scholarly journals Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Dai ◽  
Li Xia ◽  
Jinxiao Lin ◽  
Rongli Xu ◽  
Wenqiang You
Keyword(s):  
Cesarean Section ◽  
Operation Time ◽  
Anterior Wall ◽  
Control Group ◽  
Study Group ◽  
Transverse Incision ◽  
Postoperative Fever ◽  
Postoperative Changes ◽  
Perioperative Bleeding ◽  
Surgical Data

Abstract Introduction A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section. Methods The medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results No significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p < 0.05), and the operation time and average hospitalization time were slightly longer in the study group than in the control group (p < 0.05). The distribution of type III–V fibroids was slightly more in the study group than in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion Fibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.

scholarly journals Study on the Method of Enucleation of Anterior Uterine Fibroids by Transverse Incision of Lower Uterine Segment During Cesarean Section

2021 ◽  
Author(s):  
Li Xia ◽  
Jinxiao Lin ◽  
Rongli Xu ◽  
Wenqiang You ◽  
Yan Dai
Keyword(s):  
Cesarean Section ◽  
Operation Time ◽  
Anterior Wall ◽  
Control Group ◽  
Study Group ◽  
Transverse Incision ◽  
Postoperative Fever ◽  
Perioperative Bleeding ◽  
Significant Difference ◽  
Surgical Data

Abstract Introduction: A retrospective study was conducted to investigate the effectiveness and feasibility of enucleation fibroids of the anterior wall of the uterus by transverse incision of the uterus at the same time during cesarean section. Methods The medical history, surgical data, preoperative and postoperative blood system changes and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section in the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results There was no significant difference in the number of leiomyoma, pathological type, preoperative and postoperative hemoglobin, incidence of perioperative bleeding, frequency of blood transfusion, incidence of postoperative fever, uterine involution and lochia between the study group and the control group. The proportion of large fibroids in the study group was slightly higher than that in the control group (p < 0.05), and the operation time and average hospitalization time in the study group were slightly longer than that in the control group (p < 0.05).The distribution of type III-V fibroids in the study group was slightly more than that in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion It is safe and effective to enucleate the fibroids of the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. Potential to reduce the risk of pelvic adhesion and intrauterine adhesion in the future, so that some patients avoid the risk of reoperation.

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

Effect of the Modified Surgeon Assisted Bilateral Transversus Abdominis Plane Block on Time Required for First Analgesic Dose after Cesarean Section under Spinal Anesthesia: Randomized placebo-control

2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Ahmed Mamdouh
Keyword(s):  
Placebo Group ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Interquartile Range ◽  
Transversus Abdominis ◽  
Secondary Outcome ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Tap Block

Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632

scholarly journals Postpartum endometritis prevention in abdominal delivery planning in pregnant with severe anaerobic vaginal dysbiosis

2015 ◽  
Vol 96 (1) ◽  
pp. 5-9 ◽  
Author(s):  
K V Voronin ◽  
A M Alale ◽  
I I Alale ◽  
R M Banakhevich
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Discharge ◽  
Bacterial Flora ◽  
Uterine Cavity ◽  
Test System ◽  
Control Group ◽  
Study Group ◽  
Septic Complications ◽  
Ascending Infection

Aim. Prevention of purulent and septic complications in females after planned caesarean section.Methods. Out of 60 pregnant women, who underwent comprehensive examination during the trial, 35 (58.3%) were included in the study group and were delivered off by planned cesarean section; 25 (41.7%) pregnant women, included in the control group, were delivered off by urgent cesarean section. Considering the goal of the study, bacteriology of vaginal discharge, amniotic fluid and placental tissues, DNA detection of vaginal discharge bacterial flora before and after treatment (using «Femoflor-16» test system) according to classification by M.N. Boldyreva (2010), uterine cavity aspirate cytology according to classification by M.A. Kupert (2003), sonography of the uterus and uterine adnexa on the 4-5 day after the surgery according to classification of A.P. Milovanov were added to the training program for pregnant women. In the study group, pregnant patients with severe anaerobic vaginal dysbiosis at the 36-38 weeks of gestation were administered causal treatment of severe anaerobic vaginal dysbiosis, pregnant patients of the control group were not treated if severe anaerobic vaginal dysbiosis was diagnosed.Results. Performed correction of vaginal microbiota in the study group has significantly improved the course of postoperative period, reduced the incidence of uterine subinvolution, signs of chorioamnionitis as a manifestation of ascending infection compared to the control group. Postpartum endometritis has developed in 1 (2.8%) patient of the study group and in 5 (20.0%) cases in the control group. Offered method for preparing the patients with vaginal dysbiosis to cesarean section reduced the risk for postpartum endometritis by 6.8 times.Conclusion. Strategy of preparation for planned Caesarean section should include vaginal discharge bacteriology and treatment of severe anaerobic vaginal dysbiosis, which reduces the risk for postpartum endometritis by 6.8 times.

