scholarly journals Prevalence of pelvic adhesions on ultrasound examination in women with a history of Cesarean section

2014 ◽  
Vol 45 (2) ◽  
pp. 223-228 ◽  
Author(s):  
F. Moro ◽  
D. Mavrelos ◽  
K. Pateman ◽  
T. Holland ◽  
W. L. Hoo ◽  
...  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Mi ◽  
Pengfei Qu ◽  
Na Guo ◽  
Ruimiao Bai ◽  
Jiayi Gao ◽  
...  

Abstract Background For most women who have had a previous cesarean section, vaginal birth after cesarean section (VBAC) is a reasonable and safe choice, but which will increase the risk of adverse outcomes such as uterine rupture. In order to reduce the risk, we evaluated the factors that may affect VBAC and and established a model for predicting the success rate of trial of the labor after cesarean section (TOLAC). Methods All patients who gave birth at Northwest Women’s and Children’s Hospital from January 2016 to December 2018, had a history of cesarean section and voluntarily chose the TOLAC were recruited. Among them, 80% of the population was randomly assigned to the training set, while the remaining 20% were assigned to the external validation set. In the training set, univariate and multivariate logistic regression models were used to identify indicators related to successful TOLAC. A nomogram was constructed based on the results of multiple logistic regression analysis, and the selected variables included in the nomogram were used to predict the probability of successfully obtaining TOLAC. The area under the receiver operating characteristic curve was used to judge the predictive ability of the model. Results A total of 778 pregnant women were included in this study. Among them, 595 (76.48%) successfully underwent TOLAC, whereas 183 (23.52%) failed and switched to cesarean section. In multi-factor logistic regression, parity = 1, pre-pregnancy BMI < 24 kg/m2, cervical score ≥ 5, a history of previous vaginal delivery and neonatal birthweight < 3300 g were associated with the success of TOLAC. The area under the receiver operating characteristic curve in the prediction and validation models was 0.815 (95% CI: 0.762–0.854) and 0.730 (95% CI: 0.652–0.808), respectively, indicating that the nomogram prediction model had medium discriminative power. Conclusion The TOLAC was useful to reducing the cesarean section rate. Being primiparous, not overweight or obese, having a cervical score ≥ 5, a history of previous vaginal delivery or neonatal birthweight < 3300 g were protective indicators. In this study, the validated model had an approving predictive ability.


2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Rini Rahmayanti

In the world according to WHO 2014 there are (16%) SEKSIO SESARIA deliveries that exceed the recommended limits. Whereas in Indonesia according to the 2013 Riskesdas the method of cesarean section surgery was 9.8% of the total 49,603 births throughout 2010-2013. Based on the 2013 Riskesdas data in West Sumatra the rate of West Sumatra cesarean section delivery (14%) where the figure is almost close to the maximum WHO standard. One common complaint felt by post seksio sesaria mothers is surgical pain. The purpose of this study was to determine the analysis of the application of murottal therapy in post-secsio caesarea women on the indication of a history of heart disease to reduce postoperative pain in the obstetric room of RSUP Dr. M. Djamil Padang. Nursing implementation in accordance with the objectives and interventions that have been formulated. The implementation is carried out for 5 days, from 3-7 June 2018. Ny. A listens to the explanation, and demonstrates the explanation given, especially murottal Al-Qur'an therapy to reduce postoperative pain. From the results of observations and interviews that the author did, Ny.A understood what had been explained and demonstrated. It is hoped that this research will be useful for health workers to be able to apply murottal therapy as one of the complementary therapies in treating post-cesarean patients.


2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.


Author(s):  
Poornima M.

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.


2020 ◽  
Vol 89 (5) ◽  
pp. 273-277
Author(s):  
T. Rick ◽  
E. Stock ◽  
I. Van de Maele ◽  
E. Kammergruber ◽  
J. Saunders

A six-year-old, female, neutered domestic shorthair cat was presented with chronic weight loss and a two-day history of partial anorexia and lethargy. Abdominal ultrasonography revealed a regional thickening of the duodenal wall with loss of normal layering, a normally walled segmentally dilated distal aspect of the common bile duct containing slightly hyperechoic bile, and a mild to moderately enlarged major duodenal papilla. Based on the ultrasound examination, the primary differential diagnosis was a peripapillary duodenal neoplastic or less likely, an inflammatory or infectious process with secondary extrahepatic biliary obstruction. Postmortem examination revealed a duodenal, peripapillary adenocarcinoma with metastasis into the liver and lymph nodes, and external compressive obstruction of cystic- and common bile duct.


2020 ◽  
Author(s):  
Se Jin Lee ◽  
Hyun Sun Ko ◽  
Sunghun Na ◽  
Jin Young Bae ◽  
Won Joon Seong ◽  
...  

Abstract Background: Our objective was to evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. Methods: We analyzed the national health insurance database, which covers almost the entire Korean population, between 2004 and 2015. The risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma, were analyzed in multivariate logistic regression analysis. Results: During the study period, 38,402 women with diagnosed myoma(s), 9,890 women with a history of myomectomy, and 740,675 women without a diagnosed myoma gave birth. Women with a history of diagnosed myoma(s) and women with a history of myomectomy had significantly higher risks of cesarean section (aOR 1.13, 95% CI 1.1-1.16 and aOR 7.46, 95% CI 6.97-7.98, respectively) and placenta previa (aOR 1.41, 95% CI 1.29-1.54 and aOR 1.58, 95% CI 1.35-1.83, respectively), compared to women without a diagnosed myoma. And the risk of uterine rupture was significantly higher in women with previous myomectomy (aOR 12.78, 95% CI 6.5-25.13), compared to women without a diagnosed myoma, which was much increased (aOR 41.35, 95% CI 16.18-105.69) in nulliparous women. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: Women with a history of myomectomy had significantly higher risks of cesarean section and placenta previa compared to women without a diagnosed myoma.


Author(s):  
Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽  
Lankaonde Martin ◽  
Savadogo-Komboigo B. Eveline ◽  
S. I. B. Sansan Rodrigue ◽  
Ouedraogo Wendlassida Estelle ◽  
...  

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.


2021 ◽  
Vol 17 ◽  
pp. 174550652110619
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa

Background: One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia. Methods: A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings. Results: We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial. Conclusion: Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.


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