scholarly journals P16.20: Emergency Caesarean section for fetal distress in labour is associated with smaller infants than spontaneous vaginal delivery

2012 ◽  
Vol 40 (S1) ◽  
pp. 235-235
Author(s):  
T. Prior ◽  
M. Wild ◽  
E. Mullins ◽  
P. Bennett ◽  
S. Kumar
2018 ◽  
Vol 21 (05) ◽  
pp. 897-900
Author(s):  
Shahina Ishtiaq ◽  
Habiba Sharaf Ali

Objective: To determine the frequency and types of vaginal delivery in womenwith previous one caesarean section and to observe the effect of women age on success ofvaginal birth. Method: A descriptive study was carried out in the department of obstetrics& gynecology, Ziauddin University Hospital Kemari campus Karachi from January 2011 toJanuary 2013. 200 patients with previous one caesarean section for a non recurrent cause wereincluded in the study after fulfilling the inclusion and exclusion criteria. The women selectedwere evaluated and counseled for trial of labor. The frequency and mode of vaginal delivery wasrecorded in cases of successful trial of labor and caesarean section was performed in case offailed trial of labor. Results: Successful vaginal delivery was achieved in 67% of the patients andrepeat emergency caesarean section was carried out in 33% of the patients. Leading indicationfor repeat caesarean section was failure to progress, fetal distress and scar tenderness. Nomaternal and fetal complication occurred. We also observed that patients of less than 30 yearswere more likely to have a successful vaginal delivery (82%) as compared to patients older than30 years (18%). Conclusions: The trial of labor should be encouraged with vigilant monitoringin patients with previous one Caesarean section and is a safe and successful option if carefullyselected and monitored.


2017 ◽  
Vol 48 (3) ◽  
pp. 234-235 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Shahana Zaman ◽  
Nasreen Sultana ◽  
Ariful Islam ◽  
Khwaja Nazim Uddin

We report the first case of chikungunya-dengue co-infection during pregnancy requiring emergency Caesarean section (CS) because of fetal distress in a Bangladeshi primigravida. Though previously unreported, this situation may become increasingly common.


Author(s):  
Anshu Sharma ◽  
Rajiv Acharya ◽  
Yashika Pehal ◽  
Bhawna Sharma

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.


2020 ◽  
Vol 5 (3) ◽  
Author(s):  
Mullika Borisoot

PICO question In pregnant bitches due to whelp, is elective caesarean section more effective than vaginal delivery to improve puppy survival?   Clinical bottom line Category of research question The category of the research question is regarding the incidence of puppy mortalities as a result of vaginal delivery, emergency caesarean section and elective caesarean section. The number and type of study designs reviewed Two retrospective articles were reviewed and critically appraised; one retrospective study with high single canine breed bias and one study on different canine breeds but limited support in directly answering the PICO question. Strength of evidence The studies selected both had strong uses of experimental designs but together provided weak evidence to determine a definitive answer to the PICO question. Outcomes reported The outcomes from both retrospective studies suggests that the mortality rates of newborn puppies can be reduced if pregnant bitches are scheduled ahead for elective caesareans, in comparison to undergoing an emergency caesarean section when complications develop, particularly in breeds with higher risks of dystocia. Therefore, there is some evidence to support that it may be advantageous to consider the breed, age and overall health of the bitch during pregnancy to determine whether elective caesarean sections, for the safe delivery of puppies, should be considered. Conclusion There are currently insufficient studies, literatures and evidence in veterinary medicine for caesarean sections to become a routine procedure in first opinion practices. Future prospective studies should be conducted and include the optimum anaesthetic protocols with the lowest associated risks for the pregnant bitch and puppies.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.  


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Nicolas Cecere ◽  
Corinne Hubinont ◽  
Arnauld Kabulu Kadingi ◽  
Marie-Françoise Vincent ◽  
Peter Van den Bergh ◽  
...  

A 31-year-old pregnant woman ( weeks) was admitted with extreme tachypnea. She had a previous history of congenital muscular dystrophy (Ullrich’s disease) and isolated glucosuria. The patient had reduced food intake during the last 24 hours prior to admission and vomited twice. Serum glucose level was normal (112 mg/dL), while urinalysis revealed glucosuria 4+ and ketonuria 4+. ABG revealed pH 7.06, PCO29 mm Hg, and bicarbonate 2 mmol/L. Anion gap was 28 mmol/L. Tachypnea was a compensatory mechanism for a severe nonlactic metabolic acidosis. The diagnosis of starvation ketoacidosis was established. The patient received supplemental dextrose 10% intravenously and sodium bicarbonate. As fetal heart monitoring was pathological, an emergency caesarean section was performed. Umbilical cord venous pH was 7.01, with PCO234 mm Hg and bicarbonate 8 mmol/L. Starvation ketoacidosis is a rare metabolic disorder that may occur mainly in the third trimester of pregnancy. Muscular dystrophy and renal glucosuria were precipitating factors.


Author(s):  
Anuradha G. ◽  
Nirupama V. ◽  
Shirley George

Background: Emergency caesarean section (CS) is divided into four categories based on the degree of urgency by RCOG and NICE guidelines. It is recommended that the decision to delivery interval (DDI) in emergency CS should be within 30 minutes in category 1 and within 75 minutes in category 2. Our Primary objective was to study the incidence and indications of emergency CS and audit the DDI in emergency CS at tertiary care hospital. Our secondary objective was to study the effect of DDI on neonatal outcome.Methods: Descriptive study was carried out among 409 women who underwent emergency CS from August 2018 to December 2018 at St. John's medical college hospital, Bangalore. Relevant data was collected by chart review. Emergency CS were categorised according to RCOG guidelines based on the degree of urgency and further classified based on DDI as <30 minutes, 30-75 minutes and >75 minutes.Results: We had 409 cases of emergency CS. Category 1 had 113 (27.63%) cases, category 2 had 126 (30.81%) cases and category 3 had 170 (41.56%) cases. DDI of <30 minutes was achieved in 19.5% in category 1, DDI of <75 minutes was achieved in 93.65% in category 2. Fetal distress was the leading cause of emergency CS in category 1 and 2. There was a high incidence of low APGAR in babies delivered in <30 minutes and lower APGAR was significantly associated with <30 minutes of DDI (p<0.0001).Conclusions: Fetal distress was the leading cause of emergency CS. DDI interval of <30 minutes was not always associated with good neonatal outcome; Category of CS has a significant effect on neonatal outcome.


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