STUDY OF OBSTETRIC OUTCOMES IN ELECTIVE AND EMERGENCY CAESAREAN SECTION IN PATIENTS WITH PRIOR LOWER SEGMENT CAESAREAN SECTION

2021 ◽  
pp. 57-60
Author(s):  
Dipak S. Kolate ◽  
Meenal M. Patvekar ◽  
Shriraj Katakdhond ◽  
Yogesh Thawal ◽  
Kale DhanaLaxmi ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Caesarean Delivery ◽  
Emergency Caesarean Section ◽  
Obstetric Outcomes ◽  
Fetal Outcomes ◽  
Emergency Caesarean ◽  
Management Protocol ◽  
History Of

Background:Acomprehensive study of maternal morbidity and mortality with perinatal outcome in patients with prior LSCS undergoing elective or emergency caesarean section was carried out. With the sky rocketing caesarean section rates worldwide an increasing number of women face the issue of mode of delivery in their current pregnancy. There are conicting reports regarding the safety of a trial for vaginal birth after caesarean delivery (VBAC) in terms of uterine rupture, maternal and perinatal morbidity. The purpose of this study was to evaluate the obstetric and fetal outcomes of patients presenting at term with a history of previous one or more LSCS. Methods:Asix months prospective, observational study was conducted where all patients who had a term pregnancy with a history of previous one or more LSCS were included after obtaining their consent for participation. The obstetric and fetal outcomes of these patients with elective or emergency LSCS in the present pregnancy were noted and tabulated. Adescriptive analysis of these outcomes was carried out. Results: 100 Patients at term, with a history of previous one or more LSCS were studied. 38 patients underwent an elective repeat caesarean delivery and 62 in emergency.Scar dehiscence was seen in 35.5 % of the patients who were presented in emergency with uterine contractions or lower abdominal pain and those were not candidate for a trial for VBAC.All of the complications were signicantly higher in emergency group in terms of both maternal (83.9 % Vs 31.6%) and perinatal outcome (6.5% Vs 0 %). Conclusion:With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper antenatal counseling regarding plan of delivery and vigilance while operating patients with prior history of LSCS , especially in emergency situation. There should be a well dened management protocol in an effort to decrease the number of complications and bring down the overall maternal morbidity & mortality .

scholarly journals Desaceleraciones variables [Variable decelerations]

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Osvaldo Reyes
Keyword(s):  
Caesarean Section ◽  
Emergency Room ◽  
Female Patient ◽  
Fetal Monitoring ◽  
Emergency Caesarean Section ◽  
Uterine Contractions ◽  
Emergency Caesarean ◽  
History Of ◽  
Fetal Tachycardia ◽  
At Home

<p>Paciente femenina de 22 años con gestación de 38 semanas. Acude con historia de salida espontánea de líquido transvaginal en su casa, asociado a contracciones uterinas de 6 horas de evolución. Al llegar al hospital, con 3 centímetros de dilatación, 80% de borramiento, cefálico, membranas ovulares rotas, líquido meconial. Monitoreo fetal realizado en el cuarto de urgencias (figura 1) evidencia desaceleraciones profundas de tipología variable, variabilidad disminuida y taquicardia fetal hacia el final del trazo (más de diez minutos). Se realizó cesárea de urgencia, obteniéndose un producto de sexo masculino, APGAR 6/8, de 3200g, con triple circular de cordón al cuello. Evolución satisfactoria post parto.</p><p>22-year-old female patient with a 38-week gestation. She comes with history of spontaneous leakage of transvaginal fluid at home, associated with uterine contractions of 6 hours of evolution. On arrival at the hospital, with 3 centimeters of dilation, 80% effacement, cephalic, ruptured ovular membranes, meconial fluid. Fetal monitoring performed in the emergency room (Figure 1) shows deep decelerations of variable typology, decreased variability and fetal tachycardia towards the end of the line (more than ten minutes). An emergency caesarean section was performed, obtaining a male product, APGAR 6/8, of 3200g, with a triple circular cord around the neck. Satisfactory postpartum evolution.</p>

scholarly journals Association and Determinants of Decision-Delivery Interval of Emergency Caesarean Sections and Perinatal Outcome in a Tertiary Institution

