scholarly journals Association between migration status and caesarean section delivery based on a modified Robson classification in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ming Liu ◽  
Mengqi Xue ◽  
Qing Yang ◽  
Wenchong Du ◽  
Xiaoling Yan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Migrant Women ◽  
Migrant Status ◽  
Rapid Urbanization ◽  
Maternal Request ◽  
Medical Practitioners ◽  
Robson Classification ◽  
Caesarean Section Delivery ◽  
Internal Migrants ◽  
Group 1

Abstract Background China has one of the highest caesarean section (C-Section) rates in the world. In recent years, China has been experiencing a massive flow of migration due to rapid urbanization. In this study, we aimed to differentiate the rates of C-Section between migrants and residents, and explore any possible factors which may moderate the association between migrant status and C-Section rates. Methods We conducted a retrospective cohort study in Shanghai, China. All deliveries were classified using the modified Robson Classification. The association between women’s migrant status and C-Section rates was assessed using the Poisson regression of sandwich estimation, after adjusting for possible factors. Results Of the 40,621 women included in the study, 66.9% were residents and 33.1% were internal migrants. The rate of C-Section in migrants was lower than that of residents in all subjects (39.9 and 47.7%) and in group 1 subjects (based on the Robson Classification) using a modified Robson Classification. There was an association between migrant status and caesarean delivery on maternal request that was statistically significant (RR = 0.664, p < 0.001), but the association was weakened after adjusting for such factors as maternal age at delivery (aRR = 0.774, p = 0.02), ethnicity (aRR = 0.753, p < 0.001), health insurance (aRR = 0.755, p < 0.001), and occupation (aRR = 0.747, p = 0.004), but had no significant changes when adjusting for health conditions (aRR = 0.668, p = 0.001) and all considering variables (aRR = 0.697, p = 0.002). In group 1 subjects, the effect of migrant status on maternal requested intrapartum C-Section was also statistically significant (RR = 0.742, p = 0.004). Conclusion C-Section rates are lower among migrant women than residents, especially on maternal request. The medical practitioners should further reinforce the management of elective C-Section in resident women.

scholarly journals Rising trends of caesarean section in modern obstetrics: analysis by Robson classification

2020 ◽  
Vol 9 (11) ◽  
pp. 4468
Author(s):  
Shery Angel Rajakumar ◽  
Sindhura Myneni ◽  
Kamala Roshini M.
Keyword(s):  
Caesarean Section ◽  
Group Classification ◽  
Health Concern ◽  
Public Health Concern ◽  
Robson Classification ◽  
Obstetrics And Gynaecology ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: Rising caesarean section (CS) rates are a major public health concern worldwide. The main objective of our study was to analyse the CS rates according to Robson ten group classification system (TGCS).Methods: This was a retrospective study conducted in the department of obstetrics and gynaecology at Chettinad hospital and research institute, during a period of 5 years from May 2015 to April 2020. All the women who delivered by CS were included in the study. The data regarding parity, gestational age, onset of labour, number of foetuses and presentation was collected and classified according to Robson TGCS and analysed.Results: A total of 4199 women delivered during the study period. Out of 4199 women 2149 (51.18%) underwent CS. All the women who underwent caesarean section were classified according to Robson TGCS. Group 5 contributed the most (40.81%). Group 2 had the second highest contribution of 33.36%. Group 1 had 6.24%, group 3 and 4 contributed for 1.16% and 4.65% respectively. Group 6 and 7 had 2.84% and 1.68% respectively. Group 8 had 2.28%, group 9 had 0.23% and group 10 constituted 6.75%.Conclusion: As contribution of repeat CS is high among the overall CS rate it is important to reduce the primary CS rates. More analytical studies need to be done based on Robson TGCS to evaluate the indication of CS within each group.

scholarly journals The relationship between internal migration and the likelihood of high-risk pregnancy: Hukou system and high-risk pregnancies in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Di Tang ◽  
Xiangdong Gao ◽  
Peter C. Coyte
Keyword(s):  
High Risk ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Public Services ◽  
Migrant Women ◽  
Migrant Status ◽  
Registration System ◽  
Internal Migrant ◽  
Internal Migrants ◽  
The Relationship