scholarly journals Anesthetic Effect of Compound Artevacaine Hydrochloride in Patients Undergoing Oral Implantation

2021 ◽  
Vol 5 (4) ◽  
pp. 220-224
Author(s):  
Chengxi Chi ◽  
Mengmeng Zhao ◽  
Jiajing He ◽  
Yanli Wang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Research Subjects ◽  
Implant Surgery ◽  
Anesthetic Effect ◽  
Significant Difference ◽  
Oral Implant

Objective: To investigate and analyze the anesthetic effect of compound artevacaine hydrochloride in patients undergoing oral implantation. Methods: In this study, 60 patients receiving oral implant surgery in our hospital were selected as the research subjects, and the operation time was from July 2019 to March 2021. Patients were randomly selected and divided into groups for the study. 30 patients receiving lidocaine hydrochloride anesthesia were used as the control group, and 30 patients receiving compound artevacaine hydrochloride anesthesia were used as the research group. The anesthetic effect and safety of the two groups were compared and analyzed. Results: The anesthetic effect of the study group was significantly better than that of the control group (P < 0.05). The blood pressure and heart rate in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups before anesthesia (P > 0.05). There was no significant difference in the incidence of ADR between the two groups (P > 0.05). Conclusions: For patients undergoing oral implant surgery, choosing compound artevacaine hydrochloride as anesthetic drug has obvious anesthetic effect and can stabilize patients' life indexes. The anesthetic effect is obvious, and there is no obvious adverse reaction, and the clinical value is obvious.

scholarly journals Comparative Analysis on the Curative Effect of Endoscopic Submucosal Dissection and Mucosal Resection in the Treatment of Gastric Neuroendocrine Tumor

2021 ◽  
Vol 5 (5) ◽  
Author(s):  
Nannan Zhao ◽  
Nan Li
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Neuroendocrine Tumor ◽  
Reference Group ◽  
Tumor Resection ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Resection Rate ◽  
Mucosal Resection ◽  
Submucosal Dissection

Objective: To study the therapeutic effect of endoscopic submucosal dissection and mucosal resection on gastric neuroendocrine tumor. Methods: A hundred patients with gastric neuroendocrine tumor that were treated in the Affiliated Hospital of Chifeng University from January 2016 to May 2021 were randomly selected for this research. They were divided into two groups, which were the control group (endoscopic mucosal resection) and the study group (endoscopic submucosal dissection), by the digital table method. The curative effects of the two groups were observed and compared. Results: Before operation, there were no significant differences in serum CgA, TNF-?, and IL-6 between the two groups, p > 0.05. After surgical treatment, the operation time and hospital stay of the patients in the study group were shorter than those in the control group, the amount of surgical bleeding was also less compared to the control group, and the complete tumor resection rate was higher than that in the control group (p < 0.05); the levels of IL-6 and CgA of the study group were lower than those in the control group, while the levels of TNF-? were higher than those of the control group, p < 0.05; the postoperative complication rate of the study group was lower than that of the reference group (p < 0.05). Conclusion: Endoscopic submucosal dissection is more effective for gastric neuroendocrine tumors. The resection rate of the tumor is high, and the operation risk is low.

scholarly journals The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

scholarly journals Effects of radiofrequency ablation assisted partial hepatectomy in the treatment of primary liver cancer

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Yongbo Wang
Keyword(s):  
Radiofrequency Ablation ◽  
Postoperative Complications ◽  
Liver Cancer ◽  
Partial Hepatectomy ◽  
Primary Liver Cancer ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Postoperative Length

Objective: To investigate the effects of radiofrequency ablation assisted partial hepatectomy in the treatment of primary liver cancer. Methods: A total of 60 patients with primary liver cancer treated in our hospital from March 2013 to October 2015 were selected as study subjects and were divided into the control group and the study group by the random number table method, 30 cases in each group. The control group were treated with partial hepatectomy. On the basis, the study group were treated with radiofrequency ablation. The operation associated indexes (operation time, the average wound bleeding volume, postoperative length of hospital stay), preoperative and postoperative liver function indexes [alanine aminotransferase (ALT), total bilirubin (TBIL), aspartate aminotransferase (AST)], the incidence of complications and recurrence rates in the two groups were observed. Results: The operation time and postoperative length of hospital stay of the study group were significantly shorter than those of the control group, and the average bleeding volume was significantly less than that of the control group (P < 0.05). There was no significant difference in ALT, TBiL and AST between the two groups before operation(P>0.05). After operation, ALT, TBiL and AST in the two groups were significantly lower than those before operation, and the changes in the study group were greater than those in the control group (P < 0.05). The incidence of postoperative complications and the recurrence rate in 1 year after operation were significantly  lower than those in the control group (P < 0.05). Conclusion: Radiofrequency ablation has obvious positive effect in patients with primary liver cancer undergoing partial hepatectomy. It has advantages of little bleeding, short rehabilitation time, protecting liver function, few postoperative complications and low recurrence rate.

