scholarly journals Non-descent vaginal hysterectomy in previous cesarean section: a retrospective study

2020 ◽  
Vol 9 (8) ◽  
pp. 3239
Author(s):  
K. J. Jacob ◽  
Divya M. B.
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Hysterectomy ◽  
Bladder Injury ◽  
Previous Caesarean Section ◽  
Medical College ◽  
Common Complaint ◽  
Parity Number ◽  
History Of ◽  
Previous Cesarean

Background: Non-descent vaginal hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. As there is an increase in caesarean section, hysterectomy in women with previous caesarean section is also increasing. The objective of this study is to assess the feasibility and safety of non-descent vaginal hysterectomy in patients with previous caesarean section.Methods: This is a retrospective study conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur from January 2017 to December 2018. Non-descent vaginal hysterectomy in 24women with previous caesarean section was studied. Details regarding age, parity, number of caesarean sections, indication of surgery, intraoperative and postoperative complications were evaluated.Results: All 24 women underwent non-descent vaginal hysterectomy successfully. 10 women (41.7%) were between 46-49 years. Commonest indication of hysterectomy was fibroid uterus (41.7%) and most common complaint was heavy menstrual bleeding (79%). There was bladder injury in one woman with history of previous 2 caesarean section. 3 women developed UTI in postoperative period.Conclusions: Vaginal hysterectomy is associated with lower complications and more rapid recovery. A successful NDVH in previous caesarean section depends on the expertise and experience of the surgeon. NDVH in previous caesarean is safe in expert hands.

scholarly journals INCIDENCE OF PLACENTA PREVIA IN POST CAESAREAN PREGNANCY AND MATERNAL OUTCOME

2019 ◽  
pp. 1-3
Author(s):  
Sasindra Kumar Das
Keyword(s):  
Caesarean Section ◽  
Placenta Previa ◽  
Maternal Outcome ◽  
Bladder Injury ◽  
Previous Caesarean Section ◽  
Artery Ligation ◽  
Medical College ◽  
Internal Iliac ◽  
History Of ◽  
Previous Cesarean

BACKGROUND: Placenta previa, the most catastrophic complication not only poses a risk to the fetus but also endangers the mother's life. AIM:To find the incidence of placenta previa in patients with previous caesarean section and to study the maternal outcome. METHODS: A hospital based prospective study carried out in the Department of Obstetrics and Gynaecology of Gauhati Medical College and Hospital, Guwahati, Assam from 1st June 2018 to 31st May 2019. During this period, 2100 patients with history of previous caesarean section were identified and 66 patients were found to have placenta previa. RESULTS:The incidence of placenta previa was found to be 3.14%. The incidence increases with increase in number of caesarean section. Maximum patients were unbooked from rural area within the age group of 26-30 years. Outcome was studied by need of blood transfusion in 87.7%, postpartum haemorrhage in 19.6%, adherent placenta previa in 10.7%, hysterectomy in 15.1%, Internal iliac artery ligation in 6% and bladder injury in 9.09%. CONCLUSION:Incidence of placenta previa is high in patients with previous cesarean section.

Risk Analysis of Placenta Previa in Subsequent Pregnancy with History of Cesarean Section: A Case Control Study in Faridpur Medical College Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 52-54
Author(s):  
Dilruba Zeba ◽  
Shila Rani Das ◽  
Swapan Kumar Biswas ◽  
Rajib Kumar Roy ◽  
Abul Fattah ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Placenta Previa ◽  
Subsequent Pregnancy ◽  
Medical College Hospital ◽  
Bladder Injury ◽  
College Hospital ◽  
Medical College ◽  
History Of ◽  
Previous Cesarean

Placenta previa is a life threatening pregnancy complication where placenta partially or completely covers the internal cervical os causing serious adverse consequence for both mother and baby. History of cesarean delivery is an important risk factor for placenta previa. Which have a increased chance of cesarean hysterectomy and bladder injury because of an associated accrete syndrome. The objective of this study is to analyze the outcome of placenta previa with history of cesarean section. This is a prospective study done in Faridpur Medical College Hospital, Bangladesh from 01.01.2013 up to 31.12.14. Total 18 (study group) patients had undergone cesarean delivery with placenta previa and history of previous cesarean section. Among 18 patients maternal age range was 25- 40, parity 1-4, emergency hysterectomy was done in 11, average blood transfusion 2-8 and other morbidity like urinary bladder injury was 4. So we decided to conduct the study to evaluate the frequency of the placenta previa and morbidity related to number of previous cesarean deliveries.Faridpur Med. Coll. J. Jul 2015;10(2): 52-54

scholarly journals Non-descent vaginal hysterectomy in women with previous caesarean section scar: our experience

2018 ◽  
Vol 7 (6) ◽  
pp. 2404
Author(s):  
G. D. Maiti ◽  
Ashok Pillai ◽  
Tony Jose ◽  
P. R. Lele
Keyword(s):  
Caesarean Section ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Bladder Injury ◽  
Previous Caesarean Section ◽  
Technological Advancement ◽  
Scarred Uterus

