Urological complications in obstetrics

2021 ◽  
Vol 70 (5) ◽  
pp. 147-155
Author(s):  
Ilnur I. Musin ◽  
Edvard A. Berg ◽  
Ruslan I. Safiullin ◽  
Marat F. Urmantsev ◽  
Dina F. Absalyamova ◽  
...  
Keyword(s):  
Urinary Tract ◽  
High Risk ◽  
Cesarean Section ◽  
Perinatal Complications ◽  
Second Stage Of Labor ◽  
Urinary Tract Injury ◽  
High Risk Factors ◽  
Emergency Cesarean ◽  
Urological Complications ◽  
Abdominal Delivery

Urinary tract injury is a rare but severe complication during abdominal delivery. Over the past quarter of the last century, the frequency of abdominal delivery in Russia has more than tripled due to the increase in the number of pregnant women at high risk for the development of maternal and perinatal complications. Intraoperative diagnosis of urinary tract injuries allows timely treatment with better postoperative outcomes. Given the high percentage of caesarean sections in many countries, the risk of the above complications remains high. Risk factors for urinary tract injury during cesarean section are an increase in womens average age and body mass index, high parity, the presence of adhesions, prior cesarean section, emergency cesarean section, and cesarean section in the second stage of labor. This article discusses several clinical cases on the development of urological complications in obstetrics and gynecology. Due to modern progress in the field of operative obstetrics, vesicouterine fistulas caused by obstetric causes may not occur as often as in the last century. Nevertheless, even despite this, one should not forget about elementary preventive measures in operative delivery, especially in such obstetric situations as placental ingrowth, bleeding, hematoma, and parametria.

scholarly journals Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Business Communication ◽  
Communication Tools ◽  
Case Presentation ◽  
Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

scholarly journals Decision-to-Delivery Time and Perinatal Complications in Emergency Cesarean Section

2017 ◽  
Author(s):  
Günther Heller ◽  
Erik Bauer ◽  
Stefanie Schill ◽  
Teresa Thomas ◽  
Frank Louwen ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Delivery Time ◽  
Perinatal Complications ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

scholarly journals Effect of obesity on the outcome of pregnancy in primigravida patients: an Iraqi experience

2019 ◽  
Vol 8 (3) ◽  
pp. 815
Author(s):  
Ban Dawood Mahmood
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Mode Of Delivery ◽  
Reproductive Age ◽  
Controlled Study ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Emergency Cesarean ◽  
The Impact ◽  
First Time

Background: A parallel rise in the rate of obesity in women in reproductive age; and cesarean section as outcome of pregnancy is noticed in the last years in our society. It is unknown whether this dual rise is related or not. The impact is more evident on primigravida patients, so authors perform this study to assess the impact of obesity on the outcome of pregnancy in primigravida patients in a major obstetrics hospital.Methods: A prospective controlled study was conducted in Ibn Al-Balady obstetrics hospital. It included 121 primigravida patients who were divided into 3 groups according to WHO BMI categories: normal, overweight, and obese. The mode of delivery of these patients is recorded and was assessed in relation to BMI.Results: About 17% of the patients were obese and they needed more emergency CS as a mode of delivery than normal BMI patients (p<0.01). They also had longer second stage of labor (p<0.01) and delivered babies with higher birth weight that the normal group (p<0.05).Conclusions: Obesity constitutes a growing challenge on the outcome of pregnancy, duration of second stage of labor and baby birth weight in primigravida patients. Women who are getting pregnant for the first time should be advised to lower their BMI as a safety measure to avoid emergency cesarean section.

scholarly journals Outcome of pregnancy in women with previous one cesarean section

2018 ◽  
Vol 7 (8) ◽  
pp. 3257
Author(s):  
Manish Mittal ◽  
Meenakshi Kandoria ◽  
Rajeev Sood ◽  
Monica Chauhan ◽  
Rohini Rao ◽  
...  
Keyword(s):  
Cesarean Section ◽  
P Value ◽  
Perinatal Complications ◽  
Chi Square ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Vaginal Deliveries ◽  
Mother And Child ◽  
Chi Square Test ◽  
Gandhi Medical College

