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Caesarean management

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https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#1
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29305372/uterocutaneous-fistula-following-b-lynch-suture-for-primary-postpartum-haemorrhage
#2
Monika Thakur, Sandeep S Rathore, Aditi Jindal, Kunal Mahajan
A 30-year-old woman, who had undergone emergency lower segment caesarean section (LSCS) for failed induction 2 months back, presented with a fistulous opening along with discharge from her previous incision scar. She had developed a massive primary postpartum haemorrhage at the time of LSCS 2 months back, which was managed with B-Lynch suture and vessel ligation. Fistulogram revealed a connection between the uterus and the skin. The diagnosis was confirmed by a contrast-enhanced CT scan. Patient was subjected to laparotomy...
January 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29303230/planned-birth-at-or-near-term-for-improving-health-outcomes-for-pregnant-women-with-gestational-diabetes-and-their-infants
#3
REVIEW
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Eugene Dempsey, Pauline Meskell, Valerie Smith, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia...
January 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29289935/association-between-total-dose-of-ritodrine-hydrochloride-and-pulmonary-oedema-in-twin-pregnancy-a-retrospective-cohort-study-in-japan
#4
Satoshi Shinohara, Rei Sunami, Yuzo Uchida, Shuji Hirata, Kohta Suzuki
OBJECTIVE: Pulmonary oedema is recognised as a severe side effect of ritodrine hydrochloride. Recently, the number of twin pregnancies has been increasing. Few studies have reported the association between total dose of ritodrine hydrochloride prior to delivery and pulmonary oedema in twin pregnancy. We aimed to examine this association and determine the optimal cut-off threshold of total ritodrine hydrochloride dose to predict the incidence of pulmonary oedema in twin pregnancy based on obstetric records...
December 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/29284433/adaptation-of-the-who-maternal-near-miss-tool-for-use-in-sub-saharan-africa-an-international-delphi-study
#5
Abera K Tura, Jelle Stekelenburg, Sicco A Scherjon, Joost Zwart, Thomas van den Akker, Jos van Roosmalen, Sanne J Gordijn
BACKGROUND: Assessments of maternal near miss (MNM) are increasingly used in addition to those of maternal mortality measures. The World Health Organization (WHO) has introduced an MNM tool in 2009, but this tool was previously found to be of limited applicability in several low-resource settings. The aim of this study was to identify adaptations to enhance applicability of the WHO MNM tool in sub-Saharan Africa. METHODS: Using a Delphi consensus methodology, existing MNM tools were rated for applicability in sub-Saharan Africa over a series of three rounds...
December 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29282147/spina-bifida-cystica-and-severe-congenital-bilateral-talipes-equinovarus-in-one-twin-of-a-monoamniotic-pair-a-case-report
#6
Benjamin Momo Kadia, Desmond Aroke, Frank-Leonel Tianyi, Ndemazie Nkafu Bechem, Christian Akem Dimala
BACKGROUND: Spina bifida and congenital talipes equinovarus (CTEV) are common congenital malformations which may occur together and increase morbidity. Monozygous twins are particularly at risk of these malformations and discordance in one type of malformation is typical. The occurrence of both spina bifida and CTEV in one twin of a monozygotic pair is rare. CASE PRESENTATION: A 22 year-old Cameroonian primigravida at 36 weeks of a twin gestation was received in our district hospital at the expulsive phase of labour on a background of sub-optimal antenatal care...
December 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29276160/management-and-outcome-of-reduced-fetal-movements-is-ultrasound-necessary
#7
Nasser Abu Awad, Thomas Jordan, Robert Mundle, Dan Farine
OBJECTIVE: To review the management and outcome of pregnancies of women presenting to obstetrical triage with decreased fetal movements (DFM). STUDY DESIGN: A retrospective review of women presenting with DFMs to two large Canadian obstetrical centres with a combined 9490 deliveries per year. The charts were reviewed for compliance with the Canadian guidelines for demographics (age, parity, GA, comorbidities, etc.), pregnancy management (admission vs. discharge, need to deliver), and pregnancy outcomes (mortality, morbidity, GA at delivery, Apgar scores, etc...
