scholarly journals A prospective, randomized, cross sectional study of manual versus vacuum extraction of mobile head in caesarean section

2018 ◽  
Vol 7 (11) ◽  
pp. 4556
Author(s):  
Bhagyashree A. ◽  
Julie Thomas ◽  
Shobha N. Gudi
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Vacuum Extraction ◽  
Fetal Head ◽  
Cross Sectional ◽  
Foetal Head ◽  
Uterine Incision ◽  
Group I ◽  
The Mean ◽  
Manual Extraction

Background: Considering the high rate of caesarean section, and the difficulty during delivery of the floating foetal head even by the most experienced obstetrician, the use of vacuum has been described. The present study was undertaken with the hypothesis that, vacuum assisted foetal head delivery during caesarean section is safe and effective without increasing maternal and neonatal complications. The outcomes enumerated by the limited literature available need to be evaluated before it is used routinely.Methods: A prospective, randomized, comparative, cross sectional Hospital based study was conducted at St. Philomena’s Hospital, Bangalore. Every woman randomized for the study received either conventional method or ventouse extraction of fetal head at cesarean section. 200 women were enrolled into the study with 100 in each arm. The primary outcome measures were percentage of successful extractions and I-D interval. The secondary outcome measures were, uterine incision extension, estimated blood loss, Apgar scores, neonatal hyperbilirubinemia and neonatal scalp or head injury.Results: Successful extraction was done in 89 % and 98 % cases in manual and vacuum extraction cases. (p =0.0184). U-D interval in the manual extraction group was 66.59±4.64 seconds and in the Vacuum extraction group it was 56.06±3.46 seconds (P<0.001). The mean pre-delivery hemoglobin levels in group I was 11.6±0.73 compared to 11.36±0.49 gm% in group II. The mean post-delivery hemoglobin levels in group I was 10.29±0.79 compared to 10.21±0.53 gm% in group II (p <0.001). The uterine incision extensions were significantly higher in manual extraction group, 18 of the 100 women (18 %), whereas only 2 of the 100 women in vacuum group had uterine extensions (p=0.0002).Conclusions: Authors conclude that the routine use of ventouse is safe and effective for mobile fetal head extraction at cesarean section.

scholarly journals Vacuum Extractor Versus Manual Head Extraction During Cesarean Section

2021 ◽  
pp. 110-119
Author(s):  
Shahenda H. Basha ◽  
Doaa N. Shatat ◽  
Adel E. Elgergawy ◽  
Mohsen M. Elnamoury
Keyword(s):  
Cesarean Section ◽  
Maternal Obesity ◽  
Vacuum Extraction ◽  
Multiple Gestation ◽  
Fetal Head ◽  
Cesarean Section Delivery ◽  
Vacuum Extractor ◽  
Group I ◽  
Estimated Blood Loss ◽  
Group Ii

Background: For multifactorial reasons, the rate of cesarean deliveries increased clearly over a decade; decreased in vaginal births after cesarean (VBAC), multiple gestation, maternal obesity, pre-term labor, gestational diabetes or hypertension, increased number of high-risk expectant mothers and the obstetrical medico-legal environment. Delivering the fetal head at cesarean section can also be a lengthy operation and can result in maternal or fetal Complications. The vacuum extractor allows for the application of traction on the fetal head. In this study we aim to compare the safety (for mother and infant) and efficacy of delivery of the fetal head in cesarean section using vacuum extractor with the manual extraction. Methods: This study was conducted on 60 pregnant women undergoing cesarean section. All patients were between 37 and 42 weeks of pregnancy with signs of healthy fetus and were divided into 2 groups; Group I- 30 patients subjected to vacuum extraction at the cesarean section, Group II- 30 patients subjected to the conventional cesarean method. The result: The BMI of women in group I was 27.90 ± 0.96 and in group II was 28.0 ± 0.98. The gestational age of the babies in Group I and II were 39.0 ± 1.02 and 39.0 ± 0.98 weeks. U-D interval for Group I and Group II were 48.40 ± 17.63 and 73.87 ± 16.76 days respectively. The estimated blood loss in group I and group II were 478.0 ± 59.62 and 464.7 ± 52.57 respectively. The birth weight of the babies delivered in Group I and Group II were 4253.33 ± 118.72 and 4246.67 ± 135.58 KG respectively. The five minutes Apgar score for Group I and Group II were 8.50 ± 0.68 and 8.57 ± 0.57. Conclusion: The use of the vacuum extractor at cesarean section may be a safe and effective method to facilitate delivery of the large fetal head and cesarean section delivery can be simplified by this technique.