Background: Worldwide rise in cesarean section (CS) rate during the last three decades has been the cause of alarm and needs an in-depth study. The purpose of this study was to determine the outcome of pregnancy in women with previous one cesarean section and maternal and perinatal complications. It also aimed at identifying the factors, which can influence the outcome of trial of labour (TOL).Methods: The prospective study was conducted in the department of Obstetrics and Gynaecology, Kamla Nehru hospital for mother and child, Indira Gandhi Medical College, Shimla, from June 2013 to May 2014 which included all women undergoing trial for vaginal birth after a previous cesarean who were more than 34 weeks, singleton viable fetus of appropriate size with cephalic presentation with inter delivery interval more than 18 months. Collected data was analysed by Student T-test and Chi-square test was used where required, for statistical analysis using Epi info 7 software. P value <0.05 was considered significant.Results: Out of 152 subjects given trial of labour, 107 (70.39%) subjects had successful VBAC and 45 (29.61%) had repeat emergency cesarean section. The maternal morbidity in emergency cesarean section group and vaginal delivered group was seen in 14 (31%), 8 (7.47%) subjects respectively. No significant perinatal morbidity was observed. VBAC rate was significantly more in women who had prior vaginal deliveries, especially in those with previous VBAC.Conclusions: In carefully selected cases, trial of labour (TOL) after a prior cesarean is safe and often successful. A prior vaginal delivery, particularly, a prior VBAC are associated with a higher rate of successful TOL.

scholarly journals Cesarean Section or Instrumental Delivery: The Best Choice for Mode of Delivery during Second Stage of Labor

2020 ◽  
Vol 42 (2) ◽  
pp. 42-46
Author(s):  
Suniti Rawal ◽  
Neeta Katuwal ◽  
Sajana Shrestha
Keyword(s):  
Cesarean Section ◽  
Teenage Pregnancy ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Instrumental Delivery ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Second Stage Of Labour ◽  
Emergency Cesarean ◽  
Associated Risk Factors

Introduction Managing second stage of labour is very crucial. Emergency Cesarean Section (CS) or Instrumental Delivery (ID) is the only choices although complications might occur in both modes of deliveries. The rate of CS is at rise and the fear of failed ID followed by emergency CS with added complications makes the choice more difficult amongst the obstetricians. MethodsA retrospective study done to assess the maternal and fetal outcome in second stage of labour following ID and emergency CS from April 2018 to March 2019 among the pregnant women having completed 34 weeks of gestations and beyond. ResultsOf 4761 deliveries, 2537 (53.2%) were vaginal and 2224 (46.7%) CS, and amongst all, 133 (2.7%) were second stage interventions. Out of 133, 78 had ID, 76 were successful and 2 failed. Fifty seven (2.6%) were second stage CS. Nulliparas (65.8%) needed more ID, teenage pregnancy (6.5%) (p=0.04) and heart disease (18.4%) (p=0.002) were high risk for ID. Complications were more in CS, uterine extensions, (29.8%) (p<0.001), urinary complications, (43.9%) (p<0.001) and blood loss (p<0.001). Neonatal admission too was higher in CS (n=29) and more so due to respiratory distress (16/29). ConclusionDespite of few failed attempted ID, it still proved to be better choice for delivery during second stage, as both maternal and neonatal complications were higher following the second stage CS. Hence, the correct and timely decision for ID addressing the associated risk factors could lead to favorable outcome.

scholarly journals Pregnancy outcome in low risk pregnancy with decreased amniotic fluid index

2017 ◽  
Vol 6 (3) ◽  
pp. 887
Author(s):  
Swathi Bhat ◽  
Ambika H. E. ◽  
Lepakshi B. G. ◽  
Savitha C. S.
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Cesarean Section ◽  
Amniotic Fluid ◽  
Low Risk ◽  
Term Pregnancy ◽  
Amniotic Fluid Index ◽  
High Risk Factors ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy

Background: To evaluate whether oligohydramnios (AFI≤5) has any significance in the outcome of low risk pregnancies. Normal amniotic fluid index in pregnancy is one of the indicators of fetal well-being.  In a term pregnancy, oligohydramnios, a condition associated with AFI≤5, could be a sign of placental insufficiency. An association of low AFI with complications like pregnancy induced hypertension, consistently leads to poor fetal outcome. A need to deliver the fetus by cesarean section often arises. Occasionally one comes across a full-term pregnancy with AFI ≤5 with no known high risk factors; this could lead to increased cesarean section rates. Thus, it becomes necessary to evaluate if AFI ≤5 in the absence of other risk factors has any significance on obstetric outcome.Methods: Prospective case controlled study was done. Fifty women with term pregnancies and (AFI≤5) cm not associated with any other high risk factors were enrolled for the study. They were matched with fifty controls with normal AFI.Results: Except for a slight increase in variable deceleration in the study group, no differences were noted with fetal heart rate recordings in NST.  Decreased AFI was not associated with increased cesarean section rates, instrumental deliveries or meconium stained amniotic fluid. Severe asphyxia, NICU admission or perinatal mortality was not noted in either group.Conclusions: When a low risk pregnancy is associated with Oligohydramnios (AFI≤5), it does not have any deleterious effect on labor outcome or perinatal outcome.

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