scholarly journals Alternative delivery in the presence of relative indications for caesarean section

2000 ◽  
Vol 49 (1) ◽  
pp. 88-94
Author(s):  
V. I. Krasnopolsky ◽  
L. S. Logutova

In the article, the summary on the 20-years experience on labor management in high- risk pregnant is given. The prospective for the alternative labor management in diabetes mellitus, fetoplacental insufficiency, elder nullipara, uterine scar after previous cesarean sections, breach or pelvic presentation are covered.

Author(s):  
Sedigheh Ghasemian Dizajmehr ◽  
Farzaneh Rashidi Fakari ◽  
Mohsen Ghasemian

Introduction: Retroperitoneal hematoma are an important factor for hospitalization in patients with trauma and proper treatment is still under discussion and Controversial. We describe a successful case of conservative treatment of huge hematoma after cesarean section. Case presentation: An Iranian 34-year-old multigravida(G4L3) woman with three previous cesarean sections from Urmia province presented to our hospital with amniotic fluid leak. She had full-term pregnancy. Caesarean section was done. One day after caesarean section, she became dyspnea and had chest pain in left side. Embolism is suspected and enoxaparin was administered. According, hemoglobin decreased (HB:6.2) after administered the second dose of enoxaparin and a clear dullness percussion led tosuspected to hemorrhage and retroperitoneal hematoma was discontinued enoxaparin. After the patient is stable, the patient was discharged and retroperitoneal hematoma was followed up by ultrasonography and conservative treatment. Conclusion: Conservative treatment of retroperitoneal hematoma postpartum with good clinical evolution, depends on status of the patient, cause of injury and its evolution.


Author(s):  
O.P. Miklin ◽  
I.S. Glazkov ◽  
I.B. Glazkova ◽  
Z.S. Rumyantseva ◽  
N.A. Reznichenko ◽  
...  

Caesarean section (CS) is a surgical procedure performed only in critical conditions to save the life of a mother and a child. The operation should be performed only if clinically indicated. Recently, the rate of cesarean sections is growing, but the number of deaths is not decreasing. The purpose of the study is to examine the frequency of abdominal delivery in Simferopol, Simferopol Clinical Maternity Hospital No. 2, to assess the possibilities and reserves for CS reduction in the region. Methods. The authors used retrospective analysis of birth histories according to Robson classification. Results. In 2018–2019 the frequency of cesarean sections in Simferopol Clinical Maternity Hospital No. 2 increased by 3 %. It was found out that primigravida and multipara with a uterine scar in the cephalic presentation are a reserve to decrease the indicator. It may also be promising to reduce the incidence of cesarean section in pregnant women with breech presentation. Keywords: caesarean section, Robson classification, Republic of Crimea. Операция кесарева сечения является методом, проводимым только при угрожающих состояниях с целью спасения жизни матери и ребенка. Операция должна выполняться только при строгих показаниях врача. В последнее время тенденция к родоразрешению путем кесарева сечения нарастает, однако число летальных исходов не уменьшается. Цель. Определение частоты абдоминального родоразрешения в г. Симферополь на примере ГБУЗ РК «Симферопольский клинический родильный дом № 2» и оценка возможностей и резервов ее снижения в регионе. Материалы и методы. Ретроспективный анализ историй родов по классификации Робсона. Результаты. Частота кесарева сечения в ГБУЗ РК «Симферопольский клинический родильный дом № 2» в течение 2 лет возросла на 3 %. Было установлено, что резервом снижения данного показателя являются первобеременные и повторнородящие с рубцом на матке и с плодом в головном предлежании. Перспективным может быть также снижение частоты кесарева сечения у беременных с тазовым предлежанием. Ключевые слова: кесарево сечение, классификация Робсона, Республика Крым.


