The effect of placental elasticity on intraoperative bleeding in pregnant women with previous cesarean section

2020 ◽  
Vol 48 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Harun Egemen Tolunay ◽  
Hasan Eroğlu ◽  
Onur Kaya ◽  
Dilek Şahin ◽  
Aykan Yücel
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Real Time ◽  
Strain Ratio ◽  
Tissue Elasticity ◽  
Previous Cesarean Section ◽  
Third Trimester ◽  
Intraoperative Bleeding ◽  
Tissue Elastography ◽  
Previous Cesarean

AbstractBackgroundWe aimed to evaluate the efficiency of placental elasticity in predicting the amount of intraoperative bleeding via real-time tissue elastography technique.MethodsPregnant women in the third trimester of pregnancy who had planned delivery via cesarean section due to the recurrent cesareans were enrolled in the research (n = 78). Elastographic measurements of placental tissues of all cases were carried out by real-time elastographic ultrasonography. It is a tissue elastography software (Esaote MyLabSeven) that uses a 8-1-MHz multifrequency AC2541 Probe.ResultsA significant relationship was found between placental elasticity and intraoperative bleeding. There was a significant correlation between alterations in the preoperative and postoperative hemoglobin (Hb) and hematocrit (Hct) levels and placental strain ratio (SR) (P < 0.001, r: 0.831; P < 0.001, r: 0.733, respectively).ConclusionThese findings may reflect an alteration at the tissue elasticity level. We hope that the use of real-time elastographic ultrasonography technique may give an idea about the amount of bleeding during the cesarean section.

The course of pregnancy, delivery and the condition of newborn in women with uterus scar after previous cesar section

2020 ◽  
pp. 42-46
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Vaginal Delivery ◽  
Early Pregnancy ◽  
Previous Cesarean Section ◽  
Pregnancy And Childbirth ◽  
Birth Record ◽  
History Of ◽  
Previous Cesarean

The objective: Analysis of pregnancy, delivery and the condition of newborns in women with uterus scar after previous Cesarean section. Materials and methods. Observations and retrospective analysis of individual maps of pregnant women, birth record and condition of newborns in 180 women with uterus scar after previous Cesarean section from 2014-2019. Results. It was found that women in I group had no history of miscarriage, and in II group this indicator was 6.7%. We were determined that the threat of early pregnancy was observed twice often in II group as in I group. Failure uterus scar during pregnancy was diagnosing in 21.1% of women of I group against 18.9% of women of II group, as well as during childbirth in 10% of women of II group against none of women of I group. In addition, 76.7% of women of I group were born by vaginal delivery against 24.4% of women of II group. In addition, 10% of newborns in women of I group on the Apgar scale were rated 6-7 points against 65.5% in a state of varying degrees of hypoxia in women of II group. Conclusion. Pregnancy and childbirth in women with uterus scar after previous Cesarean section were accompanying by complications of fetal and neonatal disorders. More pronounced changes were observing during pregnancy, delivery and changes in the condition of newborns in women of II group against with women of I group, which can be explaining by better pre-pregnancy preparation of women of I group and better monitoring during pregnancy. Keywords: сesarean section, pre-pregnancy preparation of women, the condition of newborns.

Ultrasound diagnosis conditions of the uterus scar in pregnant and non-pregnant women

2020 ◽  
pp. 39-43
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  
Keyword(s):  
Blood Flow ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vascular Resistance ◽  
Ultrasound Examination ◽  
Ultrasound Diagnosis ◽  
Control Group ◽  
Previous Cesarean Section ◽  
Uterine Arteries ◽  
Previous Cesarean

The dynamic increase in the number of caesarean section in Ukraine and around the world remains one of the main topics of discussion, which is intensively discussing by leading scientists. The traditional assessment of the ability of the uterus scar during pregnancy, based mainly on the analysis of clinical and anamnestic data, is not high informative, and the ambiguous conclusions of the sonographic study indicate the need for further detailed study. Therefore, there is reason to believe that the development of criteria for ultrasound assessment of the condition of the uterus scar after previous cesarean section will use them to predict the possibility of spontaneous delivery in the future and remains relevant. The objective: study the features of ultrasound diagnosis of the condition of the scar on the uterus in pregnant and non-pregnant women. Materials and methods. Observations and retrospective analysis of medical records of pregnant women and birth histories in 150 women with a scar on the uterus after a previous cesarean section for the period from 2014–2019. Results. In women who became pregnant up to a year after the previous cesarean section, the most pronounced changes in blood flow were in the uterine arteries, especially during gestation 28–34 weeks. Also, in women with a failed uterus scar, changes in blood flow were most often observed in the uterine arteries at all levels and were significantly higher, compared with women with a capable uterus scar and women from the control group. In women with an insolvent uterus scar, the most pronounced changes in the indices of vascular resistance was observed in the uterine arteries, in particular the right uterine artery. Conclusion. The peculiarities of blood flow and vascular resistance in different vessels of the myometrium depending on the gestation period and the timing of pregnancy after a previous cesarean section. The obtained detailed ultrasound examination and mathematical calculation of the results of ultrasound examination of the uterus and postoperative uterus scar after previous cesarean section in non-pregnant women allowed to create a scale for assessing the condition of the uterus scar after previous cesarean section in non-pregnant women. Keywords: cesarean section, uterus scar, ultrasound, pre-pregnancy preparation of women.

