data for case and non-case of cesarean organ/space SSI between January 1, 2007 and December 31, 2012 from a tertiary care hospital in Thailand were analyzed. Stepwise multivariable logistic regression was used to select the best predictor combination and their coefficients were transformed to a risk scoring tool. The likelihood ratio of positive for each risk category and the area under receiver operating characteristic (AUROC) curves were analyzed on total scores. Internal validation using bootstrap re-sampling was tested for reproducibility. The predictors of 243 organ/space SSIs from 4,988 eligible cesarean delivery cases comprised the presence of foul-smelling amniotic fluid (four points), vaginal examination five or more times before incision (two points), wound class III or greater (two points), being referred from local setting (two points), hemoglobin less than 11 g/dL (one point), and ethnic minorities (one point). The likelihood ratio of cesarean organ/space SSIs with 95% confidence interval among low (total score of 0-1 point), medium (total score of 2-5 points), and high risk (total score of ≥6 points) categories were 0.11 (0.07-0.19), 1.03 (0.89-1.18), and 13.25 (10.87-16.14), respectively. Both AUROCs of the derivation and validation data were comparable (87.57% versus 86.08%; p = 0.418). This scoring tool showed a high predictive ability regarding cesarean organ/space SSIs on the derivation data and reproducibility was demonstrated on internal validation. It could assist practitioners prioritize patient care and management depending on risk category and decrease SSI rates in cesarean deliveries.
provided to preserving individual rights by “. . . narrowing the range of rights- violative options available to the government in the next emergency...relationship with the government as agent )142 who sounds a “fire alarm,” by bringing a complaint before the...Judicial Review,” 24-30. 142 Ibid., “Judicial Review Supports Popular Sovereignty by Mitigating the Principal- Agent Problem that Lies at the Heart of
Fadel, Hossam E
Guillimeau was the first to use the term cesarean section (CS) in 1598, but this name became universal only in the 20th century. The many theories of the origin of this name will be discussed. This surgery has been reported to be performed in all cultures dating to ancient times. In the past, it was mainly done to deliver a live baby from a dead mother, hence the name postmortem CS (PMCS). Many heroes are reported to have been delivered this way. Old Jewish sacred books have made references to abdominal delivery. It was especially encouraged and often mandated in Catholicism. There is evidence that the operation was done in Muslim countries in the middle ages. Islamic rulings support the performance of PMCS. Now that most maternal deaths occur in the hospital, perimortem CS (PRMCS) is recommended for the delivery of a fetus after 24 weeks from a pregnant woman with cardiac arrest. It is believed that emergent delivery within four minutes of initiation of cardiopulmonary resuscitation (CPR) improves the chances of success of maternal resuscitation and survival and increases the chance of delivering a neurologically intact neonate. It is agreed that physicians are not to be held legally liable for the performance of PMCS and PRMCS regardless of the outcome. The ethical aspects of these operations are also discussed including a discussion about PMCS for the delivery of women who have been declared brain dead.
The purpose of this paper is to provide a author capability of current author indexing practices in journal literature indexing practices in 'Journal of Nuclear Science and Technology of Japan'. This Journal employed keywords freely assigned by author and not taken from INIS Thesaurus or other vocabulary list. Author examined 413 literatures, comparing keywords assigned by the literatures' authors with descriptor's (ATOMINDEX) assigned by an experienced professional indexer. The results of the comparisons showed that the average set of terms assigned by author included about 70% of all the terms assigned to the same literature by the professional indexer. Authors eventually would contribute, for the most effective point to create reference to information is at the time of its generation. Consequently, it may be possible to transfer them easily to descriptors in every secondary information system. (author)
The goal of the current work is to delineate national judicial responses to Commission-issued competition soft law within two EU jurisdictions – the UK and the Netherlands. For this purpose, a comparative methodology is adopted and – in terms of theory – several hypotheses of possible judicial
Colwell, William Bradley
Due to state legislatures' reluctance to initiate school-funding reform, judicial bodies are asked to provide relief from alleged inequities. Before providing judicial review, the judiciary must decide whether an issue is justiciable (does not violate separation of powers) and warrants court intervention. Children's education has not substantially…
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Since the coming into force of the Charter as primary law of the EU, Article 47 CFR is ‘the reference standard’ when the Court deals with issues of ffective judicial protection. However, the general principle of effective judicial protection existed already for some 25 years, developed in the case
The goal of the current work is to delineate national judicial responses to Commission-issued competition soft law within two EU jurisdictions – the UK and the Netherlands. A comparative methodology is adopted and – in terms of theory – several hypotheses of possible judicial attitudes to soft law
... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Judicial review after waiver of hearing on a regulation. 1502.11 Section 1502.11 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS... petition for judicial review in a U.S. court of appeals under the appropriate statute. (1) The record for...