scholarly journals TO STUDY THE ONSET AND PROGRESSION OF AIRWAY ABNORMALITY IN TERMS OF ALTERATION IN PFT IN ASYMPTOMATIC SMOKERS.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya
Keyword(s):  
Lung Function ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Significant Difference ◽  
History Of ◽  
Young Smokers ◽  
The Mean ◽  
Group Ii

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers

scholarly journals Caesarean section at Koudougou regional hospital centre: indications and prognosis

2020 ◽  
Vol 9 (12) ◽  
pp. 4792
Author(s):  
Djiguemde Nebnomyidboumbou Norbert Wenceslas ◽  
Lankaonde Martin ◽  
Savadogo-Komboigo B. Eveline ◽  
S. I. B. Sansan Rodrigue ◽  
Ouedraogo Wendlassida Estelle ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Caesarean Section Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Important Place ◽  
History Of ◽  
Group 3 ◽  
Group 5 ◽  
Uterine Scar

Background: Objective was to study the indications and the prognosis of cesarean section in the obstetrics and gynecology department of CHR Koudougou from August 1st to October 16th 2018.Methods: This was a cross-sectional study for descriptive purposes with prospective collection of data over the month and monitoring of parturients up to the 42nd day post caesarean section. The study covered the period from August 1 to October 16, 2018. Gestures received in the work room and those hospitalized for a scheduled cesarean were involved in this study.Results: This study involved 316 deliveries. The caesarean section rate was 34.8% (n=110). The average age was 26.75 years with extremes of 12 and 42 years. Term pregnancies represented 90.9%. History of cesarean section was observed in 47, 3%. The main groups contributing to the caesarean section rate represent: Groups 5 (9.5%), Group 1 (9.2%), Group 3 (5.1%), the scar uterus (17.3%) and suffering fetal (14.6%). The reported complications were 15.5% including 3.6% parietal suppuration and 0.8% stillbirth.Conclusions: The caesarean section occupies an important place in the maternity service of the RHC of Koudougou. Robson's group 5 was the largest contributor to the overall cesarean rate in our study. Measures should be taken in this group so that the uterine scar does not become an absolute indication for cesarean.

scholarly journals Evaluation of Patients Satisfaction following Caesarean Section in a Secondary level District Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 101-106
Author(s):  
Sankar Kumar Basak ◽  
Zannatul Ferdosh ◽  
Rehena Begum ◽  
Nasim Iftekhar Mahmud
Keyword(s):  
Caesarean Section ◽  
Caesarean Delivery ◽  
District Hospital ◽  
Secondary Level ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Negative Reaction ◽  
Cross Sectional ◽  
Level Of Satisfaction ◽  
The Mean

Objective: To assess the level of satisfaction with caesarean delivery and to see the relationbetween different parameters and satisfaction. Materials & Methods: This cross sectional study was done in the department of Obstetrics& Gynaecology of the District Sadar Hospital, Laxmipur during the period of 1st January to30th June 2017. A total of 423 post-caesarean women were included in the study. Thestructured questionnaires were used for the collection of data from the patients and the datawere processed and analyzed with the help of software SPSS. Results: During the study period, among the 465 caesarean delivery 423 were enrolledfor the study. The mean age of the patients was 23.99±5.29 years and mean parity was1.22±1.27. Initial negative reaction to the decision of caesaren section was expressed by71.9% of the patients, 18.4% remained indifferent and 9.7% showed positive reaction. Themajor reasons of initial negative reaction were fear of death and dislike of caesareansection. The satisfaction following caesarean delivery was significantly associated withage, educational status and initial positive and negative reaction to the decision of caesareansection. Three hundred and fifty five (83.9%) women expressed their overall satisfactionfollowing caesarean section. Conclusion: Most patients expressed their overall satisfaction to caesarean delivery. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 101-106

scholarly journals Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

scholarly journals Caesarean Delivery Rates in Birth Centres: confrontation using Robson Classification

