Pre-pregnancy obesity compromises obstetric and neonatal outcomes

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Katharina Hancke ◽  
Theresa Gundelach ◽  
Birgit Hay ◽  
Sylvia Sander ◽  
Frank Reister ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Neonatal Outcomes ◽  
Elective Cesarean Section ◽  
Obese Women ◽  
Elective Cesarean ◽  
Group A ◽  
Grade Ii ◽  
Group B

AbstractObesity is an important issue among fertile women as it may affect obstetric and neonatal outcomes.Obstetric and neonatal outcomes of primiparous women were retrospectively analyzed in non-obese (n=11387) and obese (n=943) women. A subgroup analysis was performed in obese women divided into three groups: Grade I obesity (Group A, n=654), Grade II obesity (Group B, n=192), and Grade III obesity (Group C, n=97). Odds ratios (OR) were expressed with the corresponding 95% confidence intervals (CI).The incidence of gestational diabetes (non-obese, 1.9%; obese, 7.6%; Group C, 19.6%) and preeclampsia (non-obese, 3.3%; obese, 13.5%; Group C, 17.5%) increased with rising weight. The risk of non-elective cesarean section was significantly higher in obese women than in non-obese women (21.7% vs. 13.2%). The risk of extreme preterm birth (before 28 weeks of gestation) doubled in the Grade I obesity group (OR, 2.1; 95% CI, 1.4–3.2) and nearly tripled in women with body mass index ≥35 kg/mPre-pregnancy obesity is associated with higher incidences of gestational diabetes and preeclampsia. Our study shows that obese women have a higher risk of non-elective cesarean section and preterm birth.

Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial

2018 ◽  
Vol 46 (7) ◽  
pp. 786-790 ◽  
Author(s):  
Magdy Refaat Ahmed ◽  
Waleed Ali Sayed Ahmed ◽  
Rasha Elsayed Khamess ◽  
Manar S. Youwakim ◽  
Khaled Mohamed EL-Nahas
Keyword(s):  
Cesarean Section ◽  
Randomized Trial ◽  
Bowel Movement ◽  
Oral Intake ◽  
Bowel Function ◽  
Elective Cesarean Section ◽  
Regular Diet ◽  
Elective Cesarean ◽  
Group A ◽  
Group B

Abstract Aim: To compare the efficacy of three postoperative feeding regimens on bowel function recovery after term elective cesarean section (CS). Methods: Women recruited for this randomized trial were allocated into three groups. Women in group (A) were instructed to chew sugarless gum for 10 min every 2 h after surgery. Group (B) mothers received IV fluids for 6 h followed by sipping fruit juices sweetened with honey. Group (C) had oral intake of clear fluids after passage of flatus and regular diet with the passage of bowel movement. The main outcome measures were the timing of first return to bowel movement and initiation of regular diet. Results: The mean times to first hearing of bowel sounds, to first flatus passage and to first defecation were significantly lower in group A (10, 17.5 and 28.1 h, respectively) compared to groups B and C [15.1, 24.9 and 36 h (B) and 21.6, 38.8 and 49.4 h (C)]. Initiation of regular diet was significantly earlier in group A compared to groups B and C (21 vs. 27.5 and 40.3 h, respectively). Conclusion: Chewing gum appears to be more advantageous than early or traditional feeding regimens after term elective CS resulting in rapid recovery of bowel function.

scholarly journals Comparison of Tramadol Versus Tramadol and Paracetamol in Postop Pain Management after C-Section

2021 ◽  
Vol 15 (5) ◽  
pp. 1035-1037
Author(s):  
Usman Salamat ◽  
M.Baqir Ali Khan ◽  
Liaqat Ali ◽  
Tahir Nazeer ◽  
Amna Tahir ◽  
...  
Keyword(s):  
Body Weight ◽  
Pain Management ◽  
Cesarean Section ◽  
Pain Control ◽  
Elective Cesarean Section ◽  
Post Surgery ◽  
Postop Pain ◽  
Elective Cesarean ◽  
Group A ◽  
Group B

