Changing trends and indications for cesarean section in the last few decades

2014 ◽  
Vol 155 (29) ◽  
pp. 1140-1146 ◽  
Author(s):  
Sándor Nagy
Keyword(s):  
Cesarean Section ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Medical Liability ◽  
Optimal Management ◽  
Vaginal Birth After Cesarean ◽  
Cesarean Deliveries ◽  
Changing Trends ◽  
Primary Cesarean Delivery ◽  
Liability Claims

Cesarean section rates are increasing worldwide, which has been paralelled by an increase in primary cesarean delivery and decrease in vaginal birth after cesarean section. Behind the different frequencies there is a number of interrelated factors including advanced maternal age, increasing incidence of obesity, assisted reproductive technologies, and maternal request for non-medical reasons. The sub-optimal management of labor and the concerns about medical liability claims and litigations increase the number of abdominal deliveries. The author reviews the changing indications for cesarean deliveries in the last few decades and summarizes the effects on the obstetrical clinical practice. Orv. Hetil., 155(29), 1140–1146.

scholarly journals Classification of cesarean section through Robson criteria: an emerging concept to audit the increasing cesarean section rate

2018 ◽  
Vol 7 (11) ◽  
pp. 4674
Author(s):  
Anita Kant ◽  
Shweta Mendiratta
Keyword(s):  
Cesarean Section ◽  
Sedentary Lifestyle ◽  
Health Concern ◽  
Vaginal Birth After Cesarean ◽  
Public Health Concern ◽  
Cesarean Deliveries ◽  
Poor Tolerance ◽  
Group 5 ◽  
The Cost

Background: There has been an increase in rate of cesarean section over last five decades. This is a matter of international public health concern as it increases the cesarean section related maternal morbidity. The aim of the present study was to audit the increasing rate of caesarean section.Methods: In the present study, all cases delivered by cesarean section during the period of six months were recorded and classified according to Robson's 10 group classification system. This was an attempt to see which clinically relevant groups contributed most to the cesarean deliveries.Results: There was a trend of increased percentage of cesarean section in group 5 and 2 respectively in present study. Increasingly sedentary lifestyle and poor tolerance to pain are adding to cesarean delivery on maternal request.Conclusions: We should judiciously make use of vaginal birth after cesarean section but not at the cost of maternal or fetal health. Standardization of indication of cesarean deliveries, regular audits and definite protocols in                                                                                                                                                                                                                                                                                                                                 hospital will aid in curbing the rate of cesarean deliveries in hospitals.

Secondary infertility associated with a uterine niche after cesarean section

2020 ◽  
Vol 19 (5) ◽  
pp. 95-101
Author(s):  
M.A. Kurtser ◽  
◽  
N.M. Egikyan ◽  
N.A. Savelyeva ◽  
M.A. Vatagina ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Key Words ◽  
Assisted Reproductive Technologies ◽  
Embryo Implantation ◽  
Reproductive Technologies ◽  
Psychological Factor ◽  
Secondary Infertility ◽  
Embryo Survival ◽  
Abdominal Delivery

The frequency of abdominal delivery remains high and does not tend to decrease. This may lead to an increase in the number of complications associated with cesarean section, such as uterine niche. Considering the fact that literature data on uterine form of secondary infertility in patients with niches is lacking, and taking into account our own experience and observations made during laparoscopic and hysteroscopic metroplasty, we believe that it is necessary to discuss hypothetical mechanisms underlying the effects of uterine niches on: (1) natural embryo implantation or during an IVF program; (2) embryo survival (embryotoxicity); (3) quality and survival of spermatozoa (spermatoxicity). It is also important to analyze the psychological factor that decreases fertility in these patients. Key words: infertility; assisted reproductive technologies; isthmocele; caesarean section; niche; fertility

Optimization approaches accouchement women with pregnancy using medical assisted reproductive technologies

2017 ◽  
pp. 123-126
Author(s):  
N.P. Goncharuk ◽  
◽  
N.R. Kovyda ◽  
Keyword(s):  
Cesarean Section ◽  
Key Words ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Etiologic Factor ◽  
Optimal Method ◽  
Birth Canal ◽  
Art Program ◽  
Natural Birth

