Risk Factors and Maternal Morbidity Associated with Unintentional Hysterotomy Extension at the Time of Cesarean Delivery

2018 ◽  
Vol 36 (10) ◽  
pp. 1054-1059 ◽  
Author(s):  
Katherine H. Bligard ◽  
Jennifer K. Durst ◽  
Molly J. Stout ◽  
Shannon Martin ◽  
Alison G. Cahill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Maternal Morbidity ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Skin Antisepsis ◽  
Potential Risk Factors ◽  
Associated Risk Factors

Objective Our aim was to estimate the incidence of unintentional hysterotomy extension at the time of cesarean delivery and to identify associated risk factors and maternal morbidity. Study Design We conducted a secondary analysis of a randomized controlled trial evaluating chlorhexidine-alcohol versus iodine-alcohol for skin antisepsis in women undergoing cesarean delivery. We included patients with a low transverse hysterotomy. The primary outcome was the incidence of unintentional hysterotomy extension. Logistic regression was performed to identify independent factors associated with hysterotomy extension. Maternal morbidity was compared between patients with and without extension. Results Of 1,038 patients meeting the inclusion criteria, 71 (6.8%; 95% confidence interval [CI]: 5.4–8.5%) experienced a hysterotomy extension. Of several potential risk factors assessed, the second stage of labor was the only independent predictor of hysterotomy extension (adjusted odds ratio: 10.2; 95% CI: 2.6–39.8). Hysterotomy extension was associated with increased operative time (73 vs. 55.3 minutes; p< 0.01), need for blood transfusion (relative risk: 5; 95% CI: 1.6–15.2), and rate of additional surgical injury (RR: 17; 95% CI: 6.9–41.8). Conclusion Hysterotomy extensions are not infrequent at the time of cesarean delivery and are associated with increased maternal morbidity. Cesarean delivery during the second stage of labor is the main independent risk factor for hysterotomy extension.

scholarly journals Relaparotomy Post Cesarean Delivery: Characteristics and Risk Factors.

2021 ◽  
Author(s):  
Alina Weissmann-Brenner ◽  
Barzilay Eran ◽  
Meyer Raanan ◽  
Levin Gabriel ◽  
Harmatz Danielle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Low Birthweight ◽  
Assisted Reproductive Technologies ◽  
Placenta Previa ◽  
Univariate Analysis ◽  
Multivariate Regression Analysis ◽  
Reproductive Technologies ◽  
Second Stage Of Labor ◽  
Second Stage

Abstract Purpose: Relaparotomy following cesarean delivery (CD) is performed at a rate of 0.2-1% of CD. The objective of the present study was to identify risk factors for relaparotomy following CD, and to examine whether there is a difference in the risk of relaparotomy between CD performed during different daytimes. Methods: A retrospective study including all CD over ten years. Cases that underwent laparotomy within one week following CD were compared to those that did not. CDs for placenta accreta were excluded.Results: Sixty-four patients underwent relaparotomy following CD. In univariate analysis relaparotomy was significantly higher pregnancies following assisted-reproductive technologies (39.1%vs. 16.9%), hypertensive disorders of pregnancy (18.8%vs. 7%), twin pregnancies (29.7%vs. 10%), preterm deliveries (34.4%vs. 17.6%), low birthweight (2815gr vs. 3047gr), placenta previa (7.8% vs. 1.3%) low body mass index (22.4 vs. 24.5) and urgent CD (54.7% vs. 40.8%), especially during the second stage of labor. In a multivariate regression analysis, the adjusted odds ratio for relaparotomy was 10.24 in CD due to placenta previa, and 5.28 in CD performed at the second stage of delivery.At relaparotomy, active bleeding was found in 50 patients (78.1%), nearly half received packed cells, 12.5% developed consumptive coagulopathy, and 17.2% needed hospitalization in the intensive care unit. 6.3% underwent a second relaparotomy, mainly due to bleeding.Conclusion: Hypertensive disease, placenta previa, and urgent CDs mainly those performed at the second stage of labor are risk factors for relaparotomy after CD.

scholarly journals Liver Cancer in Guatemala: An Analysis of Mortality and Incidence Trends From 2012 to 2016

2019 ◽  
pp. 1-8 ◽  
Author(s):  
Alba J. Kihn-Alarcón ◽  
María F. Toledo-Ponce ◽  
Angel Velarde ◽  
Ximing Xu
Keyword(s):  
Risk Factors ◽  
Liver Cancer ◽  
Secondary Analysis ◽  
Mortality And Morbidity ◽  
Incidence Trends ◽  
The North ◽  
B Virus ◽  
Morbidity Data ◽  
Associated Risk Factors ◽  
Late Stages