... judicial seizure and condemnation. 329.6 Section 329.6 Animals and Animal Products FOOD SAFETY AND... PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATION DETENTION; SEIZURE AND CONDEMNATION; CRIMINAL OFFENSES § 329.6 Articles or livestock subject to judicial seizure and condemnation. Any carcass...
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Full Text Available Mehmet Baki Senturk,1 Yusuf Cakmak,2 Halit Atac,2 Mehmet Sukru Budak3 1Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey; 2Department of Obstetrics and Gynecology, Batman State Hospital, Batman, Turkey; 3Department of Obstetrics and Gynecology, Diyarbakir Research Hospital, Diyarbakir, Turkey Abstract: Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P<0.01, but these were minor. The rate of blood transfusion and prevalence of changes in hemoglobin level were similar in both groups (P>0.05. In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of
METZ, Torri D.; ALLSHOUSE, Amanda A.; GILBERT, Sara A Babcock; DOYLE, Reina; TONG, Angie; CAREY, J. Christopher
Background Laborist practice models are associated with lower cesarean delivery rates than individual private practice models in several studies; however, this effect is not uniform. Further exploration of laborist models may help us better understand the observed reduction in cesarean delivery rates in some hospitals with implementation of a laborist model. Objective Our objective was to evaluate the degree of variation in primary cesarean delivery rates by individual laborists within a single institution employing a laborist model. In addition, we sought to evaluate whether differences in cesarean delivery rates resulted in different maternal or short-term neonatal outcomes. Study Design At this teaching institution, one laborist (either a generalist or maternal-fetal medicine attending physician) is directly responsible for labor and delivery management during each shift. No patients are followed in a private practice model nor are physicians incentivized to perform deliveries. We retrospectively identified all laborists who delivered nulliparous, term women with cephalic singletons at this institution from 2007-14. Overall and individual primary cesarean delivery rates were reported as percentages with exact Pearson 95% CI. Laborists were grouped by tertile as having low, medium or high cesarean delivery rates. Characteristics of the women delivered, indications for cesarean delivery, and short-term neonatal outcomes were compared between these groups. A binomial regression model of cesarean delivery was estimated, where the relative rates of each laborist compared to the lowest-unadjusted laborist rate were calculated; a second model was estimated to adjust for patient-level maternal characteristics. Results Twenty laborists delivered 2,224 nulliparous, term women with cephalic singletons. The overall cesarean delivery rate was 24.1% (95% CI 21.4-26.8). In an unadjusted binomial model, the overall effect of individual laborist was significant (pcesarean
Full Text Available Xing Lin Feng,1 Ying Wang,1 Lin An,2 Carine Ronsmans3 1Department of Health Policy and Administration, School of Public Health, Peking University, Beijing, People’s Republic of China; 2Department of Women, Children and Adolescent Health, School of Public Health, Peking University, Beijing, People’s Republic of China; 3Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England Objective: To review the current knowledge on the prevalence, reasons, and consequences of cesarean sections in the People’s Republic of China. Methods: Peer-reviewed articles were systematically searched on PubMed. The following Chinese databases were comprehensively searched: the China National Knowledge Infrastructure, Wanfang, and the VIP information. The databases were searched from inception to September 1, 2013. Two reviewers independently screened the titles and abstracts for eligibility. Full texts of eligible papers were reviewed, where relevant references were hand-searched and reviewed. Findings: Sixty articles were included from PubMed, 17 articles were intentionally picked out from Chinese journals, and five additional articles were added, for a total of 82 articles for the analysis. With a current national rate near 40%, the literature consistently reported a rapid rise of cesarean sections in the People’s Republic of China in the past decades, irrespective of where people lived or their socioeconomic standing. Nonclinical factors were considered as the main drivers fueling the rise of cesareans in the People’s Republic of China. There was a lively debate on whether women’s preferences or providers’ distorted financial incentives affected the rise in cesarean sections. However, recent evidence suggests that it might be the People’s Republic of China’s health development approach – focusing on specialized care and marginalizing primary care – that is playing a role. Although 30 articles