Abstract Background China has one of the world’s largest internal migrant populations. The Chinese Hukou system is a unique household registration system that limits internal migrants in their access to basic urban public services, such as public health insurance and social assistance of their host city. In the case of female internal migrants, this may lead to high-risk pregnancies. The objective of this study is to assess the relationship between internal migrant status (Hukou) and the likelihood of high-risk pregnancies that occur in one large municipal-level obstetrics hospital in Shanghai, China. Methods Medical records data from the Shanghai First Maternity and Infant Hospital from January 1, 2013, to May 31, 2018, were used to analyze 133,358 live births for Shanghai natives (n = 83,872) and internal migrant women (n = 49,486). A propensity score matching approach was used in conjunction with logistic regression analysis to identify the role of internal migrant status (Hukou) on the likelihood of high-risk pregnancies. Results A greater likelihood of high-risk pregnancies were found among internal migrant women who moved from other parts of China to Shanghai. This effect was more obvious for women who gave birth for the first time and internal migrant women who were employed. Conclusion The results show the effects of internal migrant status (Hukou) and the elevated likelihood of high-risk pregnancies among internal migrant women relative to their urban counterparts in Shanghai even after accounting for self-selection by employing the propensity score matching method. China’s unique Hukou household registration system limits access to public services for internal migrant women and accordingly may account for the elevated likelihood of high-risk pregnancies.

Infeksi Herpes Simpleks Dalam Kehamilan

2017 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Fauzia Andrini Djojosugito
Keyword(s):  
Herpes Simplex ◽  
Caesarean Section ◽  
Sexually Transmitted Diseases ◽  
Recurrent Infection ◽  
Neonatal Infection ◽  
Sexually Transmitted ◽  
Caesarean Section Delivery ◽  
Common Causes ◽  
Pregnancy And Delivery ◽  
Simplex Virus

Herpes simplex virus is one the most common causes of sexually transmitted diseases. This infection is common inreproductive age women and can cause severe sequealae for fetus and neonates because this virus can be transmittedto the fetus during pregnancy and the newborn. Infection of Herpes simplex can occurs as first or primary infectionand recurrent infection. Most of the case is asymptomatic. Rarely during intrauterine, the risk of transmission ofmaternal-fetal can be increased during the last trimester of pregnancy and delivery. Based on type of infection,primary or recurrent, performing a treatment with antiviral drugs or caesarean section delivery can decrease the riskof neonatal infection

scholarly journals Term gravid uterus in a congenital umbilical hernia: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Friday Saidi ◽  
Bakari Rajab ◽  
Lameck Chinula ◽  
Nomsa Kafumba ◽  
Maganizo Chagomerana ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Umbilical Hernia ◽  
Primary Repair ◽  
Recurrent Hernia ◽  
Gravid Uterus ◽  
Patient Centered ◽  
Medical Practitioners ◽  
Vaginal Deliveries ◽  
Feasible Option ◽  
Associated Risk Factors

Abstract Background Umbilical hernias are a frequent and well-known pathology in children or adults. Congenital umbilical hernias are commonly diagnosed in childhood, and in adulthood such a hernia is usually acquired. Umbilical hernia in pregnancy may result in serious obstetric complications including antepartum hemorrhage, intrauterine fetal demise, and preterm labor, particularly if incarcerated. Case presentation We present a rare case of a congenital umbilical hernia in a term pregnancy. The patient was a 34-year-old African (Malawian) woman, living with human immunodeficiency virus (HIV) and on antiretroviral treatment, gravida 4, with three previous vaginal deliveries, and with two babies weighing 4 kg at birth. We performed herniorrhaphy at caesarean section, and at 3 months of follow-up she had no evidence of a recurrent hernia. Conclusion Congenital umbilical hernias are commonly diagnosed in childhood but might first be seen by medical practitioners in adulthood. A patient-centered approach addressing patient complaints, associated risk factors, and possible complications is recommended. Primary repair at caesarean section is a feasible option.

scholarly journals Predictors of the recurrence of surgically removed previous caesarean skin scars at caesarean section: A retrospective cohort study

2021 ◽  
Vol 7 ◽  
pp. 205951312110233 ◽  
Author(s):  
İhsan Bağlı ◽  
Rei Ogawa ◽  
Sait Bakır ◽  
Cuma Taşın ◽  
Ayhan Yıldırım ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Caesarean Section ◽  
Retrospective Cohort ◽  
Treatment Strategies ◽  
Surgical Excision ◽  
Hypertrophic Scars ◽  
Group 2 ◽  
Risk Factor For Recurrence ◽  
Group 1