2021 ◽  
Author(s):  
Peace Chinyere Igwe ◽  
John Okafor Egede ◽  
Emeka Onwe Ogah ◽  
Chidebe Christian Anikwe ◽  
Matthew Igwe Nwali ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Emergency Caesarean Section ◽  
P Value ◽  
Foetal Distress ◽  
Emergency Caesarean ◽  
Foetal Outcome ◽  
The Mean ◽  
Minute Apgar Score

Introduction: A Decision to Delivery Interval (DDI) of 30 minutes for emergency caesarean section has been widely recommended but there is little evidence to support it. This target may not be practicable in a busy maternity unity and therefore, the anticipated beneficial effect on neonatal outcome requires re-evaluation. Aim: To determine the association between decision-delivery interval and perinatal outcome of emergency caesarean section at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA) over a period of four years. Materials and Methods: This was a retrospective observational study of the cases in emergency caesarean sections performed at the Department of Obstetrics and Gynaecology, AEFUTHA from 1st January 2012 to 1st January 2016. Hospital records of the women with singleton pregnancy at term who delivered through emergency caesarean sections were retrieved. Data extracted include socio-demographic and obstetric characteristics, duration between decision for caesarean section and intervention, indications for the caesarean section, reasons for delay in DDI, association between booking status and DDI and association of DDI and foetal outcome, APGAR score at 1st and 5th minutes and admission to NICU. Data were analysed with IBM statistics version 20. The p-value <0.05 were regarded as statistically significant. Results: A total of 638 emergency caesarean sections involving singleton pregnancies at term, 522 (81.8%) of which had complete records and were analysed. The mean age of participants was 27.8±5.1 years, 89.3% were para 1-4 and 55.0% were unbooked. Only 6 (1.1%) of the emergency caesarean sections were performed within the recommended 30 minutes of DDI. The mean DDI was 189±124 minutes with range of 25 minutes to 1220 minutes. Two cases performed within 25 minutes were cases of foetal distress and cord prolapse while only a case of reduced foetal movement was delayed to 1220 minutes. The most common indications for emergency caesarean section were cephalopelvic disproportion 129 (24.7%) and foetal distress 65 (12.5%). The major cause of delay was delay in cross-matching of blood for surgery 136 (26.1%) while delay in giving informed consent contributed 67 (12.8%). There was no correlation between DDI of 75 minutes or above and the 1st minute APGAR score (AOR=2.48, CI=0.86-7.16, p-value=0.09), 5th minute APGAR score (AOR=3.08, CI=1.55-6.11, p-value=0.09), foetal outcome (AOR=0.82, CI=017-3.79, p-value=0.08) and admission to Newborn Intensive Care Unit (NICU) (AOR=2.08, CI=0.77-5.56, p-value=0.14). Conclusion: This study showed that there was no correlation between DDI>75 minutes and poor perinatal outcome. Efforts should be made to strengthen the health system and improve the quality of care in order to keep DDI within this time limit for improved perinatal health outcome and indices.

scholarly journals An appraisal of computed tomography pelvimetry in patients with previous caesarean section

2000 ◽  
Vol 6 (2-3) ◽  
pp. 260-264
Author(s):  
Y. M. Abou Ghazzeh ◽  
R. Barqawi
Keyword(s):  
Computed Tomography ◽  
Birth Weight ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Control Group ◽  
Previous Caesarean Section ◽  
Apgar Scores ◽  
Emergency Caesarean

This study was conducted to determine the value of computed tomography [CT] pelvimetry in patients with previous caesarean section. Of 219 pregnant women with one previous caesarean section, 100 had antenatal CT pelvimetry and a control group of 119 women had no CT pelvimetry. In the CT pelvimetry group, 51.0% delivered by caesarean section, 28.0% underwent elective caesarean section for contracted pelvis based on the findings of CT pelvimetry and 23% underwent emergency caesarean section after a trial labour. In the control group, 21.8% underwent emergency caesarean section. The differences in birth weight and Apgar scores between the groups were not statistically significant. CT pelvimetry increased the rate of caesarean delivery, suggesting that CT pelvimetry before a vaginal birth after a previous caesarean delivery is of limited value

scholarly journals Midgut malrotation with volvulus discovered at an emergency caesarean section for placental abruption