Background: Multimodal technique of pain control is better than unimodal technique in perioperative time. Both tramadol and paracetamol are commonly used for pain control. Aim: To compare the tramadol alone versus tramadol with paracetamol in pain management after C- section. Method: 150 patients with ASA class P1&P2 undergoing elective cesarean section under general anesthesia were included in this study and were divided into group A & B by random number table. In both group tramadol 1mg/kg body weight intravenous was given after delivery of baby and in group B intravenous paracetamol 15 mg/kg body weight was given additionally and same doses were given in postop after 8 hours for 24 hs of post-surgery. Result: Mean age in group A was 31.04±5.35 years and in group B it was 29.64±5.92. Mean pain score in group A was 1.19±0.81 and in group B it was 0.60±0.75. The degree of pain was low in group B and patients were more comfortable as compared to group A patients. Conclusion: Tramadol plus paracetamol has better pain control as compared to tramadol alone. Keywords: Tramadol, Paracetamol, Cesarean Section, VAS.

scholarly journals Uterine Atony: An Innovative Dutta's Scoring System for Elective Cesarean Section

2015 ◽  
Vol 7 (3) ◽  
pp. 113-117
Author(s):  
Indranil Dutta ◽  
Indranil Dutta
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Uterine Wall ◽  
Uterine Atony ◽  
Elective Cesarean Section ◽  
Postoperative Blood Loss ◽  
Ringer’S Lactate ◽  
Elective Cesarean ◽  
Group A ◽  
Group B

ABSTRACT Uterine atony appears suddenly and is mostly unpredictable and accounts for 80% of causes of postpartum hemorrhage (PPH), it is also one of the important causes of maternal death. Objective To analyze the efficacy of Dutta's score for early diagnosis and management of uterine atony during elective lower segment cesarean section (LSCS) to prevent PPH. Study methods: This study was undertaken at JNM, NSGH, CN at Kalyani, Nadia, West Bengal, India, from 1st June 2008 to 31st Dec 2012. Six hundred cases undergoing elective LSCS were selected for randomized trial. Clinical observations were made after placental expulsion for scoring which includes shape and size of uterus, rugosity, tone, placental localization and time of placental expulsion. Scores of 0, 1, 2 were given on each observation. Three groups are created depending on scoring: group A (n = 300)—8 to 10, group B (n = 220)—5 to 7 and group C (n = 80)—<5 for better management. Management protocols were formulated in the three groups for prevention of PPH: group A—oxytocin 10 U (5U IM + 5U IV 30 drops/min in Ringer's lactate 500 ml), group B—oxytocin 15U (5U IM + 10U IV 30 drops/min in Ringer's-lactate 500 ml) + methylergometrine (0.25 mg IM) + anterior posterior uterine wall compression, group C—oxytocin 20 U (5U IM plus 15 U IV 30 drops in ringer lactate 500 ml) + methylergometrine (0.5 mg IM) + carboprost (250 mcg IM) + lateral followed by anterior posterior uterine wall compression + isthmus compression of uterus + misoprostol 800 mg per rectal during postoperative period. Results After adopting Dutta's score and management protocols, it was interesting to observe that intra and postoperative, blood loss (within 2 hours) were found to be significantly reduced in group A—73.3% (<300 cc), 88% (<200 cc) and group B—63.6% (<300 cc), 81.8% (<200 cc). Intraoperative blood loss >500 cc were also found to be reduce in group A—14.7%, group B—16.3%. In group C, intraoperative blood loss >500 cc were seen in 41.25% and postoperative —37.5% respectively. Hemoglobin level below 11 gm% were found to be not reduced in group A (1.4%), group B (2.6%) and group C (8.7%) after 24 hours of delivery hemodynamic status in all groups were found to be uneventful. Maternal mortality was found to be nil. Conclusion Early diagnosis and management of uterine atony during elective LSCS after adopting Dutta's score were found to be not only reduce intra- and postoperative blood loss but also was found to maintain a satisfactory hemoglobin level and hemodynamic status. Maternal mortality was found to be nil. This randomized trial highlighted the importance of prompt treatment in group C to reduce intra- and postoperative blood loss and maternal mobidity and mortality. How to cite this article Dutta DK, Dutta I. Uterine Atony: An Innovative Dutta's Scoring System for Elective Cesarean Section. J South Asian Feder Obst Gynae 2015;7(3):113-117.

scholarly journals The effect of clonidine with bupivacaine on perioperative hemodynamics and post-operative analgesia in cesarean section cases

2021 ◽  
Vol 10 (8) ◽  
pp. 3049
Author(s):  
Priti Kumar ◽  
Sangeeta Arya ◽  
Sushil Kr. Singh ◽  
Sunil Kumar
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Intraoperative Hypotension ◽  
Elective Cesarean ◽  
Group A ◽  
Group B