PURPOSE Guatemala has the highest mortality and incidence of liver cancer in Central and South America. The aim of this study is to describe the extent of liver cancer in the country from 2012 to 2016 and the associated risk factors. METHODS A secondary analysis was performed using liver cancer mortality and morbidity data and data on risk factors, such as hepatitis B virus infection, cirrhosis, and alcoholism. RESULTS Analysis revealed that liver cancer causes approximately 20% of cancer deaths in the country, is more frequent in the population older than age 65 years old, and is increasing in those age 30 to 44 years. More than 25% of deaths occurred in the North and West regions. The incidence of major risk factors for development of liver cancer has decreased. CONCLUSION The high mortality of liver cancer compared with its incidence indicates that most patients are diagnosed at late stages. To reduce the burden of liver cancer, creation of strategies for earlier detection is needed.

Mortality and associated risk factors in diabetics

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S21-S26 ◽  
Author(s):  
R. J. Jarrett ◽  
M. J. Shipley
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Potential Risk Factors ◽  
Diabetic Population ◽  
Associated Risk Factors ◽  
The Relationship

Summary. In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured. Key words: diabetics; mortality rates; risk factors; coronary heart disease. There are many studies documenting higher mortality rates - particularly from cardiovascular disease -in diabetics compared with age and sex matched diabetics from the same population (see Jarrett et al. (1982) for review). However, there is sparse information relating potential risk factors to subsequent mortality within a diabetic population, information which might help to explain the increased mortality risk and also suggest preventive therapeutic approaches. In the Whitehall Study, a number of established diabetics participated in the screening programme and data on mortality rates up to ten years after screening are available. We present here a comparison of diabetics and non-diabetics in terms of relative mortality rates and the influence of conventional risk factors as well as an analysis of the relationship between duration of diabetes and mortality risk.

Abstract P625: Rate of Hemorrhagic Transformation After Ischemic Stroke and Associated Risk Factors: The Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS)

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Robert J Stanton ◽  
Eleni Antzoulatos ◽  
Elisheva R Coleman ◽  
Felipe De Los Rios La Rosa ◽  
Stacie L Demel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Fatality ◽  
Population Based ◽  
Hemorrhagic Transformation ◽  
Incidence Rates ◽  
Icd 10 ◽  
Potential Risk Factors ◽  
Adjusted Rate ◽  
Associated Risk Factors

Background: Hemorrhagic transformation (HT) of ischemic stroke can have devastating consequences, leading to longer hospitalizations, increased morbidity and mortality. We sought to identify the rate of HT in stroke patients not treated with tPA within a large, biracial population. Methods: The GCNKSS is a population-based stroke epidemiology study from five counties in the Greater Cincinnati region. During 2015, we captured all hospitalized strokes by screening ICD-9 codes 430-436 and ICD-10 codes I60-I68, and G45-46. Study nurses abstracted all potential cases and physicians adjudicated cases, including classifying the degree of HT. Patients treated with thrombolytics were excluded. Incidence rates per 100,000 and associated 95% confidence intervals (CI) were estimated for HT cases, age and sex adjusted to the 2000 US population. Multiple logistic regression was used to examine risk factors associated with HT. Results: In 2015, there were 2301 ischemic strokes included in the analysis. Of these 104 (4.5%) had HT; 23 (22.1%) symptomatic, 55 (52.9%) asymptomatic and 26 (25%) unknown. Documented reasons for not receiving tPA in these patients were: time (71, 68.3%), anticoagulant use (1, 1.0%), other (18,17.3%) and unknown (14, 13.5%), which were not significantly different compared to those without HT. Only 29/104 (18.3%) had HT classified as PH-1 or PH-2. The age, sex and race-adjusted rate of HT was 9.8 (7.9, 11.6) per 100,000. The table shows rates of potential risk factors and the adjusted odds of developing HT. 90 day all-cause case fatality for patients with HT was significantly higher, 27.9% vs. 15.7%, p<0.0001. Conclusion: We found that 4.5% of non-tPA treated IS patients had HT. These patients had more severe strokes, were more likely to have abnormal coagulation tests or anticoagulant use, and were more likely to die within 90 days. We also report the first population-based incidence rate of HT in non-tPA treated of 9.8/100,000, a rate similar to the incidence of SAH.