Background: Hysterectomy is one of the common gynaecological major surgeries performed worldwide. In spite of technological advancement with laparoscopic and robotic hysterectomy conventional hysterectomy through vaginal route of nonprolapse uterus popularly known as, Non-Descent Vaginal Hysterectomy (NDVH) remains a justifiable cost effective, cosmetically appealing option especially in resource-crunched developing country. NDVH in post caesarean scarred uterus too a technically challenged procedure requiring skills and expertise.Assessment of technical feasibility and safety of non-descent vaginal hysterectomy in women with previous caesarean section scar were studied.Methods: The study was a prospective observational study of 72 patients with LSCS scar requiring hysterectomy for benign conditions were selected based on the inclusion and exclusion criteria carried out from June 2012 to May 2017. Operating time, blood loss, surgical techniques, intra/postoperative challenges, conversion to laparotomy or laparoscopic assistance and length of hospital stay were recorded for each case. Patients were followed up till 03 months of surgery.Results: Vaginal hysterectomy was successful in all cases. Morcellation, bisection or myomectomy, were done in 86% cases. Two patients had bladder injury, which was repaired vaginally, two cases required support of laparoscopy.  No patients needed blood transfusion. None of the patients were converted to laparotomy.Conclusions: Vaginal hysterectomy is a safe and effective procedure for benign non-prolapsed uteri in women with previous caesarean section scar when uterine size is less than 14 weeks. Standby operating laparoscopy provides added advantages to surgeon in doubtful or difficult cases to avoid conversion laparotomy.

scholarly journals Diagnostic and therapeutic role of laparoscopy in chronic abdominal pain: a retrospective study in a rural tertiary care teaching hospital

2018 ◽  
Vol 6 (7) ◽  
pp. 2256
Author(s):  
Anbarasu Sasivannan ◽  
Shanthi Ponnusamy ◽  
Iyanar Kannan
Keyword(s):  
Abdominal Pain ◽  
Retrospective Study ◽  
Abdominal Cavity ◽  
Tertiary Care ◽  
Chronic Abdominal Pain ◽  
Medical College ◽  
Common Complaint ◽  
History Of ◽  
Entire Abdominal Cavity

Background: Abdominal pain was the third most common complaint of individuals often recurrent and needs immediate care. The ability of the method to access and inspect the entire abdominal cavity and retro-peritoneum without harming the structures of it places laparoscopy as the procedure of choice in the diagnosis of abdominal pain.Methods: The study is a retrospective study conducted in Tagore Medical College and Hospital, Chennai during the period of 1st January 2013 to 31st December 2017. Patients of age above 18 years with history of abdominal pain for 6 months or more were included in the study. Basic investigations were also done for the patient. Based on the clinical examinations, patients were subjected to diagnostic laparoscopy. All cases were done as elective surgeries.Results: A total of 48 patients were found in the record, in which the diagnosis remained uncertain despite of all important investigations. The majority of the patients 19 (40%) were in the age group of 21-40 years followed by 17 (36%) in 41-65 years. The duration of pain ranged between 6 months to 1 years. On laparoscopic examination, majority of patients (46%) were diagnosed with chronic appendicitis.Conclusions: Laparoscopy is not only safe, but also quick and effective investigation tool for chronic abdominal pain.

scholarly journals Catastrophic Maternal Complications of Morbidly Adherent Placenta in Patients with History of Previous Caesarean Delivery

2020 ◽  
Vol 33 (2) ◽  
pp. 96-100
Author(s):  
Mumtahena Amir ◽  
Salma Rouf ◽  
Saleha Begum Chowdhury
Keyword(s):  
Caesarean Section ◽  
Multiorgan Failure ◽  
Cross Sectional Study ◽  
Bladder Injury ◽  
Previous Caesarean Section ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
History Of

Objective:The study is aimed to describe the grave maternal outcomes encountered inpatients having morbidly adherent placenta along with history of previous caesarean section. Materials and Methods: This was a cross-sectional study from September 2014 to August2015. All the patients attended in the in-patient department of obstetrics & gynaecology inDMCH during the study period having morbid adhesion of placenta (diagnosed antenatallyby USG or diagnosed preoperatively) along with history of previous caesarean section. Result: Total 10,805 obstetric patients delivered during the study period, of which 6,337patients had caesarean sections. Out of them 37 pregnant patients were found to havemorbid adhesion of placenta along with history of previous C/S. The incidence is 1 in 292deliveries. All of the 37 patients needed hysterectomy for intractable per operativehaemorrhage. All the patients needed transfusion of more than 04 units of blood. Nineteenpatients needed ICU supports Ten (27%) patients died. Other grave complications werehypovolemic shock (19 patients), bladder injury (16patients), renal failure (07 patients),multiorgan failure (07 patients) and DIC (06 patients). Conclusion: All the patients of morbidity adherant placenta with previous Caesarean Sectionneeded caesarian hysterectomy and ten patients died. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(2) : 96-100

scholarly journals Non-descent vaginal hysterectomy in previous cesarean section: a retrospective study of 30 cases

