scholarly journals Challenges in the Caesarean Section of a Severely Kyphotic Parturient

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Manisha Chhetry ◽  
Basudeb Banerjee ◽  
Shanti Subedi ◽  
Narayan Bahadur Gharti Chhetri ◽  
Yogendra Gupta
Keyword(s):  
Caesarean Section ◽  
Skin Incision ◽  
Artery Ligation ◽  
Obstructed Labor ◽  
Uterine Incision ◽  
Uterine Artery Ligation ◽  
Breech Extraction ◽  
Good Exposure ◽  
Vertical Skin Incision ◽  
Lower Segment Uterine

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

DO TRANSVERSE SKIN INCISION & ADHESION AT POST CAESAREAN DELIVERY DELAY DELIVERY OF NEONATES & INCREASE MATERNAL MORBIDITY: A COHORT STUDY

2021 ◽  
pp. 65-70
Author(s):  
Bibekananda Das ◽  
Abhijit Pahari ◽  
Kajal Kumar Patra
Keyword(s):  
Cohort Study ◽  
Caesarean Section ◽  
Abdominal Wall ◽  
Skin Incision ◽  
Categorical Variables ◽  
Number Of Patients ◽  
Vertical Incision ◽  
Tertiary Teaching ◽  
Transverse Skin Incision ◽  
Vertical Skin Incision

Background: The most common major abdominal operation done on women is Caesarean section. Over the past century delivery by Caesarean section has been increased in both developed and developing countries. Various abdominal incisions have been used for Cesarean delivery. Today most of the caesarean section are performed with either a vertical infra umbilical midline incision [VIUI] or pfannenstiel incision. Both the skin incisions possess some benets and drawbacks. Methods: This study was a prospective cohort study conducted in the department of Gynaecology & Obstetrics, Burdwan Medical College & Hospital, Burdwan, West Bengal a tertiary teaching institute, from July, 2017 to November, 2018. 142 mothers were included in the study after informed consent from the patient about being a part of this study. Among them, 37 were with midline vertical skin incision, 51 were with transverse skin incision, and 54 were primigravida. Categorical variables are expressed as Number of patients and percentage of patients and compared across the groups using Pearson's Chi Square test for Independence of Attributes/ Fisher's Exact Test as appropriate. Results: 57.41% of primigravida are in 18 to 20 years age group, 42.59 % in 21-25 years, no women was over 25 years. women with previous vertical incision 27.03% have no adhesion, 59.46 % have mild adhesion, and 13.51% have severe adhesion. In women with previous transverse incision 21.57% have no adhesion, 47.06% have mild adhesion and 31.37%have severe adhesion. 34.7% adhesion are between uterus and bladder, 26.5% adhesion are between uterus and omentum, 20.4% adhesion are between uterus and abdominal wall, 12.2% adhesion between omentum and abdominal wall, 6.2% adhesion are in others organ Conclusions: There was signicant delay in delivery of neonates in post caesarean mothers with previous transverse skin incision than vertical incision. Previous transverse skin incision is associated with more severe adhesion than vertical skin incision

scholarly journals Whey peptides improve wound healing following caesarean section in rats

2010 ◽  
Vol 104 (11) ◽  
pp. 1621-1627 ◽  
Author(s):  
Junbo Wang ◽  
Ming Zhao ◽  
Rui Liang ◽  
Zhaofeng Zhang ◽  
Haifeng Zhao ◽  
...  
Keyword(s):  
Wound Healing ◽  
Tensile Strength ◽  
Caesarean Section ◽  
Skin Incision ◽  
Bursting Pressure ◽  
Albumin Concentration ◽  
Uterine Incision ◽  
Histological Characteristics ◽  
Scar Width ◽  
Improve Wound Healing

We sought to determine whether postcaesarean treatment with whey peptides (WP) affects the healing of skin and uterine incision in rats during puerperium. Forty-eight rats were randomly divided into two groups. After a caesarean section, twenty-four rats were intragastrically administered WP, while others were administered a control vehicle. On days 7, 14 and 21 after delivery, the serum total protein/albumin concentration, skin tensile strength, uterine bursting pressure, skin/uterine hydroxyproline (Hyp) concentration and histological characteristics of the scar were measured in eight rats in each group. In the WP group, the albumin concentration, skin tensile strength, uterine bursting pressure and Hyp concentration in the skin increased significantly on days 21, 7, 14 and 21, respectively. Low neutrophil count and smaller scar width in the skin incision were found in the WP group on day 7. Postcaesarean treatment with WP promoted significant wound healing in the skin incision, and had a significant wound healing potential in the uterus.

