Incidence and Risk Factors for Maternal Hypoxaemia During Induction of General Anesthesia for Non-elective Caesarean Section: A Prospective Multicentre Study

Background: In the tropics, leiomyoma are commonly encountered in women of the reproductive age group, although they are mostly asymptomatic. Surgery for uterine fibroid at caesarean section has remained controversial. Objective: The study design was a prospective multicentre study to analyse the clinical outcome of women that had selective caesarean myomectomy in a medical college and private hospitals in Dinajpur,Bangladesh. Method: Thirty women that had selective myomectomy at caesarean section between January 2004 and February 2012 were analysed. Results: The patients mean age was 32.6 years with age range of 21–39 years. Of the 30 patients, 21 (70 %) were Primigravida, 27 (90%) of the patients had caesarean section at term, 2 (6.6%) and 1 (3.3%) of the patients were preterm and post term respectively. A significant number of the patients 28 (93.4%) had elective caesarean section and the remaining 2 (6.6%) patients had emergency caesarean section. The 3 leading indications for caesarean section among the patients were malpresentation/abnormal lie 23%, uterine fibroids 26.6%, and a previous caesarean section with complication in 20% of the patients. Indications for myomectomy at caesarean section were fibroid in lower uterine segment in 18 (60%) patients, pedunculated uterine fibroid in 8(26.6%) patients and anterior subserous fibroid in 4 (13.3%) patients. Intraopertively in the 30 patients, 15 (50%) had fibroid(s) removed only in the lower uterine segment; while 7 (23.3%) patients had removed in the upper uterine segment and 8(26.6%) had both upper and lower uterine segments. A total of 75 fibroids were removed in the 30 patients, of which 40 (53.3%) were subserous/pedunculated, 25 (33.3%) intramural and 10 (13.3%) were submucous. Of the75 fibroids, 51 (68%) were between 6 to 10 cm size. Sixteen (53.3%) of the 30 patients lost between 751 to 1000 ml of blood intraoperatively with an average of 860 ml of blood loss. Five (16.6%) ofthe 30 patients had blood transfusion due to anaemia. Other complications encountered were puerperal pyrexia and sepsis in 2 (6.6%) patients. There was no maternal and perinatal mortality. Conclusion: Selection of patients for caesarean myomectomy reduces blood loss, anaemia and other complications. TAJ 2011; 24(1): 38-42

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Maternal and neonatal risk factors for neonatal respiratory distress syndrome in term neonates in Cyprus: a prospective case–control study

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01086-5 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Paraskevi Stylianou-Riga ◽

Theodora Boutsikou ◽

Panayiotis Kouis ◽

Paraskevi Kinni ◽

Marina Krokou ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Hypertension ◽

Caesarean Section ◽

Distress Syndrome ◽

Elective Caesarean Section ◽

Case Control ◽

Male Gender ◽

Term Neonates ◽

Systemic Hypotension ◽

Neonatal Respiratory Distress

Abstract Background Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus. Methods In a prospective, case-control design we recruited term neonates with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III hospital, the only neonatal tertiary centre in Cyprus, between April 2017–October 2018. Clinical data were obtained from patients’ files. We used univariate and multivariate logistic and linear regression models to analyse binary and continuous outcomes respectively. Results During the 18-month study period, 134 term neonates admitted to NICU were recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95% CI: 1.03–18.39, p = 0.045) and elective caesarean section (OR: 11.92, 95% CI: 1.80–78.95, p = 0.01) were identified as independent predictors of NRDS. Among neonates with NRDS, early-onset infection tended to be associated with increased administration of surfactant (β:0.75, 95% CI: − 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or systemic hypotension were associated with longer duration of parenteral nutrition (pulmonary hypertension: 11Vs 5 days, p < 0.001, systemic hypotension: 7 Vs 4 days, p = 0.01) and higher rate of blood transfusion (pulmonary hypertension: 100% Vs 67%, p = 0.045, systemic hypotension: 85% Vs 55%, p = 0.013). Conclusions This study highlights the role of elective caesarean section and male gender as independent risk factors for NRDS in term neonates. Certain therapeutic interventions are associated with complications during the course of disease. These findings can inform the development of evidence-based recommendations for improved perinatal care.

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Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽

10.1093/qjmed/hcab115.017 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hazem F El-Shahawy ◽

Sherif F El-Mekkawi ◽

. Haitham F Mohmmed ◽

Hend M Afifi

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

General Anesthesia ◽

Local Anesthesia ◽

Breast Feeding ◽

Local Anesthetic ◽

Elective Caesarean Section ◽

Control Group ◽

Cesarean Section Delivery ◽

Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

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A case of fracture of humerus in newborn delivered by elective caesarean section

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20150221 ◽

2015 ◽

Vol 1 (2) ◽

pp. 134

Author(s):

Devindra Kaur ◽

Harminder Singh

Keyword(s):

Risk Factors ◽

Case Report ◽

Caesarean Section ◽

Elective Caesarean Section ◽

Vaginal Deliveries ◽

Vertex Presentation ◽

Fracture Humerus

<p class="abstract"><span lang="EN-US">Birth fractures are common during vaginal deliveries and with breech presentations. This case report of fracture humerus during elective LSCS done for previous LSCS with vertex presentation and with no predisposing risk factors.</span></p>

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Risk factors for Caesarean sections in Ghana: evidence from the Ghana Maternal Health Survey

Journal of Biosocial Science ◽

10.1017/s0021932020000656 ◽

2020 ◽

pp. 1-18

Author(s):

Emmanuel Banchani ◽

Eric Y. Tenkorang

Keyword(s):

Risk Factors ◽

Maternal Health ◽

Caesarean Section ◽

Health Survey ◽

Elective Caesarean Section ◽

Sub Saharan Africa ◽

Maternal Complications ◽

Obstructed Labour ◽

Sub Saharan ◽

Using Data

Abstract A Caesarean section can be a life-saving intervention in case of pregnancy complications or difficult labour. The prevalence of Caesarean section continues to increase, especially in sub-Saharan Africa, yet the reasons for this remain largely unexplored. This study investigated risk factors contributing to the decision to perform Caesarean sections in Ghana using data from 8645 women aged 15–49 years from the 2017 Ghana Maternal Health Survey. The data were analysed by applying complementary log-log and logit models. The majority of Ghanaian women (about 87%) reported preferring vaginal delivery to Caesarean section. Of those who had undergone a Caesarean section for their most recent birth, about 55% had an elective rather than an emergency section. Women with labour complications (prolonged/obstructed labour) were significantly more likely to have a Caesarean section (OR=4.09, 95% CI=3.10–5.41). Furthermore, women with maternal complications, particularly prolonged/obstructed labour, were less likely to have an elective Caesarean section than those who had no such complications (OR=0.25, 95% CI=0.14–0.46). Compared with poorer women, wealthy women were significantly more likely to have an elective Caesarean section (OR=1.84, 95% CI=1.08–3.14). The findings suggest that beyond maternal complications, women’s socioeconomic and demographic characteristics are important risk factors for undergoing a Caesarean section in Ghana.

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