scholarly journals A comparative study of induction of preterm vaginal delivery at 20 to 28 weeks gestation in previous one lower segment caesarean section by foley catheter and prostaglandin E2 gel

2017 ◽  
Vol 6 (8) ◽  
pp. 3581
Author(s):  
Shruti Agarwal ◽  
Neelam Bharadwaj ◽  
Lata Rajoria ◽  
Indira Lamba
Keyword(s):  
Caesarean Section ◽  
Prostaglandin E2 ◽  
Foley Catheter ◽  
Induction Of Labour ◽  
P Value ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Catheter Group ◽  
Group A ◽  
Group B

Background: The aim of the study to assess the maternal outcome and safety of induced preterm vaginal birth after a previous one lower segment caesarean delivery.Methods: In this study, 100 women who had singleton pregnancies with a previous one term lower segment caesarean section, in whom induction of labour was required in between 20 to 28 wks of gestation, were included. Group A (n= 50) were induced by transcervical foley catheter and group B (n= 50) were induced by prostaglandin E2 gel and then progression of labour was monitored. Both groups were compared in terms of induction delivery interval, efficacy and safety.Results: In our study, all women were delivered vaginally and hysterotomy was not required. The mean induction delivery interval in Foley catheter group (20.180±3.3499 hrs) was significantly shorter (p-value <0.001) than PGE2 gel group B (24.050±3.6537 hrs). There was no case of uterine rupture, puerperal pyrexia, postpartum haemorrhage and uterine hyperstimulation.Conclusions: Women with previous lower segment caesarean section in whom premature induction of labour is required for any reason can be done easily, safely and effectively without maternal morbidity. Induction can be done more effectively by using transcervical foley catheter than intracervical prostaglandin E2 gel. It has shorter induction delivery interval and low complication. Hence, I suggest that every woman with previous one lower segment caesarean section who requires premature induction should go for trial of labour before repeating caesarean section.

scholarly journals TO DETERMINE EFFICACY OF GRANISETRON VERSUS PLACEBO FOR REDUCING SHIVERING IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION UNDER SPINAL ANAESTHESIA

2021 ◽  
Vol 71 (2) ◽  
pp. 530-34
Author(s):  
Sana Abbas ◽  
Bilal Yasin ◽  
Basit Mehmood Khan ◽  
Umer Hayat ◽  
Beenish Abbas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Elective Caesarean Section ◽  
Patient Comfort ◽  
Military Hospital ◽  
P Value ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Group A ◽  
Group B

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia. Study Design: Comparative cross - sectional study. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019. Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes. Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of <0.05. Conclusion: Prophylactic injection granisetron was efficacious against post spinal shivering, moreover provides worth while relief of nausea and vomiting which is dilemma with most of the drugs employed for control of post spinal shivering.

scholarly journals Comparative study of intrathecal preservative-free midazolam versus nalbuphine as an adjuvant to intrathecal bupivacaine (0.5%) in patients undergoing elective lower-segment caesarean section

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Manisha Kapdi ◽  
Shruti Desai
Keyword(s):  
Caesarean Section ◽  
Adverse Effects ◽  
Postoperative Analgesia ◽  
Lower Segment ◽  
Hemodynamic Stability ◽  
Lower Segment Caesarean Section ◽  
Institutional Review ◽  
Group A ◽  
Group B ◽  
Preservative Free