Background: Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful for women and treatment strategies vary. However, there is a lack of knowledge about the outcome of surgical excision of CSS during caesarean section (CS). The study aims to determine the rate of recurrence and risk factors of recurrence for surgically removed CSS. Method: This is a retrospective cohort study that used STROBE guidelines. Pfannenstiel incisions of 145 patients were evaluated. Patients were divided into two groups: recurred (group 1, n = 19) and non-recurred group (group 2, n = 126). The groups were compared. Results: The rate of recurrence of CSS was 13% in the total cohort (19/145), one of the main outcomes of the study. While emergency CS was performed for 12 patients in group 1 (63%), CS was carried out in 25 patients in group 2 (20%); this difference was significant ( P = 0.001). Before surgery, white blood cell and neutrophil counts were significantly higher in group 1 ( P = 0.014 and P = 0.023, respectively). There were 11 dark-skinned women (26%; Fitzpatrick type 4) in group 1 and 31 (74%) in group 2. This difference was statistically significant ( P = 0.031). As the other main outcome, emergency CS could be accepted as a risk factor for recurrence in the multivariate regression analysis ( P = 0.060; odds ratio = 5.07; 95% confidence interval = 0.93–17.51). Conclusion: The rate of recurrence of surgically removed previous CSS at CS is promising without adjunct therapy. Emergency CS was found to be a risk factor for recurrence. Lay Summary Background Caesarean skin scars (CSS; hypertrophic scars and keloids) are very stressful and are generally itchy and painful for women. Treatment strategies vary. However, there is a lack of knowledge about the outcome of only surgical excision of CSS scars during caesarean section (CS). The issue being explored There are few data in the literature for CSS in the lower abdomen. These scars can be removed during the second or third CS, but the results are not known exactly. How was the work conducted? In our clinic, 145 patients with CSS were given a CS and their scars were removed at the same time. While most of these scars were reported as hypertrophic by pathological examination, some were reported as keloid. At the earliest, one year after surgery, the rate of recurrence was found to be 13%. What we learned from the study Asymptomatic patients who are planning another pregnancy and do not want to receive any other radiotherapy or steroid injection therapy can wait to remove their CSS at the next CS, especially elective CS with or without adjunct therapy. Emergency CS was found to be a risk factor for the recurrence of these scars.

Caesarean section for maternal request

2011 ◽  
Vol 21 (11) ◽  
pp. 327-328 ◽  
Author(s):  
Chuks Nzewi ◽  
Leonie K. Penna
Keyword(s):  
Caesarean Section ◽  
Maternal Request

Diagnosis and surgical correction of isthmocele after caesarean section

2021 ◽  
Vol 20 (3) ◽  
pp. 56-62
Author(s):  
N.S. Mikhaelyan ◽  
◽  
D.V. Bryunin ◽  
I.D. Khokhlova ◽  
T.A. Dzhibladze ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Surgical Correction ◽  
Postoperative Rehabilitation ◽  
Double Row ◽  
Anatomical Structures ◽  
Group 3 ◽  
Group 2 ◽  
Uterine Scar ◽  
Group 1

Objective. To compare the efficacy of different methods of surgical correction of isthmocele after caesarean section. Patients and methods. The study included 56 patients aged 29–41 years, who were divided into three groups: group 1 (n = 16) – patients who underwent surgical laparoscopy with suturing the uterine wound with single-row separate muscularmuscular sutures; group 2 (n = 23) – patients after repair of the uterus with a double-row continuous seromuscular and muscular-muscular suture performed by laparoscopy; group 3 (n = 17) consisted of patients who underwent laparotomy and suturing the uterine wound with a double-row continuous suture. Results. We developed a three-stage plastic and reconstructive surgical laparotomic and laparoscopic program in case of the uterine scar incompetence, which improved the quality of life in all patients. Pregnancy occurred 9–14 months after plastic and reconstructive surgery on the uterus and resulted in timely surgical delivery in 4 (25%) patients in group 1, in 7 (30.4%) patients in group 2 and in 3 (17.6%) patients in group 3. Two (12.5%) patients in group 1 and three (13.04%) patients in group 2 were observed during pregnancy with a period of 10–28 weeks. Conclusion. The use of laparoscopy ensured better visualization of anatomical structures (vessels, nerves, ureters, bladder), which led to a decrease in intraoperative blood loss, in the risk of damage to adjacent organs and in the development of adhesions, and to accelerated postoperative rehabilitation of patients. Key words: double-row suture, istmocele, laparoscopy, metroplasty

scholarly journals The ten group Robson classification: an institutional study to analyse the caesarean section rates