Background: Cesarean section is the commonest procedure in Obstetric practice and postoperative pain can be a major factor for wound healing as well as mother and baby bonding. Spinal anesthesia is considered to be safest and easiest modality for cesarean section cases. Bupivacaine is the commonest drug given in spinal anesthesia, but many additive drugs have been introduced to cover post-operative analgesia. Clonidine is an alpha 2 agonist which can be used as an adjunct to heavy bupivacaine to extend analgesic effects.Methods: A randomized double-blind study was performed in 100 women undergoing elective cesarean section under spinal anaesthesia. After proper informed written consent patient undergoing cesarean section were divided by computerized method into group A (Given 10.0 mg 0.5% hyperbaric Bupivacaine) and Group B (Given 9.0 mg 0.5% hyperbaric bupivacaine and 30 μg clonidine).Results: Intraoperative hypotension is the most worrisome factor but it is transient and can be managed by ephedrine effectively. Intraoperative nausea and vomiting are slightly higher with clonidine as occurrence of hypotension is more. VAS scoring in post-operative period was better and need of first analgesic dose was much delayed in women been given clonidine with bupivacaine.Conclusions: Clonidine can be considered as adjunct in spinal anesthesia to extend post-op analgesic cover. 

Comparison of the effects of Dexamethasone and Ondansetron on the Reduction of Postoperative Nausea and Vomiting following Cesarean Section under Spinal Anesthesia

2020 ◽  
Vol 15 ◽  
Author(s):  
Arash karimi ◽  
Jahanbakhsh Nejadi ◽  
Mahnaz Shamseh ◽  
Nooshin Ronasi ◽  
Mehdi Birjandi
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Postoperative Nausea ◽  
Demographic Data ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Group A ◽  
Group B

Background: Postoperative nausea and vomiting (PONV) is a common complication associated with the use of anesthesia. Several antiemetics are used to reduce the incidence and severity of PONV. The aim of this study is to investigate the role of dexamethasone and ondansetron to treat PONV in patients undergoing cesarean section (c-section) under spinal anesthesia. Methods: This double-blind clinical trial study was performed on patients who were referred to the operating room of Haji Karim Asali Hospital of Khorramabad for elective cesarean section in 2016-17. Upon meeting the inclusion criteria, patients were allotted into two groups (n=60). Group A received 8mg of dexamethasone and group B received 4mg of ondansetron after spinal anesthesia. The Visual Analog Scale (VAS) questionnaire and Depression-Anxiety-Stress Scale (DASS) questionnaire was used for the analysis. Patients with mild to moderate stress, anxiety, and depression were included in the study. Data were analyzed using SPSS 16 software. Results: There was no difference in the demographic data of the two groups. The mean severity of nausea in group A was significantly higher than in group B. The frequency of vomiting in group A was 20 times higher than group B, which was found to be statistically significant, p = 0.018. Concerning the type of delivery with the frequency of nausea, the results showed that the frequency of nausea in group A was 3.24 times higher than group B, however, this difference was not statistically significant, p = 0.106. Conclusion: Based on the results of this study, ondansetron had a significant effect on the alleviation of postoperative nausea and vomiting, as compared to dexamethasone in c-section surgical candidates.

scholarly journals Comparison of effects of Bupivacaine and Ropivacaine in patients undergoing elective Caesarean section

2020 ◽  
Vol 4 (3) ◽  
pp. 859-863
Author(s):  
Sangeeta Subba ◽  
Arjun Arjun Chhetri ◽  
Rupak Bhattarai
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Safe Alternative ◽  
Elective Cesarean ◽  
Group B