The objective: to analyze the approaches to delivery of women with pregnancy after the application of curative programs of assisted reproductive technologies (ART). Patients and methods. In the process of the study, the approaches to the choice of the method of delivery of women after the application of ART were studied and analyzed. To achieve this goal, women were divided into two groups: the 1-st group – women after ART (2005-2009), whose delivery was performed in a conventional way, their number was 132 women; the 2-nd group – women after ART (2010-2014), whose delivery was performed according to the developed algorithm, their number was 162 women giving birth. Results. The comparative characteristics of the two groups established that the delivery of women after the use of assisted reproductive technologies (ART), which gave birth through the natural birth canal, in 70% ended with physiological labor. This trend indicates that the delivery of women after ART through the natural birth canal is one of the concepts for a significant reduction in the percentage of cesarean section (CS) in the hospital. Conclusion. To determine the optimal method of delivery in patients after ART, first of all, it is necessary to take into account the etiologic factor of infertility and the features of the course of pregnancy, and not the presence of an ART program in the history, as indications for the planned CS. Key words: auxiliary reproductive technologies, cesarean section.

scholarly journals Possibility of reducing blood loss during and after multiple birth

2016 ◽  
Vol 97 (6) ◽  
pp. 934-938
Author(s):  
N R Akhmadeev ◽  
F I Fatkullin ◽  
G R Khayrullina ◽  
N Yu Bystritskaya
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Reproductive Technologies ◽  
Active Management ◽  
Multiple Birth

Multiple pregnancy and multiple birth are pathologic obstetric situations. Recently occurrence of multiple pregnancy has increased due to increase of the age at planned pregnancy and widespread use of assisted reproductive technologies including in vitro fertilization. As a result clinicians practicing in obstetrics face more frequent multiple pregnancies, mostly twins. Risk of bleeding during multiple pregnancy, delivery and the postpartum period is estimated as high and is two times higher than in single pregnancy. The main causes of postpartum hemorrhage in multiple pregnancy are uterine hypotony or atony. Hemostatic changes occurring during pregnancy, unspecific and specific complications of multiple pregnancy are important as well. Correct management of the second period of a multiple vaginal delivery allows reducing the volume of blood loss. Method of fetal extraction in the intact amniotic sac allows reducing the influence of external factors on neonate’s head and the volume of blood loss during Cesarean section. Blood loss reducing is caused by amniotic sac compressing the vessels and therefore decreasing bleeding from the uterine incision for the time enough to extract the fetuses. Active management of the third period of vaginal delivery and afterbirth extraction with traction of umbilical cord during Cesarean section are crucial. Suggested regimens of uterotonics (oxytocin, carbetocin, misoprostol) and antifibrinolytics (tranexamic acid) reduce the risk of postpartum hemorrhage.

scholarly journals An institutional study of cesarean delivery on maternal request

2017 ◽  
Vol 6 (7) ◽  
pp. 2879
Author(s):  
A. Shanti Sri ◽  
Nazia Khanam
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Neonatal Outcome ◽  
Maternal Request ◽  
Cesarean Deliveries ◽  
Vaginal Deliveries ◽  
Painless Labor ◽  
One Year ◽  
Primary Cesarean Delivery ◽  
A Prospective Study

Background: Cesarean delivery on maternal request refers to a primary cesarean delivery performed because the mother requests this method of delivery in the absence of a standard medical/obstetrical indication for avoiding vaginal birth. The aim of the study was to find out the reasons behind, and the incidence of women preferring Cesarean section in the absence of obstetric and medical indications.Methods: This was a prospective study among women who came for delivery at Princess Esra Hospital, Deccan College of Medical Sciences, Hyderabad, over a period of one year from 1st April 2015 to 31st March 2016. All women who underwent Cesarean delivery for maternal request were included in this study.Results: The total number of deliveries during the study period of one year was 2574. There were 1346 (52.29%) vaginal deliveries and 1228 (47.7%) cesarean deliveries. Among 1228 Cesarean deliveries, 87 (7.08%) had maternal request as their indication. Majority of them were in the age group of more than 35 years. Multigravidae opted for Cesarean delivery more than primigravidae (59 multigravidae vs 28 primigravidae). Among the various reasons for women requesting delivery cesarean were tocophobia, refusal of trial of labor after Cesarean section (TOLAC), concurrent sterilization, prolonged infertility and treatment conception, afraid of neonatal outcome (previous adverse neonatal outcome) and astrological concerns.Conclusions: Many of the women opted for Cesarean delivery in our study for preventable reasons like painless labor and concurrent sterilization which would have been easily avoided by prior counseling starting from antenatal period and by providing labor analgesia. Patient education and personal involvement of the treating obstetrician in counseling the patient and emotional support during labor can reduce Cesarean delivery for maternal request.