scholarly journals Outcomes of induction in trial of labor after cesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 1076
Author(s):  
Anubha Varshney ◽  
Zehra Mohsin
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Induction Of Labor ◽  
Control Group ◽  
Study Group ◽  
Previous Cesarean Section ◽  
Trial Of Labor ◽  
Previous Cesarean

Background: The objective of this study is to evaluate the outcomes of induction of labor in women attempting trial of labor after cesarean delivery and to compare maternal and neonatal morbidity and mortality in women who were induced to those delivering spontaneously.Methods: The prospective study was carried out in the Department of Obstetrics and Gynecology in collaboration with the Neonatal Section, Department of Pediatrics at J.N. Medical College and Hospital, AMU Aligarh. The sample included 280 women with one previous cesarean section, of whom 130 women underwent induction of labor (study group) and 150 were admitted with spontaneous onset of labor. Prostaglandin gel and intracervical Foley’s were used for cervical ripening in the study group. Indication of cesarean section, mode of delivery, maternal and neonatal outcome were studied in between groups.Results: Overall rate of vaginal delivery after cesarean section was 45.3% and 56% in both study and control group respectively. The rate of cesarean section were higher in women who were induced and having unfavorable cervix. Maternal and neonatal morbidity were not significantly higher as compared in both groups, however one case of scar rupture was found in study group.Conclusions: Induction of labor in women with previous cesarean section had higher rates of cesarean section however it does not adversely affect neonatal and maternal morbidity. Overall vaginal birth is safe and effective in women with previous cesarean section by prostaglandin gel or intracervical Foley’s. Authors cautiously suggest, induction of labor should be considered in preselected patient with strict monitoring.

Reproductive anamnesis of women with postpartum purulent-septic complications

2017 ◽  
pp. 65-68
Author(s):  
V.I. Pyrohova ◽  
◽  
Y.R. Feyta ◽  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Cesarean Section ◽  
Postpartum Period ◽  
Preventive Measures ◽  
Control Group ◽  
Study Group ◽  
Negative Consequences ◽  
Septic Complications ◽  
Significant Percentage

Postpartum purulent-septic complications are considered to be one of the main causes of maternal loss, hence, this is why they continue to maintain their relevance and priority in modern obstetrics. The incidence of this disease remains high and aggravates the extension of the postpartum period in 5–26% of cases. Mostly postpartum purulent-septic complications are caused by not one, but a combination of several reasons that can act simultaneously or sequentially and are often caused by a combination of medical and social factors. These factors require the necessity of diligent analysis of the reproductive anamnesis of women who suffered from complications of septic nature during the postpartum period, in order to highlight the risk factors for these complications. The objective: to explore the possibility of formation of high-risk groups based on the analysis of reproductive anamnesis in women with postpartum purulent-septic complications as part of preventive measures. Patients and methods. According to the purpose of this research a detailed retrospective analysis was made of anamnesis histories of 89 women (study group) with postpartum septic complications, namely, 58 women with postpartum purulent-septic complications who bore through natural birth canal; 31 women with postpartum purulent-septic complications after cesarean section. The control group consisted of 40 women recently confined within uncomplicated maternal postpartum process. Results. It was investigated that in the group of women with postpartum complications prevailed women who were pregnant for the second time (especially after cesarean section).It is important to highlight the fact that significant percentage of menstrual disorders and the commencement of early sexual live of women in the study group. Analysis of an illness revealed a significant incidence of inflammatory diseases of the female reproductive organs, cervical pathology, chronic tonsillitis, chronic pyelonephritis, cystitis, anemia clinical history in the main group. Significant percentage is noticed of the women with thyroid disorders. Significantly higher frequency was noticed with regards to pregnancies that had negative consequences in anamnesis, the presence of gynecological pathology, surgery and vaginal microbiota disturbances before and during pregnancy in women with postpartum purulent-septic complications. A combination of two or more selected factors, especially in women with extragenital pathology and transferred infectious diseases in anamnesis, greatly increases the risk of septic complications in the postpartum period. Conclusions. Current analysis has provided implicit evidences to ensure that it is important to select a separate group at high risk of postpartum septic complications on the stage which precedes pregnancy for the development of an individual plan for diagnostic and preventive measures to prevent this disease. Key words: postpartum purulent-septic complications, risk factors, reproductive anamnesis.

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