Abstract Background Intrathecal anesthesia is common for parturients undergoing lower-segment caesarean section. Various adjuvants are added to intrathecal bupivacaine for potentiating pharmacological effects, improving quality of sensorimotor block and postoperative analgesia, and preventing adverse effects. The study period was from November 2017 to September 2018, and it was a randomized double-blinded observational study. The sample size calculation was done according to results of our pilot study (done with 5 patients in each group) and discussion with the institutional review board. Also, in this study, we aim to assess nalbuphine/midazolam as adjuvant to intrathecal bupivacaine for LSCS in terms of quality of sensorimotor block, postoperative analgesia, adverse effects, hemodynamic stability, and Apgar scores of baby at 1 and 5 min. One hundred full-term parturients between 20 and 35 years of ASA grade I/II scheduled for elective lower-segment caesarean section after approval from the institutional review board, and written informed consent were allocated into 2 groups. Randomization was done at the time of giving intrathecal anesthesia by odd and even numbers in an opaque sealed envelope. Group A (n = 50): Bupivacaine heavy (0.5%) 2.0 ml (10 mg) + 0.2 ml Preservative-free inj. midazolam 1 mg Group B (n = 50): Bupivacaine heavy (0.5 %) 2.0 ml (10 mg) + 0.2 ml (0.75 mg) Preservative-free inj. nalbuphine The primary outcome was to assess the perioperative hemodynamic stability, Apgar score, and postoperative analgesia, and the secondary outcome was to assess the complications and adverse effects during the study period. Results The onset of sensory and motor block was earlier in group A than in group B. Total duration of effective postoperative analgesia was more in the midazolam group as compared with the nalbuphine group. The incidence of complications (nausea, vomiting, and pruritus) were more in group B as compared with group A. Conclusion Nalbuphine and midazolam both are good adjuvants to hyperbaric bupivacaine for LSCS in terms of hemodynamic stability and good Apgar scores at 1 and 5 min. Intrathecal midazolam provides better postoperative analgesia and less adverse effects.

scholarly journals Comparison of the efficacy, safety, acceptability and fetomaternal outcomes of combination of mifepristone and foley’s catheter with foley’s catheter alone in induction of labour in term pregnancies with previous lower segment caesarean section

2020 ◽  
Vol 9 (10) ◽  
pp. 4181
Author(s):  
Nancy Thind ◽  
Pranav Sood ◽  
Rajeev Sood ◽  
Geetika Gupta Syal
Keyword(s):  
Caesarean Section ◽  
Cervical Ripening ◽  
Combination Group ◽  
Bishop Score ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Group A ◽  
Foley’S Catheter ◽  
Failed Induction ◽  
Group B

Background: Objective of the study was to compare the efficacy, safety, acceptability, fetomaternal outcomes of combination of mifepristone and Foley’s catheter with Foley’s catheter alone in induction of labor in term pregnancies with previous Lower segment caesarean section (LSCS).Methods: This was a prospective study of 36 women induced with mifepristone and foley’s catheter and 36 women induced with foley’s catheter alone at 37 weeks to 41+6 weeks with previous LSCS.Results: Mean bishop score on admission in combined group (2.44) was comparable with that of foley’s alone group (2.91, p=0.888). Mean Bishop score (BS) after foley’s expulsion in group A and group B was 7.46 and 6.33 respectively, which was statistically significant (p<0.001). In group A 69.5% of women delivered vaginally compared to 52.2% in group B which was comparable (p=0.230). Mean induction to delivery interval was significantly short in combination group (15.5±1.3 hours versus 20.8±1.07 hours, p=0.003). 50% women in group A required oxytocin for induction/ augmentation of labour as compared to 77.8% in group B (p=0.02). Failed induction was statistically higher in group B (p<0.05). No difference was found with regards scar dehiscence, scar rupture, Postpartum hemorrhage (PPH), wound infection, puerperal pyrexia, Meconium stained liquor (MSL), fetal distress, mean birth weight, 1 and 5 minutes Appearance, pulse, grimace, activity, and respiration (APGAR) score, neonatal outcome, hospital stay.Conclusions: Priming with mifepristone before insertion of foley’s catheter results in significant change in BS signifying that combination promotes early cervical ripening as compared to foley’s catheter alone. Mifepristone plays significant role in cervical ripening, reduces induction to delivery interval, oxytocin requirement and failed induction.

scholarly journals INDUCTION OF LABOUR;