Prevalence and risk factors of root resorption of adjacent teeth in maxillary canine impaction, among untreated children and adolescents

2018 ◽  
Vol 41 (5) ◽  
pp. 447-453 ◽  
Author(s):  
Frédéric Rafflenbeul ◽  
Catherine-Isabelle Gros ◽  
François Lefebvre ◽  
Sophie Bahi-Gross ◽  
Raphaëlle Maizeray ◽  
...  
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Root Resorption ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Data Sets ◽  
Maxillary Canine ◽  
3D Data ◽  
Potential Risk Factors ◽  
Associated Risk Factors

Summary Objectives The aim of this retrospective study was to assess in maxillary canine impaction cases both the prevalence of root resorption of adjacent teeth among untreated children and adolescents, and its associated risk factors. Subjects and methods Sixty subjects (mean age 12.2 years; SD 1.9; range 8–17 years) with 83 displaced maxillary canines and without any past or ongoing orthodontic treatment were included in this study. The presence of root resorption was evaluated on images from a single cone beam computed tomography (CBCT) unit. Potential risk factors were measured on the CBCT images and on panoramic reconstructions of the 3D data sets. The sample was characterized by descriptive statistics and multiple logistic regressions were performed to predict root resorption. Results Root resorption of at least one adjacent tooth was detected in 67.5 per cent of the affected quadrants. It was found that 55.7 per cent of the lateral incisors, 8.4 per cent of the central incisors, and 19.5 per cent of first premolars were resorbed. Of the detected resorptions, 71.7 per cent were considered slight, 14.9 per cent moderate, and 13.4 per cent severe. Contact between the displaced canine(s) and the adjacent teeth roots was the only identified statistically significant risk factor, all teeth being considered (odds ratio [OR] = 18.7, 95% confidence interval: 2.26–756, P < 0.01). An enlarged canine dental follicle, a peg upper lateral, or an upper lateral agenesis were not significantly associated with root resorption of adjacent teeth, nor were age nor gender. Conclusions Root resorption of adjacent teeth was detected in more than two-thirds of a sample of sixty untreated children and adolescents.

scholarly journals Prevalence and Risk Factors of Infection with Soil Transmitted Helminths in Children from Bandjoun, the West Region of Cameroon

2020 ◽  
pp. 34-43
Author(s):  
Vanessa Rosine Nkouayep ◽  
Peter Nejsum ◽  
Dzune Fossouo Dirane Cleopas ◽  
Noumedem Anangmo Christelle Nadia ◽  
Atiokeng Tatang Rostand Joël ◽  
...  
Keyword(s):  
Risk Factors ◽  
Demographic Data ◽  
Public Health Problem ◽  
School Age Children ◽  
National Programme ◽  
Soil Transmitted Helminths ◽  
Ancylostoma Duodenale ◽  
Potential Risk Factors ◽  
Stool Samples ◽  
Associated Risk Factors

Background: Soil-transmitted helminths (STHs) continue to be a public health problem in developing countries. In Bandjoun, annual deworming is usually administered to school-age children through the national programme for the control of schistosomiasis and soil-transmitted helminthiasis in Cameroon. However, official data on the level of STH infections are scarce in this locality. Methods: We investigated the prevalence and associated risk factors of STHs among children in Bandjoun with the intention to help design future intervention plans. We obtained demographic data and potential risk factors through the interview of children using a structured questionnaire. Stool samples from these children were collected and examined for helminth eggs using Willis’ technique. Results: Three STHs were identified with an overall prevalence of 8.7%. These nematodes were Ascaris lumbricoides (8.3%), Trichuris trichiura (0.3%) and hookworms (Ancylostoma duodenale, Necator americanus) (0.7%). Failure to wash hands before meals (AOR: 2.152 [1.056-4.389]) was the main predictor associated with Ascaris infections. Not eating food picked up from the ground (AOR: 0.494 [0.261-0.937]) and not raising pigs at home (AOR: 0.109 [0.045-0.268]) reduced risk of infection. Conclusion: We recommend that STHs control interventions in Bandjoun focus on the good management of domesticated pigs, the avoidance of contact with soil and handwashing from the earliest ages as a part of daily hygiene practice.

scholarly journals Prevalence of diarrhoea, and associated risk factors, in children aged 0-5 years, at two hospitals in Umuahia, Abia, Nigeria

2017 ◽  
Vol 9 (1) ◽  
pp. 7-14
Author(s):  
Adanma Florence Nwaoha ◽  
Camelita Chima Ohaeri ◽  
Ebube Charles Amaechi
Keyword(s):  
Risk Factors ◽  
Health Workers ◽  
Age Groups ◽  
Medical Centers ◽  
Faecal Samples ◽  
Potential Risk Factors ◽  
Stool Samples ◽  
The Government ◽  
Associated Risk Factors ◽  
And Control

