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cesarean indications

David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Yun Chai, Miaomiao Qu, Meng Jin
This study was designed to evaluate the application effect of single balloon catheters and dinoprostone on promoting cervical ripening of pregnant women in late-term pregnancy and their influences on stress and inflammatory responses. A total of 160 pregnant women with indications of labor induction were included and randomly divided into the control (n=80) and observation (n=80) groups. Patients in the control group received labor induction by administration of dinoprostone at the vaginal vault, while those in the observation group received labor induction by domestic single balloon catheters...
April 2018: Experimental and Therapeutic Medicine
Adrienne M Antonson, Bindu Balakrishnan, Emily C Radlowski, Geraldine Petr, Rodney W Johnson
Maternal infection during pregnancy increases the risk of neurobehavioral problems in offspring. Evidence from rodent models indicates that the maternal immune response to infection can alter fetal brain development, particularly in the hippocampus. However, information on the effects of maternal viral infection on fetal brain development in gyrencephalic species is limited. Thus, the objective of this study was to assess several effects of maternal viral infection in the last one-third of gestation on hippocampal gene expression and development in fetal piglets...
March 14, 2018: Developmental Neuroscience
C L Depoix, F Haegemann, F Debiève, C Hubinont
STUDY QUESTION: Is 8% O2 a better percentage of atmospheric oxygen for long-term cultures of human primary term cytotrophoblasts than the conventional 21% O2 traditionally used in cell culture? SUMMARY ANSWER: Human primary term cytotrophoblasts are able to differentiate into syncytiotrophoblasts under both atmospheric oxygen levels. WHAT IS KNOWN ALREADY: Cell culture is traditionally done under 21% O2, which is equal to a pO2 of ~160 mm Hg...
March 9, 2018: Molecular Human Reproduction
Carine Milcent, Saad Zbiri
Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008-2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do...
March 10, 2018: Health Economics Review
Z N Dolgun, C Inan, A S Altintas, S B Okten, C Karadag, N C Sayin
Background: Preterm birth is one of the most challenging problems in obstetric care and it is closely related to perinatal mortality and morbidity. The aim of the current study was to document our experience with preterm births and to analyze the association between perinatal variables and clinical outcomes. Methodology: In this retrospective study, data were derived from the medical records of 785 singleton preterm births delivered in the obstetrics and gynecology department of our institution...
March 2018: Nigerian Journal of Clinical Practice
Laura Schummers, Jennifer A Hutcheon, Michele R Hacker, Tyler J VanderWeele, Paige L Williams, Thomas A McElrath, Sonia Hernandez-Diaz
BACKGROUND: First deliveries in women older than 35, 40, or 45 are at increased risk for adverse pregnancy outcomes compared with those in younger women. However, specific relationships between each additional year of maternal age and pregnancy risks remain unclear, and absolute risks at each maternal age are not known. METHODS: Using a population-based cohort of nulliparous women in British Columbia, Canada, from 2004-2014 (n=203,414), We examined relationships between maternal age (modeled flexibly to allow curvilinear shapes) and pregnancy outcomes using logistic regression...
March 6, 2018: Epidemiology
M A Almeida, E Araujo Júnior, L Camano, A B Peixoto, W P Martins, R Mattar
OBJECTIVE: To evaluate the incidence of, indications of, and maternal and neonatal morbidity and mortality rates in cesarean sections in a private health service in Brazil. DESIGN: Retrospective and observational study. SETTING: Private health service in Vitória, Espírito Santo, Brazil. METHODS: The patients were interviewed using a structured questionnaire to determine maternal age, gestational age at the time of delivery, number of previous deliveries, type of delivery performed, duration of labor, indications for cesarean delivery, point at which cesarean section was performed, physician responsible for delivery, and maternal morbidity, fetal morbidity, and fetal mortality rates...
2018: Ceská Gynekologie
Clara Elisa Frare de Avelar Teixeira, Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Rafael Miranda da Costa, Giselle Ioná Teixeira Brighenti
INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m-2 , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome...
March 2, 2018: Revista Brasileira de Anestesiologia
Kiguna Sei, Kenichi Masui, Hidenori Sasa, Kenichi Furuya
BACKGROUND: Uterine leiomyoma is a common benign tumour, and a risk factor for various complications during pregnancy and peripartum period. Peripartum haemorrhage is the most critical complication that can cause maternal death. Although the relationship of leiomyoma and peripartum haemorrhage has been indicated, little is known about the characteristics of leiomyoma as predictors for massive haemorrhage in caesarean delivery. OBJECTIVE: We examined whether characteristics of leiomyoma and pregnant patients could predict massive haemorrhage in women undergoing caesarean delivery...
February 21, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Murat Şakir Ekşi, Ahmet Öğrenci, Osman Ersegun Batçık, Orkun Koban
De novo obstructive hydrocephalus is a rare event during pregnancy. There are only case reports presented in literature. We aimed to discuss the pathophysiological basis and management options with an exemplary case presentation and review of the current literature. A 28-year-old G2P1 patient presented to our clinic with headache, vomiting, and deteriorated vision at the 8th week of gestation. She had no history of central nervous system infection or trauma. A brain magnetic resonance imaging was obtained. There was hydrocephalus due to cerebral aqueduct stenosis (Evan's index of 58%)...