2017 ◽  
Vol 24 (04) ◽  
pp. 522-525
Author(s):  
Nadia Taj ◽  
Rahat Akhtar ◽  
Sumera Mehnaz ◽  
Aamir Furqan
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Expectant Management ◽  
Induction Of Labour ◽  
P Value ◽  
Pregnancy Induced Hypertension ◽  
Induction Group ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Objectives: To compare maternal outcome in planned induction of laborversus expectant management in pregnancy induced hypertension between 36 to 40 weeks ofgestation. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynecology UnitII of Nishter Hospital Multan. Period: January 2016 to July 2016. Materials and Methods: Onehundred and thirty six (136) women with diagnosis of mild pregnancy induced hypertension,having gestational age 36 to 40 weeks were selected for this study. The selected patients wereallocated randomly into two equal groups i.e. Group A (Induction group) & Group B (Expectantgroup). The primary outcomes of this study were rate of cesarean section delivery anddevelopment of severe pre-eclampsia. Independent sample t-test was used to compare agebetween the groups. Chi-square test was used to compare age groups and study endpointsbetween the groups. Results: Mean gestational age at the time of delivery was 38.3 ± 0.75weeks for group A and 39.2 ± 0.55 weeks for group B (P-value >0.05). Mode of delivery was 52(76.47%) patients by vaginal and 16 (23.53%) by caesarean section in group A. While in groupB, out of 68 deliveries, 40 (58.82%) patients delivered by vaginal and 28 (41.18%) by caesareansection (p-value <0.05). Regarding maternal outcomes, severe pre-eclampsia occurred in 05(7.35%) women of group A while in group B, it was noted 15 (22.05%) women (p-value<0.05).The final outcome was considered satisfactory in 76.47% patients in Induction group regardingvaginal delivery and severe pre-eclampsia while in Expectant group satisfactory outcomes wereachieved in only 23.53% women (p-value <0.05). Conclusion: Induction of labour is associatedwith improved maternal outcome in terms of caesarean section and pre-eclampsia in womenwith mild PIH beyond 36 weeks of gestation as compared to the expectant management.

scholarly journals Foley catheter with vaginal prostaglandin E2 gel versus vaginal prostaglandin E2 gel alone for induction of labour: a randomized controlled trial

2018 ◽  
Vol 7 (5) ◽  
pp. 1893
Author(s):  
Ruchika Garg ◽  
Shailza Vardhan ◽  
Saroj Singh ◽  
Richa Singh
Keyword(s):  
Prostaglandin E2 ◽  
Controlled Trial ◽  
Foley Catheter ◽  
Active Phase ◽  
Induction Of Labour ◽  
Large Sample Size ◽  
Group A ◽  
Simultaneous Use ◽  
Phase Interval ◽  
Group B

Background: Induction of labour is significant when continuing pregnancy possess adverse effect on health of mother and her unborn baby. Different methods have been used for induction of labour. At present there is very less literature regarding simultaneous use of Foleys catheter and PGs.  The present study was done to compare the efficacy of using intracervical Foleys catheter and PGE2 gel simultaneously versus PGE2 gel alone for induction of labour.Methods: Prospective study, conducted in department of obstetrics and gynaecology for duration of 6 months. 100 women requiring induction of labour were included in the study and were randomly divided into two groups. 50 women were included in group A (simultaneous use of intracervical Foley catheter with PGE2 gel) and 50 women were included in Group B (intravaginal insertion of PGE2 gel only).Results: Maternal age, gestation age, parity, indication of induction and primary Bishops score were comparable in both the groups. Mean induction to active phase interval in both groups which was 5.8±0.80 hours in Group A and 6.23±0.40 hours in Group B. Also mean time taken from induction to delivery in Group A was 10.08±5.6 hours and in Group B was 14.6±6.9 hours which was significantly less in Group A. The rate of vaginal delivery in group A and Group B was 66% and 58% respectively which was slightly more in Group A but was not significant.Conclusions: In the present study we conclude that simultaneous use of mechanical method with Foleys catheter and PGE2 gel is better and more effective method for induction of labour than PGE2 alone. However, large sample size is required to reach more confirmatory results.

scholarly journals Effect of acupuncture TENS versus conventional TENS on post cesarean section incision pain

2018 ◽  
Vol 7 (9) ◽  
pp. 3738
Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Control Group ◽  
P Value ◽  
Random Allocation ◽  
Lower Segment Caesarean Section ◽  
Post Operative Pain ◽  
Group A ◽  
Group B ◽  
Pain Rating Scale

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.

scholarly journals EFFICACY OF PHENYLEPHRINE OVER EPHEDRINE IN CONTROLLING FALL OF BLOOD PRESSURE: A CROSS SECTIONAL STUDY IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Keshav Saran Agrawal ◽  
Aruna Mahanta
Keyword(s):  
Blood Pressure ◽  
Spinal Anesthesia ◽  
Cross Sectional Study ◽  
Age Group ◽  
Lower Segment ◽  
Cross Sectional ◽  
Lower Segment Caesarean Section ◽  
Block Level ◽  
Group A ◽  
Group B