scholarly journals Dying uterus, uterine artery ligation-a curse or a blessing? a rare case report

2021 ◽  
Vol 10 (10) ◽  
pp. 4017
Author(s):  
Preeti Frank Lewis ◽  
Mridula Raghav ◽  
Roopali Sanjay Sehgal
Keyword(s):  
Caesarean Section ◽  
Uterine Artery ◽  
Case Reports ◽  
Uterine Fibroids ◽  
Rectus Muscle ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Severe Anaemia ◽  
Artery Ligation ◽  
Uterine Artery Ligation

Uterine necrosis is a rare life-threatening condition reported in few case reports associated with uterine artery embolization for uterine fibroids or postpartum hemorrhage. We report a case of hemorrhagic uterine necrosis in a 22-year-old primipara day 4 post emergency caesarean section who presented with breathlessness, abdominal distension and severe anaemia. Patient underwent emergency exploratory laparotomy 2 hours after the caesarean section with intraoperative findings suggestive of rectus muscle hematoma, bilateral uterine artery ligation was done for atonic PPH. On clinical examination uterus was corresponding to 28-30 weeks gestation size with guarding and tenderness. Ultrasonography revealed bulky uterus. CT abdomen with pelvis with contrast was done with findings suggestive of hemorrhagic ischaemic myometrial necrosis. An emergency exploratory laparotomy was performed with intraoperative findings of uterus size of 30 weeks gestation with diffuse congestion, gangrene of bilateral tubes and ovaries. Obstetric hysterectomy with bilateral salpingo-oovarectomy was done. Patient was discharged on postoperative day 9. High index of clinical suspension, prompt CT imaging and exploratory laparotomy on time proved life-saving.

scholarly journals Prevalence and root causes of surgical site infection among women undergoing caesarean section in Ethiopia: a systematic review and meta-analysis

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Fentahun Adane ◽  
Abay Mulu ◽  
Girma Seyoum ◽  
Alemu Gebrie ◽  
Akilog Lake
Keyword(s):  
Systematic Review ◽  
Caesarean Section ◽  
Surgical Site Infection ◽  
General Anesthesia ◽  
Subcutaneous Tissue ◽  
Meta Analysis ◽  
Skin Incision ◽  
Site Infection ◽  
Prolonged Labor ◽  
Vertical Skin Incision

Abstract Background Surgical site infection is a common complication in women undergoing Caesarean section and the second most common cause of maternal mortality in obstetrics. In Ethiopia, prevalence and root causes of surgical site infection post-Caesarean section are highly variable. This systematic review and meta-analysis estimate the overall prevalence of surgical site infection and its root causes among women undergoing Caesarean section in Ethiopia. Method Systematic review and meta-analysis were conducted to assess the prevalence and root causes of surgical site infection in Ethiopia. The articles were searched from the databases such as Medline, Google Scholar and Science Direct. A total of 13 studies from different regions of Ethiopia reporting the prevalence and root causes of surgical site infection among women undergoing Caesarean section were included. A random effect meta-analysis model was computed to estimate the overall prevalence. In addition, the association between risk factor variables and surgical site infection related to Caesarean section were examined. Results Thirteen studies in Ethiopia showed that the overall prevalence of surgical site infection among women undergoing Caesarean section was 8.81% (95% CI: 6.34–11.28). Prolonged labor, prolonged rupture of membrane, presence of anemia, presence of chorioamnionitis, presence of meconium, vertical skin incision, greater than 2 cm thickness of subcutaneous tissue, and general anesthesia were significantly associated with surgical site infection post-Caesarean section. Conclusion Prevalence of surgical site infection among women undergoing Caesarean section was relatively higher in Ethiopians compared with the report of center of disease control guideline. Prolonged labor, prolonged rupture of membrane, presence of anemia, chorioamnionitis, presence of meconium, vertical skin incision, greater than 2 cm thickness of subcutaneous tissue and/or general anesthesia were significantly associated with surgical site infection post-Caesarean section.

