scholarly journals EP22.21: Screening for Caesarean scar pregnancy in pregnant women with history of previous Caesarean section

2019 ◽  
Vol 54 (S1) ◽  
pp. 384-384
Author(s):  
M. Barati
2021 ◽  
Vol 86 (3) ◽  
pp. 184-188
Author(s):  
Adrián Totka ◽  
◽  
Martin Gábor ◽  
Martin Alföldi ◽  
Ivana Kunochová ◽  
...  

Summary: Objective: To describe the case of ectopic pregnancy in the scar after caesarean section and its successful treatment using the technique of sonographically controlled vacuum aspiration. Case report: The case of a 35-year-old patient with a history of two caesarean sections referred by a district gynecologist in the 6th week of pregnancy with suspected pathological localization of pregnancy in a scar after a previous caesarean section. The procedure for the diagnosis and treatment of ectopic pregnancy in the scar after previous caesarean sections has been successfully resolved using sonographically controlled vaginal vacuum aspiration. Conclusion: Caesarean scar pregnancy occurs as a complication of previous caesarean section or other uterine instrumental performances. The use of the sonographically controlled vacuum aspiration technique appears to be a successful method of treating pregnancy in a scar after a caesarean section.


2021 ◽  
pp. 28-29
Author(s):  
Naina Yadav ◽  
Kalpana Tiwari ◽  
Priyanka Goel

Caesarean scar pregnancy (CSP) is an ectopic pregnancy implanted in (1) the myometrium at the site of a previous caesarean section scar Its incidence is rising with the increase in number of caesarean sections .Very rst case was reported in 1978


Author(s):  
Anjali Choudhary ◽  
Meenakshi Tanwar ◽  
Shweta Nimonkar ◽  
Shailly Singh

Background: With the increasing caesarean section rates a new challenging evil of caesarean scar pregnancy (CSPs) has emerged. As a variant of ectopic pregnancy caesarean scar pregnancy is the rarest of all. Diagnosis and management of CSP can be challenging especially when there are no early symptoms and even lessor index of suspicion.  Objective of this endeavour was to present one institute experience of management of caesarean scar pregnancies.Methods: This are a retrospective analysis of women admitted with CSP. Detailed history, investigation, management protocols and complications were noted.Results: Of the total cases maximum women (60%) had history of previous two caesarean section. 90 % of cases were managed successfully with intra-sac or systemic methotrexate, and surgical evacuation with Foley’s catheter tamponade, only two women needed hysterectomy for uncontrolled bleeding.Conclusions: Caesarean scar pregnancy is a diagnostic and management challenge in modern obstetrics. Early ultrasound diagnosis helps in planning a successful medical treatment and serves to preserve uterus and fertility. Treatment with transabdominal intra-sac methotrexate and Foley’s catheter for tamponade is safe and effective method of treating CSPs.


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):  
Nandita Sushilkumar Kaushal ◽  
Shrikrushna Vasant Chavan ◽  
Arundhati Gundu Tilve ◽  
C. V. Hegde

Caesarean scar ectopics are the newest member of this obstetric emergency. Although rare, are associated with torrential haemorrhage. Gravida 3 para 2 with previous two caesarean sections with spotting per vaginum. Ultrasound showed a pregnancy embedded in the scar of previous caesarean section. MRI confirmed it. Beta human chorionic gonadotropin (HCG) was 15000 which dropped to 5000 after. An innovative approach was taken to laparoscopically evacuate the pregnancy. The products of conception were removed and the incision sutured so as to achieve haemostasis. Beta HCG was 15000 which dropped to 5000. Patient was haemodynamically stable and discharged on day 3. An innovative approach with skilled surgical technique not only decreased the morbidity but also avoided an unnecessary hysterectomy.


2019 ◽  
Vol 47 (5) ◽  
pp. 2248-2255
Author(s):  
Piotr Szkodziak ◽  
Anna Stępniak ◽  
Piotr Czuczwar ◽  
Filip Szkodziak ◽  
Tomasz Paszkowski ◽  
...  

Rates of caesarean section have increased over recent years and so too have associated complications, one of which is a caesarean scar defect (CSD). The defect may cause gynaecological symptoms, such as menometrorrhagia, infertility, chronic abdominal/pelvic pain or it may be asymptomatic. The presence of CSD may lead to obstetrical sequalae such as preterm delivery, uterine rupture, caesarean scar pregnancy or abnormal placenta implantation. Three cases of CSD are described here. In one case, surgical correction of the CSD was performed before a subsequent pregnancy with an uncomplicated obstetric outcome. In the other two cases, surgical correction of the CSD was not performed and the pregnancies were complicated by caesarean scar dehiscence and caesarean scar pregnancy. We suggest that women with a CSD may benefit from surgical correction of the defect before becoming pregnant to reduce the likelihood of serious complications.


2019 ◽  
Vol 12 (2) ◽  
pp. e226747 ◽  
Author(s):  
Samuel Birch ◽  
Corrine Lu

A 36-year-old woman with a history of one previous caesarean section presented to the birthing suite of a regional hospital with spontaneous rupture of membranes at 39+2/40 weeks. Syntocinon was administered to initiate uterine contractions in the absence of labour, as the patient desired vaginal birth. A caesarean section was subsequently indicated and ergometrine was administered for uterine atony. The patient immediately developed atrial fibrillation (AF). AF is the most common sustained arrhythmia in the general population, but is rare in the obstetric population. AF occurring in an intrapartum setting following the administration of syntocinon and ergometrine, is not documented in the literature. We suggest the initiation of paroxysmal AF was precipitated by an abrupt alteration in autonomic tone caused by administration of syntocinon followed by ergometrine.


2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.


2021 ◽  
Vol 11 (5) ◽  
pp. 358-361
Author(s):  
Sunil V. Jagtap ◽  
Nitin Kshirsagar ◽  
Ramnik Singh

Caesarean Scar Ectopic Pregnancy (CSEP) is one of the rarest forms of ectopic pregnancy. We present a 30 year female presented with 8 weeks of amenorrhea. Her obstetric history was G3P2D2. Her B HCG levels were >10,000 IU/L. She had history of previous 2 lower uterine segment Caesarean section. She was referred to our hospital in stage of severe hypovolemic shock related to vaginal bleeding. USG findings were suggestive of death of fetus of about 6 weeks 5 days. Gestational -sac at lower uterine segment Caesarean section scar level. Radiological diagnosis was? Scar pregnancy. On histopathology diagnosed as Caesarean scar ectopic pregnancy with area of rupture in anterolateral wall of lower uterine segment and upper cervix. The endometrium was unremarkable. We are presenting this case for its rarity, clinical radiological and histopathological findings. Key words: Scar ectopic pregnancy, Uterine rupture, Gestation, Caesarean section.


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