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difficult cesarean

Fatimah Alnafisah, Shaimaa K Dawa, Sherif Alalfy
Cutaneous endometriosis is one of the rare gynecological conditions. Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity. It commonly occurs in pelvic sites, such as the ovaries, cul-de-sac, bowel, or pelvic peritoneum. Endometriosis at the incisional scar is difficult to diagnose because of nonspecific symptoms. Usually, patients complain of pain at the site of the incision during menstruation. The main causes in most of the reported cases are obstetrical and gynecological surgeries...
January 13, 2018: Curēus
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
Berna Haliloglu Peker, Erdin Ilter, Hakan Peker, Aygen Celik, Ali Gursoy, Onur Gunaldi
STUDY OBJECTIVE: To demonstrate laparoscopic sacrohysteropexy for a case of uterine prolapse in a 12 weeks and 3 days pregnant woman. To our knowledge, this is the first case of laparoscopic sacrohysteropexy performed at 12th weeks of gestation to be reported in literature. DESIGN: A step-by-step explanation of the surgical procedure (Canadian Task Force classification III) SETTING: Uterine prolapse is very rare condition manifesting in an estimated 10000 to 15000 pregnancies (1)...
February 12, 2018: Journal of Minimally Invasive Gynecology
Shashikant L Sholapurkar
There is an increasing incidence of cesarean scar (CS) defect/niche and its sequelae, probably not entirely explained by better diagnosis or rising cesarean rate. Discussion of possible etiological factors has received scant attention but would be important to formulate preventive strategies. Meaningful informative studies on long-term sequelae of cesarean section are very difficult and none are available for causation of CS defect. Hence, it is crucial to identify key areas in etiology of CS defect for focused research...
March 2018: Journal of Clinical Medicine Research
Waleed Riad, Tarek Ansari, Nanda Shetty
Background: Failed intubation in obstetrics remains the most common cause of death directly related to anesthesia. Neck circumference has been shown to be a predictor for difficult intubation in morbidly obese patients. The aim of this study was to determine an optimal cutoff point of neck circumference for prediction of difficult intubation in obstetric patients. Methods: Ninety-four parturients scheduled for cesarean section under general anesthesia were included in the study...
January 2018: Saudi Journal of Anaesthesia
V A Eley, A Chin, I Tham, J Poh, P Aujla, E Glasgow, H Brown, K Steele, L Webb, A van Zundert
BACKGROUND: Management of labor epidurals in obese women is difficult and extension to surgical anesthesia is not always successful. Our previous retrospective pilot study found epidural extension was more likely to fail in obese women. This study used a prospective cohort to compare the failure rate of epidural extension in obese and non-obese women and to identify risk factors for extension failure. METHODS: One hundred obese participants (Group O, body mass index ≥ 40 kg/m2 ) were prospectively identified and allocated two sequential controls (Group C, body mass index ≤ 30 kg/m2 )...
February 4, 2018: Acta Anaesthesiologica Scandinavica
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
Jitendra Singh Nigam, Anita Omhare, Ankit Sharma
Endometriosis is the presence of functioning endometrium outside the basement membrane of the uterine endometrium. It affects women of reproductive age and usually presents as a painful nodule over a period of 3 months to 10 years after surgery. Extrapelvic endometriosis is uncommon and more difficult to diagnose due to its variable presentation and is often confused with other surgical conditions. Fine-needle aspiration cytology (FNAC) is a rapid, cost-effective, and accurate diagnostic tool when making this diagnosis...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Manohar Panneer, Saravana Babu, Prakash Murugaiyan
Background and Aim: Physiological changes during pregnancy and the sympatho adrenalstimulation during larynoscopy and intubation leads to evaluation of safe devices to secure airway during cesarean section under general anesthesia. I-gel, recently emerging effective supra glottic device found safe during general anesthesia in cesarean section. Aim of the study is to compare the hemodynamic disturbances and airway related complications of I-gel and Endotracheal tube in patients undergoing cesarean section under general anesthesia...
October 2017: Anesthesia, Essays and Researches
Mihaela Grigore, Demetra Socolov, Ioana Pavaleanu, Ioana Scripcariu, Ana Maria Grigore, Romeo Micu
Abdominal wall endometriosis (AWE) is a rare condition defined by the presence of endometrial tissue in the subcutaneous fatty layer and the muscles of the abdominal wall. It is usually caused by the dissemination of endometrial tissue in the wound at the time of obstetrical and gynecological surgeries. AWE is rare and difficult to diagnose. The most frequent clinical presentation is that of a palpable subcutaneous mass near surgical scars associated with cyclic pain and swelling during menses. AWE may be an underreported pathology partly because it has scarcely received attention in the radiologic literature...
November 29, 2017: Medical Ultrasonography
Scott D Fitzgerald, Jennifer Martinez, John P Buchweitz
A 7-y-old Weimaraner bitch was presented to emergency service after 3 h of active labor with no puppies produced. Hemoabdomen and hemothorax were present at the time of surgery; prothrombin time (PT) and activated partial thromboplastin time (aPTT) were both found to be within normal ranges. Surgical cesarean section was performed; 4 dead puppies and 5 live puppies were delivered. Because hemostasis was difficult to achieve, a hysterectomy was performed; however, the dog died as the operation was being completed...