2017 ◽  
Vol 6 (7) ◽  
pp. 2771
Author(s):  
Rameshkumar R. ◽  
Suma Moni ◽  
Dhanlaxmi L. ◽  
Leena Kamat
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Cesarean Section ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Previous Cesarean Section ◽  
Operative Complications ◽  
History Of ◽  
Previous Cesarean ◽  
Post Operative Complications

Background: Non-Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. Objective of present study was to assess safety, feasibility of NDVH in patients with previous cesarean section.Methods: Retrospective study was conducted in department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences, Dharwad, India from April 2008 to June 2016. Effort was made to perform hysterectomies vaginally in women with benign conditions with history of one, two or three caesarean sections. Information regarding age, parity, number of previous LSCS, uterine size, blood loss, duration of operation, difficulties in separating bladder, intra -operative, post-operative complications were recorded.Results: Total thirty cases were selected for NDVH with history of one, two and three cesarean sections. All successfully underwent NDVH, except one in which bladder injury occurred which was repaired at same time vaginally. Thirteen patients had previous one Lower Segment Cesarean Section (LSCS), sixteen had two LSCS and one had three LSCS. Commonest indication was abnormal uterine bleeding followed by leiomyoma of uterus. Mean duration of surgery was 97 min. Mean blood loss was 150 ml. Post-operative complications were minimal. Patient mobility, resumption of daily activities was fast. Mean hospital stay was 4-5 days.Conclusions: Vaginal hysterectomy is safe, cost effective method of hysterectomy in women with previous cesarean section scar requiring hysterectomy for benign conditions with fewer complications, shorter hospital stay and less morbidity.

scholarly journals Study of iatrogenic bladder injury in vaginal hysterectomy: our experience

2018 ◽  
Vol 7 (3) ◽  
pp. 903
Author(s):  
Pooja S. Singh ◽  
Haresh U. Doshi
Keyword(s):  
Retrospective Study ◽  
Early Diagnosis ◽  
Surgical Approach ◽  
Vaginal Hysterectomy ◽  
Treatment Method ◽  
Gynecologic Surgery ◽  
Bladder Injury ◽  
Benign Diseases ◽  
Medical College ◽  
Urologic Complications

Background: This study was carried out to calculate the incidence of bladder injury detected during benign gynecologic vaginal hysterectomy. This investigation examined the clinical features of urologic complications during gynecologic surgery and outcome of their management.Methods: It was a retrospective study done at Department of Gynecology, GCS medical college, Ahmedabad from year 2012-2016. All patients undergoing vaginal hysterectomy for benign diseases were included in the study. This study assessed the causative disease and surgical approach type, and treatment method of the bladder injury.Results: Of these 237 patients who underwent vaginal hysterectomies, 3 (1.26%) had bladder perforation. All the 3 cases of bladder injury underwent primary suturing during surgery without complications.Conclusions: Bladder injury was the most common urological injury during obstetric and gynecologic surgery. Early diagnosis and urologic intervention is important for better outcomes.

scholarly journals Pregnancy complicated by previous cesarean section: a retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4470
Author(s):  
Poornima M.
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Medical Records ◽  
Neonatal Outcome ◽  
Perinatal Morbidity ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Exclusion Criteria ◽  
History Of ◽  
Previous Cesarean

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.

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 Ergometrine-induced atrial fibrillation at caesarean section

2019 ◽  
Vol 12 (2) ◽  
pp. e226747 ◽  
Author(s):  
Samuel Birch ◽  
Corrine Lu
Keyword(s):  
Atrial Fibrillation ◽  
Caesarean Section ◽  
General Population ◽  
Spontaneous Rupture ◽  
Regional Hospital ◽  
Previous Caesarean Section ◽  
Autonomic Tone ◽  
Uterine Contractions ◽  
History Of ◽  
Obstetric Population

A 36-year-old woman with a history of one previous caesarean section presented to the birthing suite of a regional hospital with spontaneous rupture of membranes at 39+2/40 weeks. Syntocinon was administered to initiate uterine contractions in the absence of labour, as the patient desired vaginal birth. A caesarean section was subsequently indicated and ergometrine was administered for uterine atony. The patient immediately developed atrial fibrillation (AF). AF is the most common sustained arrhythmia in the general population, but is rare in the obstetric population. AF occurring in an intrapartum setting following the administration of syntocinon and ergometrine, is not documented in the literature. We suggest the initiation of paroxysmal AF was precipitated by an abrupt alteration in autonomic tone caused by administration of syntocinon followed by ergometrine.

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