December 21, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29275391/intractable-hyperemesis-gravidarum-in-a-patient-with-type-1-diabetes
#8
Muhammad Fahad Arshad, Nasir Javed, Mohammad Bekhit
Hyperemesis gravidarum is not uncommon. Its pathogenies is multifactorial but not fully understood. We present a case of a middle class, Caucasian pregnant woman aged 24 years with coexisting type 1 diabetes, who had severe hyperemesis gravidarum from the sixth week of pregnancy and was resistant to all standard and off-the-label treatments raising questions about the pathogenesis of hyperemesis gravidarum. She was managed with a multidisciplinary approach and was supported with total parenteral nutrition till she had an emergency caesarean section in the 29th week of pregnancy...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29249732/histological-chorioamnionitis-as-a-risk-factor-for-preterm-birth-without-disturbing-fetal-heart-rate-a-case-control-study
#9
Hyo Kyozuka, Syun Yasuda, Tsuyoshi Hiraiwa, Makiho Ishibashi, Katsuhiko Kato, Keiya Fujimori
Histological chorioamnionitis (CAM) is one form of intrauterine inflammation that is often seen in cases of preterm birth and are usually confirmed based on pathological examination after delivery. Histological CAM is related to significant neonatal morbidity and mortality; however, its etiology is unknown. The objective of this study was to determine the risk factors for histological CAM, using medical background, including fetal heart rate (FHR) patterns in preterm birth cases. The preterm birth cases delivered between 28 and 36 weeks were categorized into two groups according to the presence of histological CAM...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29249272/successful-spinal-anaesthesia-in-a-patient-with-a-tarlov-cyst
#10
N Pfund, A Oh, A Cyna
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst...
December 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29245338/multifaceted-spiral-suture-a-hemostatic-technique-in-managing-placenta-praevia-or-accrete-a-retrospective-study
#11
Yifan Meng, Peng Wu, Dongrui Deng, Jianli Wu, Xingguang Lin, Rajluxmee Beejadhursing, Ying Zha, Fuyuan Qiao, Ling Feng, Haiyi Liu, Wanjiang Zeng
Patients with total placenta previa and past history of cesarean delivery often experience overwhelming hemorrhage during childbirth. In order to control intraoperative and postoperative bleeding, we propose a novel multifaceted spiral suture of the lower uterine segment which directly sutures the bleeding site.To evaluate the efficacy and safety of multifaceted spiral suture, a retrospective study was conducted using data from 33 patients with total placenta praevia and caesarean history.All participants underwent multifaceted spiral suture and no patient experienced uncontrollable bleeding or underwent hysterectomy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29237479/birth-delivery-method-affects-expression-of-immune-genes-in-lung-and-jejunum-tissue-of-neonatal-beef-calves
#12
Carla Surlis, Keelan McNamara, Eoin O'Hara, Sinead Waters, Marijke Beltman, Joseph Cassidy, David Kenny
BACKGROUND: Caesarean section is a routine veterinary obstetrical procedure employed to alleviate dystocia in cattle. However, CS, particularly before the onset of labour, is known to negatively affect neonatal respiration and metabolic adaptation in humans, though there is little published information for cattle. The aim of this study was to investigate the effect of elective caesarean section (ECS) or normal trans-vaginal (TV) delivery, on lung and jejunal gene expression profiles of neonatal calves...
December 14, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29235940/slc9b1-methylation-predicts-fetal-intolerance-of-labor
#13
Anna K Knight, Karen N Conneely, Varun Kilaru, Dawayland Cobb, Jennifer L Payne, Samantha Meilman, Elizabeth J Corwin, Zachary A Kaminsky, Anne L Dunlop, Alicia K Smith
Fetal intolerance of labor is a common indication for delivery by Caesarean section. Diagnosis is based on the presence of category III fetal heart rate tracing, which is an abnormal heart tracing associated with increased likelihood of fetal hypoxia and metabolic acidemia. This study analyzed data from 177 unique women who, during their prenatal visits (7-15 weeks and/or 24-32 weeks) to Atlanta area prenatal care clinics, consented to provide blood samples for DNA methylation (HumanMethylation450 BeadChip) and gene expression (Human HT-12 v4 Expression BeadChip) analyses...