Background: most of the lower segment caesarean sections are done under spinal anesthesia and in more that 80% of the cases, maternal fall in blood pressure can be observed intraoperatively. Throughout history many vasopressor drugs have been evaluated for the treatment. Aim: our research was conducted to compare the effect of phenylephrine with ephedrine given for the prophylaxis of prevention of intraoperative fall in blood pressure in females who are undergoing LSCS. Materials and Methods: a total of 100 cases were considered for our study and were randomly distributed in two groups. Group A cases were administered Phenylephrine while ephedrine was given to group B cases just after spinal anesthesia. Results: most of our study subjects were in the age group of 21-25 years who were in the range of 51-55 kgs. Spinal anesthesia was given by using bupivacaine & block level was checked at 2 & 5 mins. Phenylephrine was found to be superior in control of fall in blood pressure as more than 90% of the cases were brought back to their preoperative levels in less than 4 mins after spinal anesthesia. Whereas in group B, ephedrine took much more time of around 10 mins for control of BP. Conclusion: with proper monitoring of heart rate, phenylephrine is superior to ephedrine in controlling the fall in blood pressure. Keywords: Ephedrine, Phenylephrine, Hypotension, Bradycardia.

scholarly journals Single vs Multiple Antibiotic Drug Regimen in Preventing Infectious Morbidity in Caesarean Section: A Randomised Clinical Trial

2021 ◽  
Author(s):  
Subhashchandra R Mudanur ◽  
Shreedevi S Kori ◽  
Aruna Biradar ◽  
Rajasri G Yaliwal ◽  
Dayanand S Biradar ◽  
...  
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Multiple Dose ◽  
Caesarean Delivery ◽  
Surgical Site Infections ◽  
Cost Effective ◽  
P Value ◽  
Infectious Morbidity ◽  
Group A ◽  
Group B

Introduction: Surgical site infections are a serious cause of maternal morbidity and mortality. Various preventive measures are being used to reduce the incidence of surgical site infections. One of them is the use of prophylactic antibiotics. In this study, authors have evaluated three antibiotic regimen with respect to preventing infectious morbidity in caesarean section. Aim: To study the efficacy and cost-effectiveness of a single dose (ceftriaxone) versus multiple doses of antibiotic therapy (ceftriaxone and ornidazole) administered preoperatively in women undergoing caesarean delivery. Materials and Methods: A prospective interventional study was conducted on 300 pregnant women undergoing emergency or elective caesarean delivery. Study was conducted at BLDE (DU) Shri BM Patil Medical College and Research Centre, Vijayapur, Karnataka, India. Patients were randomly assigned to three groups by block random sampling with 100 women in each group. Group A received Inj. ceftriaxone 1 gm single dose 60 minutes prior to commencement of surgery. Group B received Inj. ceftriaxone 1 gm along with Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and Group C received Inj. ceftriaxone 1 gm and Inj. ornidazole 500 mg intravenous infusion 60 minutes prior to commencement of surgery and a repeat dose 12th hourly for 24 hours followed by Tab. cefixime 200 mg and Tab. ornidazole 500 mg twice daily for four days postoperatively. The effectiveness of therapy was measured in terms of adverse effects of antibiotics such as nausea and vomiting and postoperative complications like pyrexia, foul smelling lochia, surgical site infections, uterine tenderness, peritonitis and endometritis. Results: There was no statistical difference in outcome measures in side-effects of antibiotics (p-value=0.13), fever (p-value=0.68), lochia discharge (p-value=0.88), wound infection (p-value=0.39) and peritonitis (p-value=0.30) among the three groups. The single dose medication in group A had a cost of Rs.60 INR (0.82 cents USD), which was significantly less compared to the multiple dose regimens in group B that cost Rs.203 INR ($2.76 USD). The mean hospital stay in non infectious and infectious patients were 5 and 10 days in present study (p<0.0001). Conclusion: Caesarean delivery poses 5-20 times greater risk of postoperative infection when compared to vaginal birth. There has been a shifting trend of increasing caesarean deliveries and postoperative infections can contribute to overwhelming health and economic burden. Present study shows outcome measures which were statistically insignificant among the three study groups with different prophylactic regimen for caesarean delivery, so it’s safe to state that both single dose and multiple dose regimen provided equal protective coverage in reducing maternal infectious morbidity. Also, single dose regimen proved to be cost-effective. So, to conclude single dose prophylactic antibiotic given preoperatively in caesarean section is both cost-effective and as is efficient.