Ways to reduce cesarean section under conditions typical urban maternity hospital

2017 ◽  
pp. 50-53
Author(s):  
N.P. Goncharuk ◽  
◽  
N.R. Kovyda ◽  
Keyword(s):  
Cesarean Section ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Maternity Hospital ◽  
High Risk Group ◽  
Positive Trend ◽  
Careful Study ◽  
Male Factor ◽  
Uncomplicated Pregnancy ◽  
History Of

The objective: Study ways to reduce the frequency of cesarean section (CS) in a typical urban maternity hospital. Patients and methods. In the course of the study, the history of the delivery of women of a typical urban maternity home was studied and analyzed, the birth of which was completed by holding a COP for the period from 2001 to 2014. Results. According to the analysis, the number of births has steadily increased every year: from 2.082 in 2001 to 4.655 in 2014. However, during a careful study of the structure of labor during the study period, a wave-like increase in the percentage of CS was noted from 17% in 2001 to 21.25% in 2008, followed by a positive trend of its decline - to 17.8% in 2014. In the conditions of the study, the structure of the most common indications from the mother and the child for conducting operations of the COP was established. The leading place among the testimony from the mother was the scar on the uterus. This indicator increased from 6.6% in 2001 to 36.3% in 2014, that is, almost 5 times. So, in modern obstetrics, it remains an important problem to find ways to reduce the number of scars on the uterus as the main indication for CS operation. Conclusion. 1. The delivery of women with a vaginal scars on the uterus is a reserve for reducing the percentage of Caesarean section (CS), reducing blood loss, more physiological delivery, rapid post-natal adaptation of newborns, and restoring the woman in labor after the delivery. 2. Women with a pathological preliminar period constitute a high-risk group for the development of abnormalities of labor. Therefore, there is a need to create and implement algorithms for managing women with a pathological preliminar period. 3. In the presence of polyhydramnios or lack of water it is necessary to carry out careful monitoring of women in labor, to react promptly and immediately to changes in the nature of labor. 4. To reduce the number of abnormalities of labor, it is necessary to develop new criteria for the selection of candidates for rhodostimulation and the introduction of integrated approaches to assessing the «maturity» of the cervix. 5. The reserve for reducing the frequency of CS after ART is, of course, a group of patients whose cause of infertility is the male factor and the somatic anamnesis is not burdened and pregnancy is characterized by a favorable course, as well as patients younger than 30 with tubal peritoneal infertility in the history of Uncomplicated pregnancy. Key words: c-section, scar on the uterus, abnormal labor, assisted reproductive technologies.

Re-imagining Reproduction: Unsettling Metaphors in the History of Imperial Science and Commercial Surrogacy in India

Somatechnics ◽  
2015 ◽  
Vol 5 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Kalindi Vora
Keyword(s):  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
The Body ◽  
Body Parts ◽  
Colonial History ◽  
Women's Bodies ◽  
Commercial Surrogacy ◽  
Art Practices ◽  
History Of ◽  
Travel Industry

This paper provides an analysis of how cultural notions of the body and kinship conveyed through Western medical technologies and practices in Assisted Reproductive Technologies (ART) bring together India's colonial history and its economic development through outsourcing, globalisation and instrumentalised notions of the reproductive body in transnational commercial surrogacy. Essential to this industry is the concept of the disembodied uterus that has arisen in scientific and medical practice, which allows for the logic of the ‘gestational carrier’ as a functional role in ART practices, and therefore in transnational medical fertility travel to India. Highlighting the instrumentalisation of the uterus as an alienable component of a body and subject – and therefore of women's bodies in surrogacy – helps elucidate some of the material and political stakes that accompany the growth of the fertility travel industry in India, where histories of privilege and difference converge. I conclude that the metaphors we use to structure our understanding of bodies and body parts impact how we imagine appropriate roles for people and their bodies in ways that are still deeply entangled with imperial histories of science, and these histories shape the contemporary disparities found in access to medical and legal protections among participants in transnational surrogacy arrangements.

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