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Caesarean management

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
M Creaney, R M Moriarty, M Milner, C Murphy
Congenital muscular dystrophies are characterised by progressive skeletal muscle weakness from birth or early infancy. Maternal respiratory compromise, joint contractures and presence of spinal instrumentation or fusion are some of the anaesthetic challenges that may be encountered in the obstetric setting. The choice of anaesthetic technique for surgical delivery needs to be considered on an individual basis. Multi-disciplinary involvement is paramount to optimise peripartum care and outcomes. In this case report, we present the use of dexmedetomidine, humidified high-flow nasal oxygen, rocuronium and sugammadex in the anaesthetic management of a wheelchair-bound, non-invasive bilevel positive airway pressure ventilation-dependent parturient with congenital muscular dystrophy, who was presenting for caesarean section...
February 9, 2018: International Journal of Obstetric Anesthesia
S C Seah, S A L Laili, A Hairiah, A G Ab Rahim
Caesarean scar implantation is one of the rarest form of ectopic pregnancies and most unwanted complication of caesarean scar. However, with the increasing numbers of caesarean section performed, caesarean scar pregnancy (CSP) may be on the rise. The diagnosis is often difficult, but establishing an accurate diagnosis of CSP in the early first trimester is utmost important to prevent its detrimental consequences of uterine rupture and fatal haemorrhage. Hence, we present a case to highlight the role of imaging in diagnosing and managing this condition to prevent its associated high morbidity and mortality...
February 2018: Medical Journal of Malaysia
Jinglan Zhang, Jiakai Lu, Xiaorui Zhou, Xuefeng Xu, Qing Ye, Qitan Ou, Yanna Li, Jiapeng Huang
OBJECTIVES: The mortality of pregnant women with idiopathic pulmonary arterial hypertension (PAH) is very high. There are limited data on the management of idiopathic PAH during pregnancy. The authors aimed to examine systematically the characteristics of parturient women with idiopathic PAH, to explore the adverse effects of idiopathic PAH on pregnancy outcomes, and to report the multidisciplinary perioperative management strategy from the largest comprehensive cardiac hospital in China...
March 7, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Samanthi De Silva
No abstract text is available yet for this article.
March 2018: Journal of Perioperative Practice
Maria Lúcia Moleiro, Luís Guedes-Martins, Alexandrina Mendes, Cláudia Marques, Jorge Braga
Nowadays, postpartum hemorrhage is the major cause of maternal mortality and morbidity worldwide. Uterine atony is its main cause; thus, prophylactic measures, as well as medical and surgical fast approaches, have been developed to manage it. The uterine compression sutures are a possible treatment that preserves the uterus and, consequently, the fertility potential. Bearing that in mind, we report two cases of postpartum hemorrhage after caesarean section, successfully treated with a new modification of Pereira suture - longitudinal and transverse uterine sutures were applied after no response was registered to the first-line therapies...
February 2018: Revista Brasileira de Ginecologia e Obstetrícia
Emaduldin Seyam, Emad Moussa Ibrahim, Ayman Moheb Youseff, Eissa M Khalifa, Enas Hefzy
Objective: The aim of the current study was to laparoscopically investigate the effects of peritoneal nonclosure on the sites, types, and degrees of adhesions developed after primary caesarean section (CS) in women complaining of secondary infertility after first CS delivery. Study Design: This was a cross-sectional study, where 250 women suffering from secondary infertility after their first CS had been recruited. They had been classified into group I ( n  = 89), where both the visceral and parietal peritoneum had been left opened; group II ( n  = 75), where only the parietal peritoneum had been closed; and group III ( n  = 86), where both peritoneal layers had been closed...