1970 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
N Nargis ◽  
AK Al-Mahmood ◽  
D Akhter

To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19


Author(s):  
Sonali S. Somani ◽  
Sunita Sudhir ◽  
Shashikant G. Somani ◽  
. Bushra

Background: Caesarean section (CS) is one of the most common obstetric procedures worldwide and an increased rate of caesarean section has been observed in recent studies. Maternal morbidities and mortality associated with repeat caesarean section is an important health problem. The present study aims at knowing the various intraoperative complications encountered during repeat caesarean sections. Objective was to study the incidence and type of surgical difficulties encountered in repeat cesarean sectionsMethods: It was a prospective observational study of 118 cases of repeat cesarean sections. Intra-operative findings of all cases were analyzed to know the difficulties encountered because of previous cesarean section.Results: In present study, out of total 118 cases of previous cesarean sections, 71 (60.17%) cases were of previous one caesarean section and 47(39.83%) were of previous two cesarean sections. Following intraoperative morbidities were encountered – adhesions (1 caesarean section vs 2 caesarean section – 40.85 vs 65.96% respectively) , thin lower uterine segment (1 caesarean section vs 2 caesarean section – 21.13 vs 36.17% respectively), advanced bladder(1 caesarean section vs 2 caesarean section – 15.49 vs 36.17 % respectively) , extension of uterine incision(1 caesarean section vs 2 caesarean section – 9.86 vs 19.15% respectively) , scar dehiscence(1 caesarean section vs 2 caesarean section –7.04 vs 31.91% respectively), excess blood loss (1 caesarean section vs 2 caesarean section –7.04 vs 19.15% respectively), 1 case of placenta accrete was found in previous 2 caesarean section 2.13%) which needed caesarean hysterectomy. uterine rupture and bladder injury seen in one patients of previous 2caesarean section. Time taken for surgery was more in repeat CS group Delivery.Conclusions: An increasing number of CS is accompanied by increased maternal morbidity. Intraoperative complication which increase the risk of morbidity are adhesion, placenta accreta. It is prudent to involve a senior experienced obstetrician in repeat cesarean section. The best way to reduce this is by reducing primary caesarean section rates. Patients with previous caesarean section should be considered as high risk and should be counseled for regular antenatal check-up and they should be given option of vaginal birth after CS whenever possible.


2014 ◽  
Vol 44 (S1) ◽  
pp. 336-336
Author(s):  
S. Wozniak ◽  
P.R. Szkodziak ◽  
P. Czuczwar ◽  
E. Wozniakowska ◽  
P. Milart ◽  
...  

2019 ◽  
Vol 1 (4) ◽  
pp. 16-20 ◽  
Author(s):  
A. V. Lugovaya ◽  
N. M. Kalinina ◽  
V. Ph. Mitreikin ◽  
Yu. P. Kovaltchuk ◽  
A. V. Artyomova ◽  
...  

Apoptosis, along with proliferation, is a form of lymphocyte response to activating stimuli. In the early stages of cell differentiation, the apoptotic response prevails and it results to the formation of tolerance to inductor antigen. Mature lymphocytes proliferate in response to stimulation and it means the initial stage in the development of the immune response. Since in this case apoptosis and proliferation acts as alternative processes, their ratio can serve as a measure of the effectiveness of the cellular response to activating signals. The resistance of autoreactive T-cells to apoptosis is the main key point in the development of type 1 diabetes mellitus (T1DM). Autoreactive T-cells migrates from the bloodstream to the islet tissue of the pancreas and take an active part in b cells destruction. The resistance of autoreactive effector T-cells to apoptosis may suggest their high proliferative potential. Therefore, the comparative evaluation of apoptosis and proliferation of peripheral blood lymphocytes can give a more complete picture of their functional state and thus will help to reveal the causes of ineffective peripheral blood T-ceiis apoptosis in patients with T1DM and will help to understand more deeply the pathogenesis of the disease. in this article, the features of proliferative response of peripheral blood T-cells in patients with T1DM and in individuals with high risk of developing T1DM have been studied. Apoptosis of T-cell subpopulations has been investigated. The correlation between the apoptotic markers and the intensity of spontaneous and activation- induced in vitro T-cells proliferation of was revealed. it was determined, that autoreactive peripheral blood T-cells were resistant to apoptosis and demonstrated the increased proliferative potential in patients with T1DM and in individuals with high risk of developing T1DM.


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