Introduction: Spinal anesthesia is considered a reasonable choice for cesarean section. Bupivacaine and ropivacaine have been used as intrathecal drugs alone or in combination with various opioids. Ropivacaine is considered a valid and safe alternative to bupivacaine for spinal anesthesia. Objectives: To compare the efficacy and safety of hyperbaric ropivacaine with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Methodology: Sixty pregnant women undergoing elective cesarean section were allocated into two groups. Group R received 3 ml of 0.5% hyperbaric ropivacaine (2 ml 0.75% plain ropivacaine mixed with 1 ml of 25 %dextrose) and Group B received 2.5 ml of 0.5% hyperbaric bupivacaine. Both the groups were compared in terms of onset of sensory and motor block, regression of sensory and motor block, duration of analgesia and side effects. Results: The onset of sensory block was comparable in both groups but was statistically insignificant. The onset of motor block in Bupivacaine(7.53 ± 1.72) min was faster when compared to Ropivacaine group(14.33 ± 6.19) min. Regression of sensory and motor block both were faster in Ropivacaine group. Duration of analgesia was longer in Bupivacaine group(131.17 ± 32.95)min than Ropivacaine group(125.33 ± 30.54)min. Conclusion: Ropivacaine can be used as an alternative to Bupivacaine for spinal anesthesia in cesarean section but has a shorter duration of sensory and motor block.

scholarly journals BREECH PRESENTATION AT TERM;

2013 ◽  
Vol 20 (04) ◽  
pp. 526-529
Author(s):  
BUSHRA MUKHTAR, ◽  
BUSHRA KHAN ◽  
NUZHAT RASHEED
Keyword(s):  
Cesarean Section ◽  
Neonatal Mortality ◽  
Apgar Score ◽  
Breech Presentation ◽  
Fetal Outcome ◽  
Vaginal Birth ◽  
Elective Cesarean Section ◽  
Mortality And Morbidity ◽  
Elective Cesarean ◽  
Group B

Objective: To compare the fetal outcome of elective cesarean section with elective vaginal birth for Term Breechpresentation in terms of APGAR Score, Respiratory Distress Syndrome, Admission in Neonatology Unit and Neonatal mortality. Design:Quasi experimental study. Setting: Department of Obstetrics & Gynaecololgy Bahawal Victoria Hospital, Bahawalpur. Methods: Total 120cases were included in the study divided into two groups, each having 60 fulfilling the inclusion criteria. Group 'A' had those who deliveredby planned cesarean and Group 'B' comprised those having planned vaginal delivery. Results: It was found that neonatal mortality was3.33 in vaginal and 0 in cesarean group. Mean APGAR Score at 1 and 5 minute was 8.47 and 9.53 in vaginal and 8.58 and 9.62 incesarean group. RDS was more in cesarean (5) than vaginal group (1.6). Admission in Neonatalogy Unit was more in vaginally deliveredgroup (8.33) as compared to the cesarean section group (5). Conclusion: Planned cesarean delivery in breech presentation at term isassociated with a reduction in neonatal mortality and morbidity as compared to the planned vaginal birth.

scholarly journals Assessment of compliance with a color coded protocol for non-elective cesarean section in a maternity ward in France.

2021 ◽  
Author(s):  
Oriane Vetier ◽  
Marie-Alice Yanni ◽  
Linda Lassel ◽  
Helene Isly ◽  
Alain Beuchée ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Statistical Tests ◽  
Neonatal Outcomes ◽  
University Hospital ◽  
Elective Cesarean Section ◽  
Maternity Ward ◽  
Color Code ◽  
Significant Difference ◽  
Elective Cesarean ◽  
Maternal And Neonatal Outcomes

Purpose: The aim of a color coded protocol for non-elective cesarean-sections is to improve decision-delivery interval by better organization of care in a maternity unit. We set out to assess compliance of a color coded protocol and its impact on maternal and neonatal outcomes since its implementation in our maternity ward. Materials and methods: This was a retrospective study including a sample of 200 patients per year who underwent an non-elective cesarean section delivery in Rennes University Hospital from January 1, 2015 to December 31, 2018. Patients were grouped by year and by color code (red, orange or green). The main outcome was compliance with the protocol (color code in accordance with indication for cesarean section) and compliance with the corresponding decision-delivery interval. Secondary outcomes were maternal and neonatal outcomes. The statistical tests performed were Fisher’s test for qualitative parameters and Kruskal-Wallis test for quantitative parameters. Results: Eight hundred patients were included during the study period. There was no significant difference in patient characteristics over the years. There was a significant improvement in protocol compliance: full compliance increased from 22.4% in 2015 to 76.5% in 2018 (p<0.0001). No difference was observed in the decision-delivery interval overall but compliance with the 15-minute decision-delivery interval imposed by a red coded protocol increased between 2015 and 2018 (p=0.0020). Conclusion: We observed a significant improvement in compliance with the color coded protocol between 2015 and 2018 and in the 15-minute decision-delivery deadline for the red code.

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