scholarly journals An analytical study of intraoperative, immediate post-operative and perinatal complications in previous two caesarean section

2018 ◽  
Vol 7 (10) ◽  
pp. 4239
Author(s):  
Prachi Singh ◽  
Ritika Agarwal ◽  
Shweta Yadav
Keyword(s):  
Caesarean Section ◽  
Analytical Study ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Perinatal Complications ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Adherent Placenta ◽  
Maternal Morbidity And Mortality

Background: Lower segment caesarean section is one of the commonest operations performed now a day.It has been seen that in cases with previous caesarean section there is increased maternal morbidity and mortality due to placenta previa, adherent placenta and caesarean hysterectomy.The present study was conducted to know the fetomaternal outcome and intra and immediate post-operative complications in cases with previous two lower segment caesarean section.Methods: The present study was conducted in TMMC Moradabad between January 2017-January 2018.Total 68 cases were previous two lower segment caesarean section were included in the study. Neonatal outcome and intraoperative and immediate postoperative complications were seen in these cases.Results: In the present study majority of the cases were in 30-34 years age group (39.7%), the maximum number of caesarean sections were done between gestational age of 37-39.6 weeks (47.1%). Intraoperatively adhesions between uterus, anterior abdominal wall and bladder was seen in less than half of the cases i.e. in 42.6% cases. Out of 68 cases with previous two lower segment caesarean operated 13 cases had placenta previa and 4 cases had adherent placenta.Conclusions: The present study shows that the maternal and perinatal morbidity and mortality is increased with increasing number of caesarean sections. So, there should be reduction in rate of primary caesarean section which can reduce the rate of placenta previa and adherent placenta in subsequent pregnancies.

scholarly journals Study of maternal and perinatal outcome in abruptio placentae

2020 ◽  
Vol 9 (5) ◽  
pp. 1882
Author(s):  
Krupa Patel ◽  
Jaydeep Bhatu ◽  
Swati Patel
Keyword(s):  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Placental Abruption ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Abruptio Placentae ◽  
Medical Facilities ◽  
Maternal Morbidity And Mortality ◽  
Future Management

Background: Abruptio placentae is very frequently seen in our population. Few studies have reported maternal and fetal morbidity and mortality associated with this condition. No work has been done on abruptio placentae in our setup. The data generated will help to improve maternal and fetal morbidity and mortality by planning prompt management of future cases of placental abruption. Objective of this study was to study possible etiological factors of abruptio placentae, analyse maternal outcome, perinatal outcome in the form of maternal morbidity and mortality and discuss possible preventive measures and future management optionMethods: The retrospective observational study it was included all cases presenting with ante partum haemorrhage during the study period. Subjects selected for the study were all cases diagnosed as having abruptio placentae. All other causes of APH like placenta previa and other extraplacental causes were excluded.Results: In the present study incidence of abruptio placentae is higher in 25-30 year that were 42.5% and more in 2nd gravida patient. PIH was accounting for 50%, most of the patients (95%) were anaemic at admission and majority of them required blood transfusion.one maternal mortality (2.5%) occurred, perinatal mortality was 75%.Conclusions: Abruptio placentae serious condition with manifestation of significant maternal and perinatal morbidity and mortality. Complications can be reduced by provisional antenatal care to every woman and with improvement in medical facilities, availability of blood transfusion, proper management of shock. With liberalization of caesarean section, the rate of maternal morbidity and mortality is gradually on the decline.

scholarly journals Case report of venous air embolism in complete placenta previa in a case of lower segment caesarean section

2021 ◽  
Vol 10 (5) ◽  
pp. 2067
Author(s):  
Korichi Noureddine ◽  
Lakshmi Ramanathan ◽  
Aboobaker Thode ◽  
Vipin Reghunatan ◽  
Vijyakumari .
Keyword(s):  
Pulmonary Embolism ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Placenta Previa ◽  
Fatal Outcome ◽  
Air Embolism ◽  
Lower Segment ◽  
Venous Air Embolism ◽  
Lower Segment Caesarean Section ◽  
Life Threatening

Thromboembolic episodes in the pregnant and postpartum period in patients remain rare but fatal causes of maternal morbidity and mortality. They can be either venous air embolism, venous thrombo-embolism which include deep vein thrombosis and pulmonary embolism and last but not the least amniotic fluid embolism. The incidence of embolic episodes is more in LSCS patients than in patients coming for normal vaginal deliveries for all the type of embolisms, ranging from 10-97% for air embolisms depending on the surgical position and diagnostic tools with a potential for life threatening events, for venous thromboembolism (VTE)  it is 0.5-2.2%  patients per 1000 deliveries and increased  5-10-fold in pregnancy and 15-35% in postpartum period as compared to   the non-pregnant  women, the highest being during the 1st 3-6 weeks postpartum. After that the risk declines rapidly, although a small risk increase persists up to 12 weeks. After delivery, incidence of pulmonary embolism ranges from 0.11-0.73% per 1000 deliveries. It is rare, unpredictable, and unpreventable life-threatening complication of pregnancy. According to the International Cooperative Pulmonary Embolism registry, the death rate from massive PE among hemodynamically unstable patients is 52%. Last but not the least, incidence of amniotic fluid embolism ranges from 1/8000 to 1/15000. Delayed diagnosis, delayed treatment or inadequate treatment and inadequate thromboprophylaxis account for many of these deaths. Hence, early detection and proper management helps to prevent maternal mortality and morbidity in our patients. Also, thrombotic prophylaxis helps in preventing the fatal outcome and morbidity and mortality in our patients. Here, we report a case of a patient with complete placenta Previa scheduled for elective Lower segment caesarean section who developed venous air embolism (VAE) but with prompt detection and treatment a fatal outcome was prevented.