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
G Bocci ◽  
N Nante ◽  
M Napolitani ◽  
I Scinicariello ◽  
L Kundisova ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Multiple Pregnancy ◽  
Vaginal Birth ◽  
Cross Sectional ◽  
Group V ◽  
Mortality And Morbidity ◽  
Birth Centre ◽  
Robson Classification ◽  
Group I ◽  
Birth Centres

Abstract Background A caesarean section (CS) is a life-saving procedure, reducing perinatal mortality and morbidity, over last decades CS rates are increasing. In 2015 the Robson classification (RC) was introduced by WHO as a global standard for assessing, monitoring and comparing CS rates within healthcare facilities and between them. The aim of this cross-sectional study was to identify the most numerous groups according to RC. Methods All women, who delivered by CS from January 2015 to June 2017 in two hospitals in the province of Siena (Italy): I level Birth Centre of Grosseto (GR) and II level Birth Centre of Siena (SI) were included. Age, type of hospital and group based on RC were extracted from Medical Register. The RC divides women into 10 groups based on 5 basic obstetric characteristics (parity, number of foetuses, previous CS, onset of labour, gestational age, foetus presentation). The percentages of the group’s contribution to the overall CS rate were calculated and confronted for two birth centres. All analysis was performed with Stata. Results A total of 2115 women was analysed, 50.5% from SI. Average age was 34.3±5.7; significantly higher for SI (34.7±5.6vs33.9±5.8). Most contributing groups were group V: multiparous, singleton, cephalic, term, with previous CS (24.2%), group II: nulliparous, singleton, cephalic, term, induced labour or CS (24%), group I: nulliparous, singleton, cephalic, term, spontaneous labour (11.45%), group VIII: multiple pregnancy (10.7%) and group X: singleton, cephalic, pre-term (10.4%). Differences for type of birth centre were observed for groups I, II, V and VIII: I and VIII were more numerous in SI, II and V in GR (chi2; p &lt; 0.05). Conclusions The most numerous groups were I, II e V, concordant with literature. Reduction of CS rates in group V could be obtained through lowering of primary CS rates and by promotion of Vaginal Birth After CS. Healthcare professionals could help to reduce labour-related anxiety and elective CS rates. Key messages The most contributing groups to overall caesarean section rates were groups I, II e V, as reported in literature. Reduction of CS rates could be obtained through lowering rates of primary CS, but also by promotion of Vaginal Birth After CS.

scholarly journals Comparative study of vectis versus manual method for extraction of fetal head during lower segment cesarean section

2016 ◽  
Vol 6 (1) ◽  
pp. 34
Author(s):  
Priyanka HK ◽  
Madhavi Yeddala ◽  
Vimala KR ◽  
Shailaja N. ◽  
Bhat BS ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Neonatal Outcomes ◽  
P Value ◽  
Lower Segment ◽  
Fetal Head ◽  
Abdominal Incision ◽  
Manual Method ◽  
Lower Segment Cesarean Section ◽  
Manual Extraction ◽  
Fundal Pressure

Background: Delivery of fetal head through uterine incision is often the major technical problem during low transverse cesarean section when the presenting part is unengaged. Techniques to deliver head under special circumstances are traumatic to both mother and fetus. This study aims to establish the role of vectis in extraction of fetal head during lower segment cesarean section (LSCS) and to assess associated difficulties or untoward effects of use of vectis over manual method.Methods: The study was undertaken in PESIMSR, Kuppam, Andhra Pradesh over two years. Vectis was used in extraction of fetal head in LSCS in 100 cases of full term pregnancy and maternal and neonatal outcomes were compared with 100 cases of manual extraction.Results: Incision-delivery time interval was similar in both vectis and manual extraction method (p value of 0.390). Vectis group did not require any fundal pressure for extraction of head where as 100% of women in manual extraction group required fundal pressure (p value: <0.001) which is statistically significant. The length of abdominal incision for majority of cases in vectis group was smaller and statistically significant compared to manual extraction group (p value of 0.001). Neonatal outcomes were similar in both the groups.Conclusions: As per our study, usage of vectis has shown significant advantage in reducing maternal discomfort caused due to fundal pressure and length of abdominal incision required, with negligible difference in neonatal and other maternal outcomes in comparison to manual method of extraction.

