The efficacy of onion extract in the management of subsequent abdominal hypertrophic scar formation

2020 ◽  
Vol 29 (10) ◽  
pp. 612-616
Author(s):  
Emre Sinan Güngör ◽  
Duygu Güzel ◽  
Ali Galip Zebitay ◽  
Gülşah İlhan ◽  
Fatma Ferda Verit
Keyword(s):  
Caesarean Section ◽  
Allium Cepa ◽  
Hypertrophic Scar ◽  
Caesarean Delivery ◽  
Control Group ◽  
Surgical Removal ◽  
Study Group ◽  
Caesarean Scar ◽  
Prophylactic Use ◽  
Elective Caesarean Delivery

Objective: Development of postoperative scars is often a problem. This study aimed to evaluate the efficacy of gel containing Allium cepa extract, allantoin and heparin (Contractubex, Merz Pharmaceuticals GmbH, Frankfurt, Germany) in reducing scarring after a caesarean section by comparing it with a control group, and also intra-individually, using the Vancouver Scar Scale (VSS). Method: A total of 120 patients who underwent a second elective caesarean delivery and who presented with hypertrophic scar development after their first caesarean section were included in the study. A scar revision was performed for all patients during the second caesarean operation. Patients in the study group (n=60) were advised to apply the topical scar gel postoperatively for a period of 6 months. The control group (n=60) received no treatment. Results: Significant reductions were observed in the vascularity, pigmentation and height subgroups of the VSS for those in the group who continued the treatment to 24 weeks. An intra-individual analysis showed that the gel effectively reduced scarring after the second caesarean section. Conclusion: The prophylactic use of the gel to reduce scar development offers better results for vascularity, pigmentation and height subscales of the VSS after surgical removal of the primary caesarean scar during the second caesarean section. The results were better both intra-individually, and also in comparison with the control group and support the use of a gel containing Allium cepa extract, allantoin and heparin to reduce scarring after a caesarean section.

scholarly journals Comparative study to assess the outcome of omitting bladder flap formation from caesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 882
Author(s):  
Pratiksha Gupta ◽  
Suman Kumari
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Caesarean Delivery ◽  
Operating Time ◽  
Randomised Control Trial ◽  
Control Group ◽  
Study Group ◽  
Care Hospital ◽  
Total Operating Time ◽  
Formation Step

Background: The aim of this study is to evaluate the effects of omitting the step of bladder flap formation at lower-segment caesarean delivery.Methods: It is a RCT (randomised control trial), non-blinded study conducted in a tertiary care hospital. A total of 104 women who underwent caesarean delivery (elective or emergency) were prospectively randomized to one of the two groups. In the study group (n= 54), caesarean was performed without formation of a bladder flap. In the control group (n=50), caesarean was performed with the formation of a bladder flap before the uterine incision.Results: There were differences of median skin incision to delivery interval (5 versus 6.5 minutes, P <0.0001), median total operating time (35 versus 44.5 minutes, P 0.0002), and median blood loss (haemoglobin 0.5 versus 1g/dl, P 0.0001) in favor of the study group. Postoperative incidence of urinary tract infection was reduced in the study group (1% versus 9%, P <0.0006) and bowel function returned early in the study group (day 2 versus 3, P<0.0001).  Bladder flap formation step was successfully omitted in (11/18, 61.11%) of previous CS (caesarean section) patients in the study group and (7/12, 58.33%) in control group illustrating that unless required, BF (bladder flap) formation step can even be omitted in previous CS patients.Conclusions: Omission of the bladder flap provides short term advantages such as reduction of total operating time, incision-delivery interval, and reduced blood loss and that this technique can even be applied in previous caesarean section patients.

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.

scholarly journals Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars

2021 ◽  
Vol 18 (16) ◽  
pp. 8249
Author(s):  
Grzegorz Trybek ◽  
Justyna Rydlińska ◽  
Magda Aniko-Włodarczyk ◽  
Aleksandra Jaroń
Keyword(s):  
Treatment Process ◽  
Infectious Complications ◽  
Control Group ◽  
Surgical Removal ◽  
Study Group ◽  
Impacted Tooth ◽  
Platelet Rich Fibrin ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

scholarly journals Study of the efficacy of tranexamic acid in reducing blood loss after child birth