2018: Obstetrics and Gynecology International
Rosalba De Nola, Edoardo Di Naro, Luca Maria Schonauer, Giuseppe Lucarelli, Michele Battaglia, Maria Grazia Fiore, Salvatore Andrea Mastrolia, Giuseppe Loverro
RATIONALE: PNETs (primitive neuroectodermal tumors) are a family of highly malignant neoplasms characterized by small round cells of neuroepithelial origin. They usually involve bone and soft tissues, and have a higher incidence in childhood. PATIENT CONCERNS: In this case report, we describe the obstetric and oncological outcome of a huge mass diagnosed as a leiomyoma in a 39-year-old pregnant woman who complained of low back pain, dysuria, and urinary frequency at 22 weeks of gestation...
January 2018: Medicine (Baltimore)
Kemal Beksaç, Fatih Aktoz, Gökçen Örgül, Hasan Tolga Çelik, A Seval Özgü-Erdinç, M Sinan Beksaç
OBJECTIVE: To evaluate "papillary thyroid carcinoma-pregnancy" interaction among cancer survivors. MATERIAL AND METHODS: The clinical records of 8 pregnant women who received treatment for papillary thyroid cancer before their pregnancy were evaluated. Clinical features, pregnancy/ perinatal outcomes and high-risk factors were compared with 45 control cases who were randomly assigned from the institutional perinatal medicine database. RESULTS: Patients in the cancer group were older than the control group (34...
February 20, 2018: Journal of the Turkish German Gynecological Association
Kassam Mahomed, Kellie Wild, Christopher R Weekes
BACKGROUND: Pre-labour rupture of membranes (PROM) at term is a common event with early induction of labour reducing infectious morbidity without increasing the caesarean rate. Syntocinon is commonly used for induction but prostaglandins are also routinely used. Large studies have shown no difference in the maternal and neonatal outcomes with either method. AIM: To assess the safety and efficacy of vaginal prostaglandin (PG) compared to syntocinon for induction of labour in term-PROM...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Haleema Shakur, Danielle Beaumont, Sue Pavord, Angele Gayet-Ageron, Katharine Ker, Hatem A Mousa
BACKGROUND: Postpartum haemorrhage (PPH) - heaving bleeding within the first 24 hours after giving birth - is one of the main causes of death of women after childbirth. Antifibrinolytics, primarily tranexamic acid (TXA), have been shown to reduce bleeding in surgery and safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.An earlier Cochrane review on treatments for primary PPH covered all the various available treatments - that review has now been split by types of treatment...
February 20, 2018: Cochrane Database of Systematic Reviews
Pina Amin, Summia Zaher, Richard Penketh, Sobha Cherian, Rachel E Collis, Julia Sanders, Kiron Bhal
OBJECTIVE: To evaluate caesarean section (CS) rates and moderate to severe hypoxaemic ischaemic encephalopathy (HIE) rates with other core intra-partum outcomes following reconfiguration of maternity services in Cardiff, South Wales, UK. DESIGN: Cohort study of births from 2006 to 2015. SETTINGS: A University tertiary referral centre for foetal and maternal medicine with 6000 births/year, University Hospital of Wales, United Kingdom. METHOD: Data relating to births from 1 January 2006 to 31 December 2015 were extracted from the computerized maternity database on a yearly basis...
February 19, 2018: Journal of Maternal-fetal & Neonatal Medicine
Paul A Agius, Mary-Ann Davey, Rhonda Small
BACKGROUND: Understanding the prevalence of, and factors associated with, caesarean birth among immigrant populations is essential for appropriate antenatal and postnatal resource allocation. AIMS: To compare rates of caesarean birth between one of the largest immigrant populations of women giving birth in Australia (Vietnamese-born women) with those of Australian-born women and investigate the odds of unplanned caesarean in these women, controlling for maternal characteristics, pregnancy complications and labour management factors...