January 2018: Asian Journal of Neurosurgery
Ge'er Zhang, Zimin Pan
OBJECTIVE: To analyze the clinical features, diagnosis and treatment of gestational trophoblastic diseases in cesarean scar. METHODS: Clinical data of three cases of gestational trophoblastic diseases in cesarean scar diagnosed in Women's Hospital, Zhejiang University School of Medicine during December 2011 and December 2016 were collected. And literature search was performed in Wanfang data, VIP, CNKI, PubMed, ISI Web of Knowledge and EMbase database. RESULTS: A total of 20 cases of gestational trophoblastic diseases were included in the analysis...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Matthias David, Katrin Alexandra Scherer, Wolfgang Henrich, Jürgen Breckenkamp
Objectives: Does the incidence and/or indication(s) for emergency cesarean section differ if the pregnant woman has an immigrant background (IB)? Does a lack of language proficiency (communication problems) and a low acculturation level result in a longer decision-to-delivery interval (D-D interval)? Are neonates born to women with IB by emergency cesarean section in a poorer condition post delivery? Patient cohorts and method: Standardized interviews were carried out before or immediately after delivery in three Berlin obstetric hospitals...
February 2018: Geburtshilfe und Frauenheilkunde
Clara Bermúdez-Tamayo, Mira Johri, Nils Chaillet
INTRODUCTION: audits of indications for cesarean section (CS), feedback for health professionals, and implementation of best practices, as compared with usual care (QUARISMA study), resulted in a small reduction in the rate of CS in Quebec and important cost savings from a health care payer perspective. Determining the budget impact would enable estimation of the financial consequences if the program is extended nationwide. MATERIAL AND METHODS: a retrospective pre-post study design was used to estimate cost prior to and after the implementation of QUARISMA in Quebec (105,351 subjects)...
February 9, 2018: Midwifery
Phillip Schulten Sebastian, Jan Philip Suppelna, Timoleon Dagres, Günter Noè, Michael Anapolski, Joscha Reinhard, Harald Krentel, Clemens Tempfer, Sven Schiermeier
OBJECTIVE: This study examines the recommendations of international guidelines on the use of antepartum and intrapartum cardiotocography. MATERIAL AND METHODS: The guidelines of Germany, Canada, UK, USA, Sri Lanka, Australia as well as FIGO have been compared. The recommendations on the use of cardiotocography were separately evaluated for antepartum and intrapartum use. RESULTS: Antepartum: In risk-free pregnancies the use of cardiotocography is not recommended in all countries...
February 23, 2018: Zeitschrift Für Geburtshilfe und Neonatologie
Matheus Schimidt Evangelista, Karina Slompo, Jorge Rufino Ribas Timi
Venous thromboembolism events are important causes of maternal death during pregnancy and the postpartum period worldwide. A review of the literature with the objective of evaluating venous thromboembolism events in the puerperium according to the route of delivery was performed through a bibliographic survey in the Medline, LILACS and Scielo databases. We observed that patients submitted to cesarean sections present a significantly higher risk of developing venous thromboembolism when compared with those who undergo spontaneous vaginal delivery...
February 23, 2018: Revista Brasileira de Ginecologia e Obstetrícia
Mahmoud M Elgari, Omar F Khabour, Samaher M Alhag
Preeclampsia is a condition that might severely impact the health of mothers and their newborns. The aim of this investigation is to examine hematological parameters in mothers with preeclampsia and umbilical cord blood. Eighty preecalmptic mothers were recruited in the study. In addition, eighty normal pregnant mothers served as controls. Hematological parameters that include hemoglobin (Hb), red blood cell count (RBC), red cell distribution width (RDW), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell counts (WBC), platelet counts, mean platelet volume (MPV) and Platelet large cell ratio (PLCR) were examined...
February 23, 2018: Clinical and Experimental Hypertension: CHE
Saraswathi Vedam, Kathrin Stoll, Marian MacDorman, Eugene Declercq, Renee Cramer, Melissa Cheyney, Timothy Fisher, Emma Butt, Y Tony Yang, Holly Powell Kennedy
METHODS: Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110) detailed differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92) verified the 'on the ground' relevance, importance, and realities of local interpretation of these state laws...
2018: PloS One
Cláudia Vicari Bolognani, Lílian Barros de Sousa Moreira Reis, Adriano Dias, Iracema de Mattos Paranhos Calderon
BACKGROUND: The global increase in C-section rates is real. In Brazil, these indices correspond to 58.94% in the Midwest region and 52.77% in the Federal District. OBJECTIVE: To evaluate the C-section rates and identify the groups with the greatest risk at two reference hospitals in the public network of Federal District/Brazil, using 10-Group Robson System. METHOD: A cross-sectional study of 6579 births assisted at the Hospital A (HA) and the Hospital B (HB) during 2013...
2018: PloS One
Gulten Ozgen, Burcu Dincgez Cakmak, Betul Dundar, Fatma Nurgul Tasgoz, Feyza Bayram, Burak Karadag
OBJECTIVE: Isolated oligohydramnios is defined as an amniotic fluid index below five centimeter with no other coexisting condition. There are still controversies about the management and pregnancy outcomes. A marker predicting these is crucial. Low pregnancy associated plasma protein-A levels were reported to be related with adverse pregnancy outcomes. We aimed to determine the role of first trimester pregnancy associated plasma protein-A for poor outcomes in preterm isolated oligohydramnios cases...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
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