I315 Caesarean section - The surgical technique

2009 ◽  
Vol 107 ◽  
pp. S78-S78
Author(s):  
M. Stark
Keyword(s):  
Caesarean Section ◽  
Surgical Technique

scholarly journals The marks that humans’ leave are too often scars

2020 ◽  
Vol 9 (12) ◽  
pp. 5163
Author(s):  
Nandita Sushilkumar Kaushal ◽  
Shrikrushna Vasant Chavan ◽  
Arundhati Gundu Tilve ◽  
C. V. Hegde
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Chorionic Gonadotropin ◽  
Innovative Approach ◽  
Previous Caesarean Section ◽  
Caesarean Scar ◽  
Obstetric Emergency ◽  
Beta Hcg ◽  
Beta Human Chorionic Gonadotropin ◽  
Products Of Conception

Caesarean scar ectopics are the newest member of this obstetric emergency. Although rare, are associated with torrential haemorrhage. Gravida 3 para 2 with previous two caesarean sections with spotting per vaginum. Ultrasound showed a pregnancy embedded in the scar of previous caesarean section. MRI confirmed it. Beta human chorionic gonadotropin (HCG) was 15000 which dropped to 5000 after. An innovative approach was taken to laparoscopically evacuate the pregnancy. The products of conception were removed and the incision sutured so as to achieve haemostasis. Beta HCG was 15000 which dropped to 5000. Patient was haemodynamically stable and discharged on day 3. An innovative approach with skilled surgical technique not only decreased the morbidity but also avoided an unnecessary hysterectomy.

The temptation of cesarean section (Basic NB! Modified Techniques)

2018 ◽  
pp. 22-25
Author(s):  
Yu.V. Herman ◽  
◽  
D.O. Grigurko ◽  
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Cesarean Section ◽  
Key Words ◽  
Surgical Intervention ◽  
Section Technique

Obstetrics has changed in an era of «selective caesarean section». In a few decades, a rather rare operation, designed to save the lives of the mother and the baby, has become a frequent and even casual way of giving birth. The modified cesarean section technique, performed simultaneously by two surgeons, is an advanced surgical intervention. The peculiarities of its implementation indicate that the risks associated with this surgery are decreased. Key words: cesarean section, modification, surgical technique, perfection, safety.

scholarly journals Repair of the myometrial scar defect at repeat caesarean section: a modified surgical technique

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shahul Hameed Mohamed Siraj ◽  
Karuna Mary Lional ◽  
Kok Hian Tan ◽  
Ann Wright
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Operating Time ◽  
Uterine Wall ◽  
Lower Segment ◽  
Modified Technique ◽  
Large Defect ◽  
Risk Of Rupture ◽  
Future Pregnancy ◽  
Myometrial Thickness

Abstract Background To investigate whether the existing surgical technique for uterine closure at repeat lower segment Caesarean section (LSCS) can be modified to achieve adequate residual myometrial thickness (RMT) to ensure scar integrity and reduce complications in future pregnancy. Methods Women with a significant scar defect at repeat LSCS had the anterior uterine wall closed by a single experienced obstetrician with a technique focused on recognition, mobilisation and apposition of the retracted myometrial edges at the boundary of the defect. This was aimed at anatomical restoration of the lower segment. The RMT at the scar area was assessed by postnatal pelvic ultrasound scan at three months. Results Thirty women with a history of at least one previous CS, incidentally found to have a large defect at operation underwent the technique with prior consent. A postnatal scan showed a mean residual myometrial thickness of 8.4 mm (SD ±1.3 mm; range 5.6–11.0 mm). The average operating time was 91 mins and the average blood loss 728 ml. Two women who underwent the repair have gone on to have a further uneventful CS. Conclusion This modified technique resulted in scan evidence of an RMT indicative of uterine wall stability postnatally and offers the potential for reducing the risk of rupture and placenta accreta spectrum (PAS) in future pregnancy.

scholarly journals Maternal outcome in accreta cases. Conservative surgery and hysterectomy in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from January 2017 to January 2018