February 12, 2018: Women and Birth: Journal of the Australian College of Midwives
Yvonne M Cargill, Catherine Jane MacKinnon
OBJECTIVE: To provide guidelines for operative vaginal birth in the management of the second stage of labour. OPTIONS: Non-operative techniques, episiotomy, and Caesarean section are compared to operative vaginal birth. OUTCOME: Reduced fetal and maternal morbidity and mortality. EVIDENCE: MEDLINE and Cochrane databases were searched using the key words ''vacuum" and "birth" as well as "forceps" and "birth" for literature published in English from january 1970 to June 2004...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Aida Kalok, Pravin Peraba, Shamsul Azhar Shah, Zaleha Abdullah Mahdy, Mohamad Abdul Jamil, Nirmala Kampan, Suraya Sulaiman, Nor Azlin Mohamed Ismail
Background Gestational diabetes mellitus (GDM) is on the rise globally and there are various screening guidelines with regard to patients' criteria. Materials and methods We conducted a prospective cross-sectional study to determine the prevalence of GDM amongst low-risk pregnant women above the age of 25 years. A modified glucose tolerance test (MGTT) was performed between 24 and 36 weeks of gestation. Women with GDM were divided into two groups for analysis: age between 25 and 34 years (group A) and above 35 years (group B)...
February 9, 2018: Hormone Molecular Biology and Clinical Investigation
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Valerie Smith, Pauline Meskell, Eugene Dempsey, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Pregnant women with pre-existing diabetes (Type 1 or Type 2) have increased rates of adverse maternal and neonatal outcomes. Current clinical guidelines support elective birth, at or near term, because of increased perinatal mortality during the third trimester of pregnancy.This review replaces a review previously published in 2001 that included "diabetic pregnant women", which has now been split into two reviews. This current review focuses on pregnant women with pre-existing diabetes (Type 1 or Type 2) and a sister review focuses on women with gestational diabetes...
February 9, 2018: Cochrane Database of Systematic Reviews
Saverio Bellizzi, Howard Sobel, Ana Pilar Betran, Marleen Temmerman
Background: Around the world, the incidence of multiple pregnancies reaches its peak in the Central African countries and often represents an increased risk of death for women and children because of higher rates of obstetrical complications and poor management skills in those countries. We sought to assess the association between twins and early neonatal mortality compared with singleton pregnancies. We also assessed the role of skilled birth attendant and mode of delivery on early neonatal mortality in twin pregnancies...
June 2018: Journal of Global Health
Jennifer M Woods, Anecita Gigi Lim
Aims and objectives: The aim of this article was to determine whether the incidence of intrathecal morphine-induced pruritus (ITMI) was influenced by ethnicity, age or gender in relation to orthopaedic versus caesarean surgeries. Background: The use of intrathecal morphine for patients undergoing total hip and knee joint replacements and for lower segment caesarean sections (LSCS) has gained popularity worldwide since its introduction over 30 years ago. Several international studies show that morphine delivered via the intrathecal route is an effective and safe method of pain relief...
February 2018: British Journal of Pain
Thobeka P Jikijela, Sindiwe James, Balandeli S I Sonti
BACKGROUND: The rate of caesarean section deliveries has increased globally and mothers are faced with challenges of postoperative recovery and caring thereof. Midwives have a duty to assist these mothers to self-care. OBJECTIVE: The objective was to explore and describe experiences of post-caesarean section delivered mothers of midwifery care at a public hospital in Nelson Mandela Bay. METHODS: A qualitative, descriptive and explorative research design was used in the study...
January 30, 2018: Curationis
Antonio Simone Laganà, Luis Alonso Pacheco, Andrea Tinelli, Sergio Haimovich, Jose Carugno, Fabio Ghezzi
Current data suggest the development of isthmocele in approximately 60% after a primary caesarean section (CS) and 100% after three CSs. In cases where myometrial thickness is greater than 3 mm, hysteroscopic treatment of cesarean-induced isthmocele represents a feasible and safe approach; conversely, when myometrial thickness is less than 3 mm, the laparoscopic approach should be favored due to risk of uterine perforation and bladder injury. Considering the lack of available evidence, and the need of a clear indication to counsel our patients, the members of this committee concur in recommending to strongly encourage patients to wait at least 3 months after the procedure to conceive...
February 2, 2018: Journal of Minimally Invasive Gynecology
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