December 13, 2017: Epigenetics: Official Journal of the DNA Methylation Society
https://www.readbyqxmd.com/read/29223042/experiences-of-early-labour-management-from-perspectives-of-women-labour-companions-and-health-professionals-a-systematic-review-of-qualitative-evidence
#14
REVIEW
Sarah Beake Rm Ma Research Associate, Yan-Shing Chang Ba MPhil PhD Lecturer, Helen Cheyne Rm Rgn MSc PhD Professor Of Midwifery, Helen Spiby MPhil Rn Rm Professor Of Midwifery, Jane Sandall Rm MSc PhD Professor Of Social Science And Women's Health, Debra Bick
OBJECTIVES: to examine evidence of women's, labour companions' and health professionals' experiences of management of early labour to consider how this could be enhanced to better reflect women's needs. DESIGN: a systematic review of qualitative evidence. SETTING AND PARTICIPANTS: women in early labour with term, low risk singleton pregnancies, not booked for a planned caesarean birth or post-dates induction of labour, their labour companions, and health professionals responsible for early labour care (e...
November 13, 2017: Midwifery
https://www.readbyqxmd.com/read/29222252/diagnosis-and-management-of-postpartum-ovarian-vein-thrombosis
#15
REVIEW
Bethany T Samuelson Bannow, Leslie Skeith
A 26-year-old woman experienced persistent fever (39.5°C), chills, and right-lower-quadrant tenderness 3 days after caesarean delivery. A computed tomography (CT) scan of the abdomen and pelvis with contrast revealed enlargement of her right ovarian vein with an associated intraluminal filling defect. What is the best treatment of this patient?
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29207784/emergency-peripartum-hysterectomy-a-14-year-experience-at-a-tertiary-care-centre-in-india
#16
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29197879/corticosteroid-induced-leukocytosis-in-pregnancy-a-prospective-observational-study
#17
H Y Voon, M S Leong, C W Li, A Bujang, H Suharjono
BACKGROUND: In the course of managing preterm labour, increasing trends of total white cell count raises concern for the obstetrician, suggesting a possible underlying infectious aetiology. Although mild leukocytosis is expected in pregnancy, the patterns of increment after corticosteroid administration are not well described beyond animal models and in a small number of human studies. METHODS: Seventy-three consecutive patients who required antenatal corticosteroids for either preterm labour or prelabour caesarean section were recruited and given a standard course of 12mg dexamethasone phosphate, twelve hours apart...
October 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/29193647/the-incidence-characteristics-managements-and-outcomes-of-anaphylaxis-in-pregnancy-a-population-based-descriptive-study
#18
Stephen J McCall, Kathryn J Bunch, Peter Brocklehurst, Rhiannon D'Arcy, Kim Hinshaw, Jennifer J Kurinczuk, D Nuala Lucas, Benjamin Stenson, Derek Tuffnell, Marian Knight
OBJECTIVE: The aim of this study was to estimate the incidence of anaphylaxis in pregnancy and describe the management and outcomes in the UK. DESIGN: A population based descriptive study using the UK Obstetric Surveillance System(UKOSS). SETTING: All consultant-led maternity units in the UK. POPULATION: All pregnant women who had anaphylaxis between 1st October 2012 and 30th September 2015. Anaphylaxis was defined as a severe, life-threatening generalised or systemic hypersensitivity reaction...
November 29, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29180591/developing-outcome-measures-assessing-wound-management-and-patient-experience-a-mixed-methods-study
#19
Daisy Elliott
OBJECTIVES: To develop outcome measures to assess practical management of primary surgical wounds and patient experience. DESIGN: Mixed methods, including qualitative interviews and data extraction from published randomised controlled trials (RCTs). SETTING: Two university-teaching NHS hospitals and three district NHS hospitals in the South West and Midlands regions of England. PARTICIPANTS: Sixty-four patients and 15 healthcare professionals from abdominal general surgical specialities and obstetrics (caesarean section)...
November 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29180341/-surgical-management-of-pregnancy-associated-acute-stanford-type-a-aortic-dissection-analysis-of-5-cases
#20
Xin Li, Hong-Yu Zhang, Feng-Zhen Han, Chang-Jiang Yu, Xiao-Ping Fan, Rui-Xin Fan, Jian Zhuang
OBJECTIVE: To explore the diagnosis and treatment of pregnancy-associated acute Stanford type A aortic dissection to improve the maternal and fetal outcomes. METHODS: We analyzed the perioperative data of 5 pregnant women with acute Stanford type A aortic dissection treated between June, 2009 and February, 2017. RESULTS: The median age of the women was 30 years (range, 22-34 years) with gestational weeks of 23-38 weeks upon diagnosis. All the 5 patients received surgical interventions...
November 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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