scholarly journals Effect of shared decision making on mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Hadizadeh-Talasaz ◽  
Faezeh Ghoreyshi ◽  
Fatemeh Mohammadzadeh ◽  
Roghaieh Rahmani
Keyword(s):  
Decision Making ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Shared Decision Making ◽  
Mode Of Delivery ◽  
Decisional Conflict ◽  
Control Group ◽  
Shared Decision ◽  
Previous Cesarean Section ◽  
Previous Cesarean

Abstract Background The promotion of vaginal birth after cesarean section (VBAC) is the best method for the reduction of repeated cesarean sections. Nonetheless, the decisional conflict which often results from inadequate patient involvement in decision making, may lead to delayed decision making and regret about the choices that were made. The present study aimed to determine the effect of shared decision making on the mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section. Methods This randomized clinical trial was conducted on 78 pregnant women with a previous cesarean section referring to community health centers in Torbat-e Jam, Iran, in 2019. They were randomly assigned to two groups of intervention and control. During weeks 24-30 of pregnancy, the Decisional Conflict Scale (DCS) was completed by pregnant mothers. Apart from the routine care, the experimental group received a counseling session which was held based on the three-talk model of shared decision making. This session was moderated by a midwife; moreover, a complementary counseling session was administered by a gynecologist. During weeks 35–37 of pregnancy, DCS was completed, and the Decision Regret Scale (DRS) was filled out for both groups at the 8th weeks postpartum and they were asked about the mode of delivery. Data were analyzed in SPSS software (version 19) using the Mann-Whitney, Chi-squared and Fisher’s exact tests. p-value less than 0.05 was considered statistically significant. Results After the intervention, the decisional conflict score was significantly lower in the shared decision making (SDM) group, compared to that in the control group (14.90 ± 9.65 vs. 25.41 ± 13.38; P < 0.001). Moreover, in the SDM group, the rate of vaginal birth was significantly higher than that in the control group (P < 0.001). Two month after the delivery, the mean score of decision regret was lower in the SDM group, in comparison to that in the control group (15.67 ± 23.37 vs. 27. 30± 26.75; P = 0.007). Conclusions Based on the results of the study, shared counseling can be effective in the reduction of decisional conflict and regret, as well as rate enhancement of VBAC. Therefore, it can be concluded that this counseling method can be used in prenatal care to reduce the rate of repeated cesarean section. Trial registration IRCT20190506043499N1; Name of the registry: Iranian Registry of Clinical Trials; Registered 10. August 2019. URL of registry: https://en.irct.ir/trial/39538. Date of enrolment of the first participant to the trial: August 2019.

scholarly journals Induction of Labor with Vaginal Dinoprostone (PGE2) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes

2021 ◽  
Vol 10 (22) ◽  
pp. 5221
Author(s):  
Nuria López-Jiménez ◽  
Fiamma García-Sánchez ◽  
Rafael Hernández Pailos ◽  
Valentin Rodrigo-Álvaro ◽  
Ana Pascual-Pedreño ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Previous History ◽  
Population Group ◽  
Induction Of Labor ◽  
Neonatal Outcomes ◽  
Previous Cesarean Section ◽  
La Mancha ◽  
History Of ◽  
Previous Cesarean

Background: Vaginal dinoprostone (PGE2) is currently used as the prostaglandin of choice in many obstetric units. However, few studies have evaluated its safety, especially in women who previously had a cesarean section. Objective: To evaluate the efficacy and safety of PGE2 in pregnant women who are undergoing induction of labor (IOL), and who have had a previous cesarean section. Materials and Methods: A prospective observational study was conducted in La Mancha Centro Hospital in Alcázar de San Juan, Spain, from 1 February 2019 to 30 August 2020. Obstetric and neonatal outcomes, following IOL with PGE2, in 47 pregnant women who wanted a trial of labor after cesarean (TOLAC), and 377 pregnant women without a history of cesarean section, were analyzed. The outcomes were analyzed by bivariate and multivariate analyses using binary and multiple linear regression. Results: A total of 424 women were included in this study. The percentage of cesarean sections in the TOLAC group was 44.7% (21), compared with 31.6% (119) in the group without a history of cesarean section (adjusted odds ratio: 1.4; 95% CI: 0.68–2.86). In the multivariate analysis, no statistically significant differences were observed between both groups for obstetric and neonatal outcomes (p > 0.05). However, two uterine ruptures (4.3%) occurred in the group of patients with a history of cesarean section who underwent IOL with PGE2. Conclusions: The induction of labor with vaginal dinoprostone (PGE2), in patients with a previous history of cesarean section, was not associated with worse obstetric or neonatal outcomes compared with the group of patients without a history of cesarean section in our study sample. However, further research is needed regarding this IOL method, and it should be used with caution in this population group.

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