2021 ◽  
Vol 55 (1) ◽  
pp. 88-92
Author(s):  
Kofi T. Mensah ◽  
Raphael Kwarase ◽  
Stephenson Laari ◽  
William N. A. Thompson
Keyword(s):  
Small Bowel ◽  
Caesarean Section ◽  
Placental Abruption ◽  
Emergency Caesarean Section ◽  
Midline Laparotomy ◽  
Midgut Malrotation ◽  
Emergency Caesarean ◽  
Uncommon Presentation ◽  
History Of ◽  
Bowel Gangrene

Adult midgut malrotation with volvulus (AMMV) is an uncommon presentation which may be found incidentally during abdominal radiologic investigations or at laparotomy. We report a case of AMMV and small bowel gangrene in a 35-year-old Gravida four, Para three at 39 weeks, 4 days gestation who presented with a short history of worsening abdominal pain, repeated vomiting and abdominal wall guarding. Emergency caesarean section performed on account of a suspected placental abruption incidentally revealed a long segment of non-viable small intestine. Subsequent midline laparotomy disclosed a midgut malrotation with volvulus and bowel gangrene. This resulted in a 4.6m resection of non-viable small bowel with Ladd’s procedure. The patient developed moderate symptoms of short bowel syndrome in the post-operative period which was successfully managed non-operatively. This case report represents a rare diagnosis, in the West-African sub-region, of an adult midgut malrotation with volvulus mimicking a third trimester obstetric emergency.

scholarly journals Indications of Emergency Caesarean Section at a Tertiary Care Hospital in Dhaka City

2018 ◽  
Vol 15 (2) ◽  
pp. 36-40
Author(s):  
Rifat Sultana ◽  
Mahmuda Khatun ◽  
Dewan Shahida Banu ◽  
Mst Nurunnahar Aktar ◽  
Rumana Ashraf ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Emergency Caesarean Section ◽  
Hypertensive Disorder ◽  
Previous Caesarean Section ◽  
Foetal Distress ◽  
Common Indication ◽  
Obstructed Labour ◽  
Antepartum Haemorrhage ◽  
Emergency Caesarean ◽  
History Of

Background: Caesarean Section is now a common surgical practice during child birth.Objective: The purpose of the present study was to see the indication of emergency caesarean section.Methodology: This descriptive type of cross sectional study was conducted in the Department of Gynaecology & Obstetrics at Dhaka Medical College Hospital during the period from July 2006 to December 2006 for a period of 6 months. The pregnant women who were selected for emergency caesarean section during the mentioned period of study were included as study population. The details of the indication of the caesarean section were recorded.Result: A total number of 100 cases were recruited in this study. Among the all indications of emergency caesarean section history of previous caesarean section was the most common which was found in 25(25.0%) cases. Foetal distress was the second common indication of emergency caesarean section which was 18(18.0%) cases. Obstructed labour was also reported in 11(11.0%) cases. Antepartum haemorrhage (8.0%) was another indication of emergency caesarean section. Considering the hypertensive disorder preeclamptic toxaemia (7.0%), eclampsia (5.0%) and pregnancy induced hypertension (1.0%) were the reported as the indications of emergency caesarean section. Some other indications of emergency caesarean section were recorded which were mal-presentation (7.0%), prolonged labour (6.0%), cephalopelvic disproportion (4.0%) and failed trial labour (4.0%).Conclusion: In conclusion history of previous caesarean section is the most common indication for emergency caesarean section obstructed labour, antepartum haemorrhage as well as foetal distress, malpresentation and cephalopelvic disproportion.Journal of Science Foundation 2017;15(2):36-40

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