Acoustic Rhinometry of Asian Noses

2008 ◽  
Vol 22 (6) ◽  
pp. 617-620 ◽  
Author(s):  
Pongsakorn Tantilipikorn ◽  
Perapun Jareoncharsri ◽  
Siriporn Voraprayoon ◽  
Chaweewan Bunnag ◽  
Peter A. Clement
Keyword(s):  
Reference Value ◽  
Acoustic Rhinometry ◽  
Cross Sectional ◽  
Mean Values ◽  
Thai Subjects ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Black Populations ◽  
Female Subjects

Background Each ethnic group has different nasal cavity geometries. The reference value of the minimal cross-sectional area (MCA) and the nasal volume (NV) is mandatory for rhinologic evaluation in regular practice and for research. This study was designed to study the normal value of acoustic rhinometry (AR) in Asian subjects in comparison with other ethnic groups. Methods AR was performed in 135 healthy Thai subjects. Subjects were divided into two groups: group I, with normal anterior rhinoscopic appearance; group II included subjects with asymptomatic, slightly deviated nasal septa. Results The mean of the MCA was 0.61 ± 0.60 cm2 before decongestion and 0.64 ± 0.14 cm2 after decongestion. The mean distance from the nostril to the point of MCA (D) was 1.66 ± 0.59 cm before decongestion and 1.41 ± 0.74 cm after decongestion. The mean of the NV measured between 0 and 4 cm was 3.66 ± 0.67 cm3 before decongestion and 4.18 ± 0.75 cm3 after decongestion. Before decongestion, there were no significant differences in the mean of the MCA, D, and NV between group I and group II subjects; however, there were significant differences in mean MCA and NV after decongestion. There were no differences in the parameters between male and female subjects before decongestion, except for the D, but after decongestion the mean values of the MCA, D, and NV were significantly higher in male subjects compared with female subjects. Conclusion The results of this study can be used as a reference value for Asian ethnicities. Thai subjects had measurements comparable with those of the European study and somewhat different from the study in black populations.

scholarly journals Degree Of Proteinuria In Post-Icteric State Of Hepatitis E Virus (Hev) Infected Patients

2012 ◽  
Vol 7 (2) ◽  
pp. 37-39
Author(s):  
W Nargis ◽  
BU Ahamed ◽  
S Zabeen ◽  
F Alam ◽  
MA Wahab ◽  
...  
Keyword(s):  
Hepatitis E Virus ◽  
Hepatitis E ◽  
Cross Sectional Study ◽  
Urinary Protein ◽  
Age Group ◽  
Cross Sectional ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii

Introduction: Nephropathies, as one of the multiple extrahepatic features of Hepatitis E virus (HEV) infection, can occur in clinically improved HEV hepatitis patients which in majority of the cases remain clinically silent for a long period. By the time these are reported, patients have already developed renal insufficiency which may even lead to renal replacement therapy. Proteinuria, a simple test in practice, can be a useful tool for early detection of the underlying renal impairment. Objective: The aim of this study was to detect the presence of proteinuria and to evaluate the degree of proteinuria in HEV- hepatitis patients during post-icteric state. Materials and Methods: This cross sectional study was conducted on 50 diagnosed patients of clinically improved HEV-hepatitis at the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) with active cooperation of the Department of Hepatology, BSMMU, between July 2006 and June 2007. Cases were chosen carefully, to exclude the acute state of illness and the patients of HEV were selected during their third or fourth follow-up, in their post-icteric phase. The study subjects were grouped according to equal age ranges in group-I (18-26 year) and group-II (27-35 year). Depending on the level of spot urinary protein (mg/dl) the subjects were also categorized as having trace, mild and moderate proteinuria. Results: The mean age of HEV infected subjects was 24.72±2.59 years. The mean spot urinary protein in age group-II patients was raised compared to age group-I and the difference was highly significant (p<0.001). Moreover, there was no significant difference (p>0.05) of spot urinary protein of male and female. Majority of HEV patients (42%) presented with mild proteinuria and mostly (53.3%) was of age group-I. Conclusion: Spot urinary protein concentration should be checked in every HEV- hepatitis patient to detect the presence and level of proteinuria. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10395 JAFMC 2011; 7(2): 37-39

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