MORBID ADHERENT PLACENTA: PREDICTION, DIAGNOSIS AND MANAGEMENT

2007 ◽  
Vol 18 (4) ◽  
pp. 357-381 ◽  
Author(s):  
JM PALACIOS JARAQUEMADA ◽  
CH BRUNO ◽  
WA CLAVELLI
Keyword(s):  
Caesarean Section ◽  
Maternal Morbidity ◽  
Placenta Accreta ◽  
Close Relation ◽  
Morbidity And Mortality ◽  
Vital Importance ◽  
Diagnosis And Management ◽  
On Demand ◽  
Adherent Placenta ◽  
Maternal Morbidity And Mortality

Morbid adherent placenta (MAP), also known as placenta accreta, increta or percreta, is one of the main causes of maternal morbidity and mortality. Its incidence has noticeably increased in the last few decades, a fact directly related to the increase in caesarean sections. There is a close relation between iterative caesarean sections and MAP. This connection is of vital importance, since caesarean rates have risen worldwide, especially in the countries where there is the possibility of caesarean section on demand.

scholarly journals Use of a Fibrin Sealant Patch at Cesarean for Conservative Management of Morbidly Adherent Placenta

2018 ◽  
Vol 08 (04) ◽  
pp. e325-e327 ◽  
Author(s):  
James Greenberg ◽  
Julian Robinson ◽  
Jean Carabuena ◽  
Michaela Farber ◽  
Daniela Carusi
Keyword(s):  
Cesarean Delivery ◽  
Fibrin Sealant ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Artery Embolization ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
Maternal Morbidity And Mortality ◽  
Repeat Cesarean Delivery

Background Morbidly adherent placenta represents a surgical challenge and source of maternal morbidity and mortality. We report the use of a fibrin sealant patch to address hemorrhage associated with a morbidly adherent placenta during cesarean delivery. Case A patient underwent repeat cesarean delivery with complete anterior placenta previa and anticipated morbidly adherent placenta. Bleeding persisted following delivery and removal of the placenta, despite uterine artery embolization. A fibrin sealant patch was applied as an adjuvant intervention to the placental bed and hemostasis was achieved without resorting to a hysterectomy. Conclusion Postpartum hemorrhage is an ongoing leading source of maternal morbidity and mortality. A case is presented in which a fibrin sealant patch provided control of focal placental bed bleeding, allowing removal of a focal morbidly adherent placenta and avoidance of hysterectomy.

scholarly journals Primary lower segment caesarean section in multipara: materno-fetal outcomes

2018 ◽  
Vol 8 (1) ◽  
pp. 279
Author(s):  
Grishma P. Agrawal
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Primary Objective ◽  
Perinatal Morbidity ◽  
Lower Segment ◽  
Safe Delivery ◽  
Lower Segment Caesarean Section ◽  
Vaginal Deliveries ◽  
The Status ◽  
Almost All

Background: All-natural birth has a purpose and a plan; who would think of tearing open the chrysalis as the butterfly is emerging? Who would break the shell to pull the chick out?” ~ Marie Mongon. It is of particular interest, in light of increased incidence of abdominal delivery throughout the country and in the world, to judge the validity of this procedure when used for the first time in the multipara.Methods: All the cases of Primary caesarean delivery in multipara over a period of 18 months were studied with regards to the indication, associated risks factors, and perinatal morbidity and mortality. The primary objective of the study was to find out the status of primary Lower Segment Caesarean Section (LSCS) in multipara in tertiary care center.Results: The overall incidence of LSCS was 30.7%. The incidence of Primary LSCS in multipara was 23.4%. The most common indication of LSCS was Foetal Distress i.e. 40.8%. Almost all caesarean sections were done in Emergency (99.2%). 12.3% of patients underwent PPH intra-operatively with 0.7% patient requiring Obstetric hysterectomy. Majority of the neonates were admitted in NICU for Respiratory Distress (30%). Major cause of Post-operative morbidity was wound gape seen in 10.8% patients.Conclusions: The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand. Hence a multiparous woman in labour requires the same attention as that of primigravida and may still require a caesarean section for safe delivery. Good antenatal and intrapartum care and early referral will help reduce the maternal and perinatal morbidity.

scholarly journals Previous two lower segment caesarean section with placenta previa and placenta accreta woman with COVID-19 suspect: case report

2020 ◽  
Vol 9 (10) ◽  
pp. 4311
Author(s):  
Dhananajay Borse ◽  
Binay Mitra ◽  
Aparna Sharma
Keyword(s):  
Caesarean Section ◽  
Histopathological Examination ◽  
Placenta Previa ◽  
Postoperative Recovery ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Polymerase Chain ◽  
Female Baby ◽  
Operative Findings ◽  
Suspect Case

A pregnant woman with gravida 3, para 2, living 2 and gestational age of 37 weeks and 3 days was referred to a zonal hospital as previous two lower segment caesarean section (LSCS) term pregnancy with placenta previa for safe confinement with complaints of dry cough. She was admitted with a diagnosis of COVID-19 suspect. During her hospitalization, oxygen (O2) saturation was normal. On investigations her counts were normal. Patient was planned for elective LSCS. COVID-19 test i.e. real time-polymerase chain reaction (RTPCR) report was suspect and asked for repeat sampling. During elective LSCS, delivered single live female baby with intra operative findings of placenta previa with adherent placenta and permpartum hysterectomy was done for same. Uterus with placenta was sent for histopathological examination (HPE). During the surgery her oxygen concentration was normal. Her postoperative recovery was uneventful.

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