Diarrhoea is the second leading cause of infectious mor­bidity and mortality in children under five years of age. This study aimed at identifying the most common parasites and potential risk factors for diarrhoea among children 0-5 years attending Abia State Specialist hospital and Federal Medical Centre, Umuahia, in south east­ern Nigeria. We used 400 faecal samples from children with diarrhoea –and 200 without– in combination with hospital-based case control and a questionnaire Stool samples were processed with direct normal saline and formal-ether sedimentation method for parasitological stud­ies. More males than females were infected in nearly all age groups in both diarrhoeal and control groups (X2=23.04, df=1, P<0.05: X2=11.52, df=1, P<0.05 respectively). Amachara had more infections (X2=0.15, df=1, P< 0.05). January had the highest rate of infection (22.5%). Main clinical features were watery depositions over 3 times a day, diarrhoea lasting for days, fever, vomiting, and dehydration. Mothers learned about the problem through health workers, television and in medical centers. Risk correlated with mother’s education, occupation, latrine type, waste water disposal, hand washing, kitchen cleaning; sources and storage of water; and bottle milk (P< 0.05).Ignorance greatly con­tributed to the spread of parasitic disease in the area: the government should improve education and other strategies to alleviate the spread of the disease..

scholarly journals EFEKTIVITAS POSISI TANGAN PENOLONG DALAM PENCEGAHAN RUPTUR PERINEUM PADA PERSALINAN NORMAL

2017 ◽  
Vol 9 (01) ◽  
pp. 68
Author(s):  
Mulyati Priyantini ◽  
Yuli Trisnawati
Keyword(s):  
Maternal Morbidity ◽  
P Value ◽  
Cross Sectional ◽  
Second Stage Of Labor ◽  
Whitney Test ◽  
Second Stage ◽  
Mann Whitney Test ◽  
Significant Difference ◽  
U Value ◽  
Quota Sampling

ABSTRAKFokus utama asuhan persalinan adalah pencegahan komplikasi untuk mengurangi angka kesakitan dan kematian ibu. Salah satu upaya adalah mencegah terjadinya ruptur perineum. Posisi tangan yang dipakai penolong persalinan kala II untuk mencegah ruptur perineum antara lain posisi tangan APN dan Varney. Penelitian ini bertujuan untuk mengetahui efektivitas antara posisi tangan penolong menurut APN dan menurut Varney dalam mencegah ruptur perineum spontan pada kala II persalinan di RSIA ‘Bunda arif’ Purwokerto. Penelitian ini merupakan penelitian observasional analitik, menggunakan pendekatan cross sectional dengan populasi seluruh persalinan spontan di RSIA ‘Bunda arif’ Purwokerto. Sampel yang digunakan adalah quota sampling  sebanyak 30 sampel yang memenuhi kriteria inklusi. Metode analisis data menggunakan uji U Mann-Whitney. Hasil penelitian ini adalah Kejadian ruptur perineum pada posisi tangan menurut APN sebanyak 93,3%, sedangkan menurut Varney sebanyak 86,7%. Hasil analisa statistik uji U Mann-Whitney didapatkan p value = 0,550 (p>0,005) sedangkan U value  = 33,000 (Uh < U t ), artinya tidak ada perbedaan bermakna, tetapi posisi tangan Varney lebih baik dengan selisih ruptur 6,6%. Posisi tangan penolong menurut Varney lebih efektif daripada posisi tangan menurut APN dalam pencegahan ruptur perineum spontan pada kala II persalinan, tetapi keduanya tidak memberikan perbedaan yang bermakna terhadap kejadian ruptur perineum. Penolong persalinan dapat menemukan metode yang paling tepat dalam meminimalisir kejadian ruptur perineum spontan untuk menurunkan angka kesakitan dan kematian ibu.Keyword : Posisi tangan penolong, ruptur perineumEFFECTIVENESS OF HANDLING POSITION IN PREVENTION OF PERINEUM RUPTURE IN NORMAL LABORABSTRACTMain focus of delivery care is preventing the complication to reduce the maternal morbidity and mortality. One of the efforts to prevent the occurance of perineal rupture. The position hand which is used birth attendant in the second stage of labor to prevent perineal rupture among others APN and Varney hands position. The goal of this reasearch is to know the effectiveness between APN and Varney hands position to prevent spontanoeus perineal rupture in the second stage of labor in RSIA ‘Bunda arif’ Purwokerto. This reasearch was observational analytic by approachment cross sectional with population of this reasearch was all of spontaneous delivery in RSIA ‘Bunda arif’ Purwokerto and the sample used quota sampling, it’s about 30 sample can be a inclusion criteria. The analyze method data used U Mann-Whitney test. The result of this experiment are precentage of spontaneous perineal rupture by  APN hands position is 93,3%, while by Varney is 86,7%. Result of statistic analysis used U Mann-Whitney test is p value = 0,550 (p>0.005) and U value  = 33,000 (Uh < U t). It means, not significant difference, but Varney hands position better by a margin of 6.6%. the conclusion are varney hands position is more effective than APN hands position in  prevention spontaneous perineal rupture in the second stage of labor, but both not significant for perinel rupture. Suggestion : Birth attendants can find the most appopriate method to minimize perineal ruptured to reduce maternal morbidity and mortalityKeyword : APN & Varney hands position, and perineal rupture.

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