scholarly journals Incidence of post-operative (caesarean section) infectious morbidities in cleansing and non-cleansing group after povidone iodine vaginal cleaning

2021 ◽  
Vol 10 (9) ◽  
pp. 3393
Author(s):  
Pragya Verma ◽  
Dolly Chawla ◽  
Rashmi Khatri ◽  
Preeti Verma
Keyword(s):  
Caesarean Section ◽  
Povidone Iodine ◽  
Medical College ◽  
Lower Segment Caesarean Section ◽  
Significant Difference ◽  
Maternal Morbidity And Mortality ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Control Study

Background: Despite of wide spread use of prophylactic antibiotics and various antiseptic measures, post-operative infection remains one of the significant and serious complication of caesarean delivery contributing to high maternal morbidity and mortality. Objective was to study the incidence of post-operative infectious morbidities in patients with/without povidone iodine vaginal cleansing done prior to caesarean section.Methods: A prospective randomized control study was done in the department of obstetrics and gynecology of Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi.Results: Mean age of participants in group A is 26.22±2.47 years and in group B is 26.48±2.3 years. Majority women (84.0%) underwent emergency lower segment caesarean section (LSCS). (6.4%) women developed post-operative endometritis, out of which maximum (4.6%) belong to no vaginal cleansing group (B) compared to 1.8% in povidone iodine vaginal cleansing group(A), which is statistically significant (p=0.01). Over all (13%) women had post-operative fever, with significant difference among the two groups i.e. (8.6%) were in group B versus (4.4%) in group A (p=0.005).Conclusions: Povidone iodine vaginal cleansing prior to caesarean section is significantly effective in reducing post-operative infectious morbidities.

Transversus abdominis plane block by landmark technique with ropivacaine versus bupivacaine for post-operative analgesia in patients undergoing lower segment caesarean section deliveries

2021 ◽  
Vol 8 (4) ◽  
pp. 551-555
Author(s):  
Aishwarya M Chavan ◽  
Geetha R Acharya ◽  
Jyoti V Kale ◽  
Nidhi R Dabral
Keyword(s):  
Patient Satisfaction ◽  
Caesarean Section ◽  
Postoperative Period ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Lower Segment ◽  
Rescue Analgesia ◽  
Lower Segment Caesarean Section ◽  
Group B

Transversus Abdominis Plane (TAP) Block is an efficacious abdominal field block which is widely used component of multimodal analgesia. Compare the efficacy of Inj. Ropivacaine 0.2% and Inj. Bupivacaine 0.2% when used in TAP block for post-operative analgesia in lower segment caesarean section deliveries(LSCS) done under spinal anaesthesia. Randomized double blinded prospective study conducted after institutional ethics committee in our institute. We have recruited sixty patients scheduled for an elective LSCS which were enrolled into two groups to receive TAP block with bupivacaine 0.2% 15ml Group B (n=30) versus ropivacaine 0.2% 15ml Group R (n=30) + dexamethasone 2mg bilaterally. TAP block was administered on completion of surgery. Primary objective was to compare time to rescue analgesia in postoperative period. Secondary Objectives wereto compare hemodynamic response during postoperative period, measure the intensity of pain using visual analogue scale (VAS), number of analgesic doses in first 24 hours, patient satisfaction with pain management and complications if any.SPSS software 16 version. Time for rescue analgesia was shorter in Group B (6.7 hour) than in Group R (9.47 hour) (p = 0.00). VAS was lower in Group R. Higher dose of analgesics was required in Group B (p=0.008). All this led to higher patient satisfaction score in Group R. This study concludes that 0.2% ropivacaine provided a longer duration of analgesia compared to 0.2% bupivacaine when used in TAP block for post-operative analgesia in LSCS deliveries.

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