2021 ◽  
Vol 10 (5) ◽  
pp. 1863
Author(s):  
Nagajyothi Gunturu ◽  
D. Shivani ◽  
P. Sravanthi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Third Stage

Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section. 

scholarly journals Efficacy of Tranexamic Acid in Reducing Blood Loss during and After Caesarean Section: A Case control Study

2020 ◽  
Vol 18 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
Dipendra Khadka
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Apgar Score ◽  
Postpartum Haemorrhage ◽  
Group Versus ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section

Introduction: The incidence of caesarean section is increasing day by day. One of the most common complications is primary or secondary postpartum haemorrhage. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in varieties of surgery. Aims: To study the efficacy of tranexamic acid in reducing blood loss during and after the lower segment caesarean section. Methods: Arandomized, case controlled, prospective study was conducted on 100 women undergoing lower segment caesarean section carried out in the Department of Obstetrics and Gynaecology, Nepalgunj Medical College, Kohalpur from Sept 2019 to Feb 2020.Fifty of them were given tranexamic acid immediately before lower segment caesarean section and were compared with 50 others to whom tranexamic acid was not given. Blood loss was collected and measured during two different time interval. The first period was considered from placental delivery to end of lower segment caesarean section and second from the end of lower segment caesarean section to 2 hours postpartum period. Vital signs at time of delivery, at 1 hour and 2 hour postpartum and APGAR score at 1 min and 5 min were studied in both the groups. Results: Tranexamic acid significantly reduced the quantity of blood loss from the placental delivery to 2 hours post-partum: 360.9 ml in the study group, versus 443 ml in the control group (p=0.0008).It also significantly reduced the quantity of blood loss from the end of  lower segment caesarean section to 2 hours postpartum:71.5 ml in the study group versus 112.6 ml in the control group (p=0.0002).There was 18% less incidence of postpartum haemorrhage , who received tranexamic acid(p=0.02).There were no significant adverse drug reaction and difference in APGAR score in both the groups. No complications or side effects were reported in either group. Conclusion: Tranexamic acid is safe and effective in reducing blood loss among women undergoing lower segment caesarean section.

STUDY ON THE EFFECT OF ADVANCED MATERNAL AGE AT OBSTETRIC AND PERINATAL LEVEL

2021 ◽  
pp. 60-62
Author(s):  
Juliya John ◽  
Aswath Kumar ◽  
Saley Daniel
Keyword(s):  
Caesarean Section ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Gestational Hypertension ◽  
Preterm Labour ◽  
Perinatal Outcomes ◽  
Advanced Maternal Age ◽  
Control Group ◽  
Study Group ◽  
Adverse Perinatal Outcomes

INTRODUCTION: Advanced maternal age is commonly considered to be 35 years or older. The association between adverse perinatal outcomes and advanced maternal age has been a matter of controversy in several studies. While some researchers have noted an increased rate of adverse pregnancy outcomes in women older than 35 years, others have failed to nd any association between advanced maternal age and adverse perinatal outcomes. This discordance in conclusions could be attributed to the heterogeneity of study populations, differences in the denition of pregnancy outcomes, and failure to adjust for potential confounders. Therefore, we aimed to investigate the impact of advanced maternal age on obstetric and perinatal outcomes in this study. MATERIALS AND METHODS: The study was carried out among the patients who presented to the labour ward. This is a prospective observational study. The demographic data of these women, gestational age at time of delivery and complication during pregnancy are noted. They will be followed up till discharge and mode of delivery, perinatal outcome and any intrapartum and postpartum complications will be recorded in the research proforma. Sample Size: 252. RESULTS: Though there were higher incidence of Gestational hypertension, PROM, Preterm labour, placenta previa, Malpresentation, Multiple Pregnancy, FGR and treatment taken for infertility among the study group when compared to control group, their statistical signicance could not be established. There was also higher incidence of caesarean section (50.8%) and Operative vaginal delivery (2.6%) in the study group. There was no statistically signicant weight difference among the babies born to mothers in case and control group. CONCLUSION: Pregnant women of Advanced Maternal Age is thought about with great concern among the doctors as well as patients. In this study, there is an increased incidence of antenatal complications like Gestational Diabetes Mellitus, Gestational Hypertension, Caesarean Section and Preterm labour in women aged more than 35 years compared to the women of age 20 to 35 years.