scholarly journals A case series of masquerade postpartum haemorrhage

2018 ◽  
Vol 7 (12) ◽  
pp. 5165
Author(s):  
Oluwasomidoyin O. Bello ◽  
Olatunji O. Lawal
Keyword(s):  
Caesarean Section ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Hemodynamic Instability ◽  
Artery Ligation ◽  
College Hospital ◽  
Bleeding Vessel ◽  
Uterine Incision ◽  
Good Clinical Condition ◽  
Case Series Report

Postpartum hemorrhage (PPH) is an obstetric emergency with different causes. Management is directed towards the cause and can be medical or surgical. This is a case series report of four patients who presented to University College Hospital; Ibadan, Nigeria with PPH following emergency caesarean section (EMCS) with three performed for prolonged obstructed labour. All the cases had severe PPH, hemodynamic instability and presented 14 to 84 days post caesarean section. Surgical exploration revealed extension of caesarean incision into the uterine vessel with slipped ligature in two of them and bleeding vessel without ligature in the other two. Two had haemostasis secured with uterine artery ligation, one had repair of uterine incision extension while the 4th had hysterectomy. The length of hospital stay was 5 to 13 days. All recovered fully post-operatively and were discharge home in good clinical condition.

The Efficiency of Temporary Uterine Artery Ligation on Prevention of the Bleeding in Cesarean Section

2021 ◽  
pp. 1-8
Author(s):  
Recep Erin ◽  
Ahmed İssak ◽  
Kübra Baki Erin ◽  
Deniz Kulaksiz ◽  
Yeşim Bayoğlu Tekin
Keyword(s):  
Cesarean Section ◽  
Uterine Artery ◽  
Mean Value ◽  
Controlled Study ◽  
Closing Time ◽  
Artery Ligation ◽  
Uterine Incision ◽  
Uterine Artery Ligation ◽  
Before And After ◽  
Difference Operation

<b><i>Objective:</i></b> We aimed to evaluate the effect of temporary ligation of the uterine artery on postpartum bleeding during uncomplicated cesarean section. <b><i>Design:</i></b> This was a prospective, randomized, and controlled study. We recruited a total of 200 patients, including 100 cases and 100 controls. <b><i>Methods:</i></b> The bilateral uterine artery was temporarily clamped 2 cm below the uterine incision in the study group and compared with controls. Patient demographics, the amount of intraoperative bleeding, the duration of the operation, the closure time of the uterine incision, the need for additional uterotonics, the need for additional sutures, and the hemoglobin values before and after birth were assessed. <b><i>Results:</i></b> The mean value of the amount of bleeding in the clamped and control groups was 267.3 ± 131.8 mL and 390.2 ± 116.4 mL, respectively. The amount of bleeding was significantly decreased for clamped group (<i>p</i> &#x3c; 0.001). A significant reduction occurred in the results of pre- and postoperative values of hemoglobin and hematocrit difference, operation duration, and the closing time of the uterine incision in the experimental group which has temporary uterine artery clamping. <b><i>Limitations:</i></b> The cases of recurrent cesareans were not included in this study. <b><i>Conclusion:</i></b> Temporary uterine artery ligation can be used to reduce the amount of bleeding during uncomplicated cesarean delivery and prevent postpartum hemorrhage.

COMPARATIVE STUDY BETWEEN PATWARDAN TECHNIQUE OF DELIVERY AND TRADITIONAL WAY OF DELIVERING BABIES BY PULL OR PUSH METHOD AT MMCH, MADHUBANI, BIHAR

2021 ◽  
pp. 28-29
Author(s):  
Chhote Lal Paswan ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Comparative Study ◽  
Uterine Artery ◽  
Broad Ligament ◽  
Blood Transfusions ◽  
Artery Ligation ◽  
Uterine Artery Ligation ◽  
Haematoma Formation

In this paper we discuss the after math of two different approaches of delivering the babies during caesarean section in advanced labour. The two techniques are “Patwardans Technique” and “Traditional way of delivering the babies by Pull or Push method”. The post-operative factors that were monitored include uterine extensions, broad ligament haematoma formation relaparotomy, uterine artery ligation and need for blood transfusions. It was concluded only after studying 200 patients that Patwardans technique is relatively a better technique.

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