2021 ◽  
Author(s):  
Lekshminath Gopinath ◽  
Rajani Vaidya
Keyword(s):  
Caesarean Section ◽  
Policy Making ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Robson Classification ◽  
Relative Contribution ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Group 5

Background: Over the last few decades, there has been an alarming increase in the rate of deliveries by caesarean section (CS) in most of the countries, though the drivers of this trend are not completely understood. In 1985, WHO had proposed that ideal rate for regional CS rates should not exceed 10-15%. The Robson’s classification system is simple, robust and flexible. The study was done as it was important to have a tool to monitor, compare the CS rates in a same setting and between different settings over a period of time and to optimise the CS rates.Methods: It was a retrospective study conducted in the department of obstetrics and gynaecology in a tertiary care centre. The hospital delivery records were reviewed for a period of 15 months from April 2020 to June 2021.Results: The total number of deliveries during the study period was 1016. The total number of CSs was 441 and the total number of vaginal deliveries was 575.The CS rate was 43.4%. The relative contribution from groups 1, 2 and 5 in our study accounted for 76.36% and group 5 accounted for 44.4% of the total CSs. These 3 groups should be the focus of attention to reduce the overall CS rates.Conclusions: It is advisable that all institutions can use the Robson’s report table to analyse the population catered by them and to make institutional specific policies. This will allow comparing the data amongst the different institutions and countries which can help in policy making.

scholarly journals ASSESSMENT OF DRUG UTILIZATION AMONG PEDIATRIC PATIENTS IN PRIVATE CLINIC AND PUBLIC HOSPITAL OF BANGLADESH

2020 ◽  
pp. 54-58
Author(s):  
AHSAN UDDIN ◽  
TRIPTI RANI PAUL ◽  
MONALISA MONWAR ◽  
SHAHIN SARKER ◽  
CHAND SULTANA ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Private Practice ◽  
Public Hospital ◽  
Pediatric Patients ◽  
Medical Practitioners ◽  
Number Of Patients ◽  
Sensitivity Tests ◽  
Questionnaire Form ◽  
Current Guidelines ◽  
Group 1

Objective: Aim of the study was to assess drug utilization among pediatric patients in both private practice and hospital settings in Rajshahi city, Bangladesh. Methods: This observational study was conducted during a period of two months (March to April) in 2017. Prescriptions were randomly collected from patients and recorded in a predesigned questionnaire form. The data analysis was carried out by using a statistical software package GraphPad Prism. Results: The study involved a total of 185 patients, of which 62.70% were male and 37.30% were female. The patient’s age ranges from 1 mo-12 y and highest number of patients visited physicians belong to group 1 mo-1 y (47.57%). Most commonly occurring disease conditions were pneumonia (24%), the leading cause of hospitalizations among the children's age group of 1 mo-1 y. The results indicated that physician’s handwriting was not clear and legible in 50 (27.03%) prescriptions. A total of 468 drugs were prescribed with an average of 2.53 per prescription. However, none of the drugs were prescribed by generic name. The most commonly prescribed drugs were antibiotics 173 (93.5%). About 78% patients were exposed to antibiotics, of which single antibiotic was prescribed in 116 (62.70%) and two antibiotics in 23 (12.43%) prescriptions. Among the drugs, NSAIDS 65 (35.14%), anti-histamine 57 (30.81%), anti-asthmatic 49 (26.49%) drugs were assigned in prescriptions followed by vitamin and minerals 51 (27.57%). Steroids 57 (30.81%) and hypnotics 26 (14.05%) were also accounted in many prescriptions. Interestingly, antibiotics were indiscriminately prescribed in private practices without any bacteriological examinations, whereas in hospital settings, most of the treatment was initiated after culture and sensitivity tests. Conclusion: Children were highly exposed to antibiotics, steroids and hypnotics in both private practice and hospital settings.  So Medical practitioners should be aware of current guidelines for prescriptions of antibiotics and drugs in child.

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