2021 ◽  
Vol 29 (3) ◽  
pp. 129
Author(s):  
Fita Maulina ◽  
Mohammad Adya Firmansha Dilmy ◽  
Yudianto Budi Saroyo ◽  
Yuditiya Purwosunu
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Placenta Accreta ◽  
Conservative Surgery ◽  
Massive Bleeding ◽  
Maternal Outcome ◽  
Bladder Injury ◽  
Previous Caesarean Section ◽  
Intraoperative Bleeding ◽  
The Mean

HIGHLIGHT1. As the incidence of placenta accreta is increasing which seems to parallel the increasing cesarean delivery rate, advance planning should be made for the management of delivery. 2. Maternal outcome of placenta accreta cases in a national hospital was reported based on the surgical technique performed.3. No significant results of maternal outcome undergoing conservative surgery and conventional hysterectomy in managing accreta cases in the national hospital.ABSTRACTObjectives: To report maternal outcome based on surgical technique on the management of accreta. The study was conducted in Cipto Mangunkusumo Hospital, Jakarta, Indonesia from January 2017 to January 2018.Case Report: There were 1609 cases of pregnant women delivered during the study period. From these, the prevalence of previous caesarean section was 73 cases, including 20 cases of accreta. Total maternal mortality for 1 year in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, was 11, and accreta contributed 3 cases. We reported 20 cases of accreta in pregnancy The maternal outcomes, including bladder injury, duration of operation, intraoperative bleeding, length of hospitalization, and mortality, were evaluated. From 20 cases, 8 patients had one previous caesarean history, 11 had second previous caesarean section, while 2 patient had third previous caesarean section history. Of women with placenta accreta, about 7 patients (35%) had delivery in fullterm pregnancies, while 13 (65%) had delivery in preterm pregnancy. Surgical technique in accreta management mostly was hysterectomy to override bleeding complication along the delivery. From 20 cases, 16 caesarean sections were followed-up with hysterectomy. Four cases were with conservative management. From all the hysterectomy performed, four were complicated with bladder injury. The mean intraoperative bleeding was 600 - 5500 cc of blood, while the mean of post-operative transfusion was 1000 -3000 cc. There were 2 maternal deaths in this study. Thirteen patients were admitted to the ICU after the procedure.Conclusion: Accreta increases morbidity due to massive bleeding. It is important to have algorithm for managing abnormal implantation of the placenta. Our cases revealed no significant results of maternal outcome between conservative surgery and conventional hysterectomy in managing accreta cases in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

scholarly journals Living with obstetric fistula for ten years: a delayed diagnosis and review of pertinent surgical technique

2021 ◽  
Vol 8 (2) ◽  
pp. 126-130
Author(s):  
Atit Poudel ◽  
Ganesh Dangal
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Vesicovaginal Fistula ◽  
Obstetric Fistula ◽  
Delayed Diagnosis ◽  
Fistula Repair ◽  
Common Cause ◽  
Transvaginal Approach ◽  
Obstructed Labour ◽  
Martius Flap

Obstructed labour is a common cause of vesicovaginal fistula in the developing world. Those fistulae occurring after labour and its complications is called obstetric fistula. We report a case of complex obstetric fistula in a 32 y woman who was having continuous leakage of urine since last 10 y following caesarean section for obstructed labour. A successful fistula repair was done with transvaginal approach with Latzko technique and interposition with Martius flap.

scholarly journals Association between surgical technique, adhesions and morbidity in women with repeat caesarean section: a retrospective study in a rural hospital in Western Tanzania

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
R. Mooij ◽  
I. H. Mwampagatwa ◽  
J. van Dillen ◽  
J. Stekelenburg
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Low Income ◽  
Maternal Morbidity ◽  
Large Scale ◽  
Adhesion Formation ◽  
Skin Incision ◽  
Rural Hospital ◽  
Local Data ◽  
Repeat Surgery