November 1, 2017: Journal of Veterinary Diagnostic Investigation
Lisa Leffert, Alexander Butwick, Brendan Carvalho, Katherine Arendt, Shannon M Bates, Alex Friedman, Terese Horlocker, Timothy Houle, Ruth Landau, Heloise Dubois, Roshan Fernando, Tim Houle, Sandra Kopp, Douglas Montgomery, Joseph Pellegrini, Richard Smiley, Paloma Toledo
Venous thromboembolism is recognized as a leading cause of maternal death in the United States. Thromboprophylaxis has been highlighted as a key preventive measure to reduce venous thromboembolism-related maternal deaths. However, the expanded use of thromboprophylaxis in obstetrics will have a major impact on the use and timing of neuraxial analgesia and anesthesia for women undergoing vaginal or cesarean delivery and other obstetric surgeries. Experts from the Society of Obstetric Anesthesia and Perinatology, the American Society of Regional Anesthesia, and hematology have collaborated to develop this comprehensive, pregnancy-specific consensus statement on neuraxial procedures in obstetric patients receiving thromboprophylaxis or higher dose anticoagulants...
March 2018: Anesthesia and Analgesia
J Eric Jelovsek, Kevin Chagin, Maria Gyhagen, Suzanne Hagen, Don Wilson, Michael W Kattan, Andrew Elders, Matthew D Barber, Björn Areskoug, Christine MacArthur, Ian Milsom
BACKGROUND: Little progress has been made in the prevention of pelvic floor disorders, despite their significant health and economic impact. The identification of women who are at risk remains a key element in targeting prevention and planning health resource allocation strategies. Although events around the time of childbirth are recognized clinically as important predictors, it is difficult to counsel women and to intervene around the time of childbirth because of an inability to convey a patient's risk accurately in the presence of multiple risk factors and the long time lapse, which is often decades, between obstetric events and the onset of pelvic floor disorders later in life...
February 2018: American Journal of Obstetrics and Gynecology
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah Altahtam
With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia (RA) difficult and unpredictable, we report anesthetic management of such a patient who underwent CS using continuous spinal anesthesia technique...
October 2017: Saudi Journal of Anaesthesia
N Chaillet, E Bujold, B Masse, W A Grobman, P Rozenberg, J C Pasquier, A Shorten, M Johri, F Beaudoin, H Abenhaim, S Demers, W Fraser, M Dugas, S Blouin, E Dubé, R Gauthier
BACKGROUND: Rates of cesarean delivery are continuously increasing in industrialized countries, with repeated cesarean accounting for about a third of all cesareans. Women who have undergone a first cesarean are facing a difficult choice for their next pregnancy, i.e.: (1) to plan for a second cesarean delivery, associated with higher risk of maternal complications than vaginal delivery; or (b) to have a trial of labor (TOL) with the aim to achieve a vaginal birth after cesarean (VBAC) and to accept a significant, but rare, risk of uterine rupture and its related maternal and neonatal complications...
September 20, 2017: Trials
Hiroaki Soyama, Morikazu Miyamoto, Hidenori Sasa, Hiroki Ishibashi, Masashi Takano, Kenichi Furuya
OBJECTIVE: Uterine artery embolization has become an effective treatment for postpartum hemorrhage. The safety of pregnancy after uterine artery embolization for postpartum hemorrhage has been established. CASE REPORT: We present the case of a pregnant woman with asymptomatic uterine complete rupture who underwent uterine artery embolization for a previous placenta previa. She had not been diagnosed with uterine rupture until cesarean section was performed, and fortunately, we obtained the best maternal and neonatal outcomes...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
Theresa Morris, Kelly McNamara, Christine H Morton
BACKGROUND: Given the increasing proportion of United States hospitals that are for-profit, we examined whether women who give birth in for-profit hospitals are more likely to have cesareans than women who give birth in not-for-profit hospitals. We hypothesized that cesareans are more likely to occur in for-profit hospitals because of the organizational emphasis on short-term financial indicators, including payment of shareholder dividends. METHODS: We used logistic regression and difference of means tests to analyze data from the Listening to Mothers III survey of women who gave birth in the United States in 2011 and 2012...
July 24, 2017: Birth
Hiroki Ishibashi, Morikazu Miyamoto, Hiroshi Shinnmoto, Wakana Murakami, Hiroaki Soyama, Masaya Nakatsuka, Takahiro Natsuyama, Masashi Yoshida, Masashi Takano, Kenichi Furuya
PURPOSE: The aim of this study was to prenatally predict placenta accreta in posterior placenta previa using magnetic resonance imaging (MRI). METHODS: This retrospective study was approved by the Institutional Review Board of our hospital. We identified 81 patients with singleton pregnancy who had undergone cesarean section due to posterior placenta previa at our hospital between January 2012 and December 2016. We calculated the sensitivity and specificity of several well-known findings, and of cervical varicosities quantified using magnetic resonance imaging, in predicting placenta accreta in posterior placenta previa...
October 2017: Archives of Gynecology and Obstetrics
Felicia Ketcheson, Christy Woolcott, Victoria Allen, Joanne M Langley
BACKGROUND: The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. METHODS: We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan...
July 11, 2017: CMAJ Open
Megan Marx Delaney, Pinki Maji, Tapan Kalita, Nabihah Kara, Darpan Rana, Krishan Kumar, Jenny Masoinneuve, Simon Cousens, Atul A Gawande, Vishwajeet Kumar, Bhala Kodkany, Narender Sharma, Rajiv Saurastri, Vinay Pratap Singh, Lisa R Hirschhorn, Katherine Ea Semrau, Rebecca Firestone
BACKGROUND: Adherence to evidence-based essential birth practices is critical for improving health outcomes for mothers and newborns. The WHO Safe Childbirth Checklist (SCC) incorporates these practices, which occur during 4 critical pause points: on admission, before pushing (or cesarean delivery), soon after birth, and before discharge. A peer-coaching strategy to support consistent use of the SCC may be an effective approach to increase birth attendants' adherence to these practices...
June 27, 2017: Global Health, Science and Practice
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