Anaesthesia for Caesarean section: Basic principles

2020 ◽  
pp. 273-296
Author(s):  
Rachel Collis
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Enhanced Recovery ◽  
Current Evidence ◽  
Basic Principles ◽  
Cardio Vascular ◽  
Available Information ◽  
Vasopressor Use ◽  
Obstetric Surgery ◽  
Elective Caesarean Delivery

Management of the woman for caesarean delivery requires meticulous planning and skill from the anaesthetist. The time available to plan and communicate with the woman will depend on the degree of urgency to deliver the baby. However, this chapter sets out the important basic principles which need to be adhered to, regardless of the time available. Information and consent for the planned technique is discussed, with a review of antacid prophylaxis and monitoring requirements for the woman and fetus prior to delivery. Enhanced recovery in obstetric surgery is considered the gold standard for elective caesarean delivery, with attention to the details of each aspect described. Caesarean section confers considerable cardio-vascular instability, therefore attention to maternal positioning to minimize aorto-caval compression, intravenous pre-loading, and current evidence to support the practice of differing vasopressor use is highlighted.

scholarly journals Study of effects of oligohydramnios on perinatal outcome

2020 ◽  
Vol 9 (6) ◽  
pp. 2525
Author(s):  
Aashka M. Mashkaria ◽  
Babulal S. Patel ◽  
Akshay C. Shah ◽  
Shashwat K. Jani ◽  
Vismay B. Patel ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Stress Test ◽  
Fetal Distress ◽  
Control Group ◽  
Study Group ◽  
Amniotic Fluid Index ◽  
Lower Segment Caesarean Section ◽  
And Control

Background: Oligohydramnios has got a noteworthy influence on perinatal outcome. Hence, early detection and its timely management will aid in curtailing of perinatal morbidity and mortality and leading to decreased operative interventions. Therefore, the present study is conducted to look for the effects of oligohydramnios.Methods: This comparative study was a prospective observational study conducted at study institution. The women were divided into study and control groups based on AFI (amniotic fluid index), 100 cases were selected in each group.Results: Out of the 200 women, included in the present study, 35% of the patients in the study group had non-reactive non-stress test (NST) while in the control group 7% had it. Caesarean section was performed in 58% of cases in the study group as compared to 30% in the control group. Amongst these, Fetal distress was the most common indication for LSCS (lower segment caesarean section). There were no perinatal deaths in this study.Conclusions: Based on this study it has been observed that, amniotic fluid index of ≤5 cm was commonly associated with increased LSCS rates, intrauterine growth restriction, non-reactive NST, and abnormal Doppler velocimetry studies. Therefore, every case of oligohydramnios requires to be assessed meticulously. Prompt detection; timely management and treating the underlying condition improve outcome.

scholarly journals Analgesic Efficacy of Pfannenstiel Incision Infiltration with Ropivacaine 7.5 mg/mL for Caesarean Section

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
N. K. Nguyen ◽  
A. Landais ◽  
A. Barbaryan ◽  
M. A. M'Barek ◽  
Y. Benbaghdad ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
Analgesic Efficacy ◽  
Control Group ◽  
Time Interval ◽  
Double Blind ◽  
Pfannenstiel Incision ◽  
Significant Difference ◽  
H 26 ◽  
Labour Suite

Background. Pain after Caesarean delivery is partly related to Pfannenstiel incision, which can be infiltrated with local anaesthetic solutions.Methods. A double- blind randomized control trial was designed to assess the analgesic efficacy of 7.5 mg/mL ropivacaine solution compared to control group, in two groups of one hundred and forty four parturients for each group, who underwent Caesarean section under spinal anaesthesia: group R (ropivacaine group) and group C (control group). All parturients also received spinal sufentanil (2.5 g).Results. Ropivacaine infiltration in the Pfannenstiel incision for Caesarean delivery before wound closure leads to a reduction of 30% in the overall consumption of analgesics (348 550 mg for group R versus 504 426 mg for group C with ), especially opioids in the first 24 hours, but also significantly increases the time interval until the first request for an analgesic (4 h 20 min 2 h 26 for group R versus 2 h 42 1 h 30 for group C). ThePvalues for the two groups were: for paracetamol, for ketoprofen andPfor nalbuphine which was the most significant. There is no significant difference in the threshold of VAS in the two series.Conclusion. This technique can contribute towards a programme of early rehabilitation in sectioned mothers, with earlier discharge from the post-labour suite.

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