Abstract Background The worldwide incidence of birth by Caesarean Section (CS) is rising. Many births after a previous CS are by repeat surgery, either by an elective CS or after a failed trial of labour. Adhesion formation is associated with increased maternal morbidity in patients with repeat CSs. In spite of large-scale studies the relation between the incidence of adhesion formation and CS surgical technique is unclear. This study aims to assess maternal and neonatal morbidity and mortality after repeat CSs in a rural hospital in a low-income country (LIC) and to analyse the effect of surgical technique on the formation of adhesions. Methods A cross-sectional, retrospective medical records study of all women undergoing CS in Ndala Hospital in 2011 and 2012. Results Of the 3966 births, 450 were by CS (11.3%), of which 321 were 1st CS, 80 2nd CS, 36 3rd CS, 12 4th and one 5th CS (71, 18, 8, 3 and 0.2% respectively). Adhesions were considered to be severe in 56% of second CSs and 64% of third CSs. In 2nd CSs, adhesions were not associated with closure of the peritoneum at 1st CS, but were associated with the prior use of a midline skin incision. There was no increase in maternal morbidity when severe adhesions were present. Adverse neonatal outcome was more prevalent when severe adhesions were present, but this was statistically non-significant (16% vs 6%). Conclusions Our results give insight into the practice of repeat CS in our rural hospital. Adhesions after CSs are common and occur more frequently after midline skin incision at 1st CS compared to a transverse incision. Reviewing local data is important to evaluate quality of care and to compare local outcomes to the literature.

scholarly journals Management of Vesicouterine Fistulae during "Fistulae Surgical Caravan" in Cote D'ivoire

2018 ◽  
Vol 13 (2) ◽  
pp. 27-31
Author(s):  
L.E. Djanhan ◽  
J.M. Dia ◽  
M.M. Menin ◽  
B. Kouamé ◽  
E. Bohoussou ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Rural Areas ◽  
Average Duration ◽  
Case Series ◽  
Repair Rate ◽  
Vesicouterine Fistulae ◽  
Surgical History ◽  
Scarred Uterus ◽  
Urogenital Fistulae

Aims : To describe the epidemiological, clinical and therapeutic characteristics of patients treated for vesico-uterine fistula. Methods : This was a case series of 34 patients prospectively collected for  descriptive purposes. They were treated for Vesico-uterine fistulae during "fistulas surgical caravans" from 1st January 2012 to 31st December 2016. Results :Vesico-uterine fistulae represented 2.1% of all treated urogenital fistulae. At the time of fistula occurrence, the average age of the patients was 33.3 years, and the majority were illiterate (88.2%), lived in rural areas and were unemployed (73.5%). All the fistulae were associated to childbirth, the majority of which took place on a scarred uterus (67.6%). And this childbirth responsible for the fistula was a delivery done by caesarean section in 97.7% of cases. Average duration of the fistula before management was 6 years. Finally, all the patients were operated by the same surgical technique, made by abdominal extra peritoneal transvesical way. The successful first repair rate was 97.1% in 33 patients. The only case of failure was successfully cured using surgical another technique in a second attempt. Conclusion: The vesicouterine fistulae were rare, were mostly associated to previous uterus surgical history and the successful rate is almost 100%.  

scholarly journals CAESAREAN SECTION

2010 ◽  
Vol 17 (03) ◽  
pp. 505-511
Author(s):  
HABIBA SHARAF ALI ◽  
NEELOFER SALEEM ◽  
FARAH AGHA
Keyword(s):  
Caesarean Section ◽  
Surgical Technique ◽  
Royal College ◽  
Surgical Techniques ◽  
Large Cities ◽  
Cochrane Reviews ◽  
Set Up ◽  
Study Setting

Objective: To determine what surgical techniques are used by obstetricians in Pakistan for caesarean section operations and to compare it with the recommendation, proposal and guidelines of Royal College of Obstetrician and Gynecologist (RCOG) and Cochrane Reviews. Methods: A questionnaire was set up regarding surgical technique used during caesarean section and one hundred obstetricians were part of study. Setting: Hospitals in two large cities of Pakistan i.e. Karachi and Rawalpindi were requested to fill them. Period: Jan 2009 to June 2009. Result: Substantial and remarkable and difference noted in the practice of caesarean section among the obstetricians. Certain practices and procedures performed by our obstetrician are same as proved to be beneficial and valuable based on evidence and recommended by the RCOG and Cochrane Data on pregnancy. Conclusion: We observed that our obstetricians follow different surgical techniques for performing caesarean section. Some of the techniques follow recommendations by RCOG and provide to effective and beneficial by cochrane data.

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