Uterine inversion during caesarean section: a case report

The present report aim to sensitise the obstetrician regarding risk of uterine inversion in a scarred uterus and the importance of immediate manual replacement. Represented case is of 40 years gravida five with previous one spontaneous abortion and previous history of three ectopic pregnancies with history of open left salpingectomy for ruptured left tubal ectopic pregnancy and history of laparoscopic right tubal clipping and uterine rupture repair for cornual pregnancy underwent an emergency caesarean section at 34 weeks. Since there were no signs of placental separation, controlled cord traction of placenta was attempted and uterine inversion was noticed. Manual replacement of uterus was done followed by manual removal of the adherent placenta. There was no postpartum haemorrhage. Inversion of uterus during caesarean section is a rare obstetric complication. If unrecognized it could lead to serious morbidity due to haemorrhage and shock. Prompt diagnosis and repositioning of the uterus are important measures in management.

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Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

Khalij-Libya Journal of Dental and Medical Research ◽

10.47705/kjdmr.215207 ◽

2021 ◽

pp. 45-50

Author(s):

Suher Dafaus ◽

Amel Morgham ◽

Nasreen Osman

Keyword(s):

Caesarean Section ◽

Positive Family History ◽

Previous History ◽

Severe Preeclampsia ◽

Intrauterine Fetal Death ◽

Chronic Hypertension ◽

Hypertensive Disorder ◽

Adequate Treatment ◽

History Of ◽

The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181909 ◽

2018 ◽

Vol 7 (5) ◽

pp. 1817 ◽

Cited By ~ 1

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.

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Non Tubal Ectopic Pregnancy

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48986.15326 ◽

2021 ◽

Author(s):

Shohei Tanabe ◽

Takashi Suzuki ◽

Satoshi Shiojima ◽

Satoru Nakayama ◽

Hiroshi Adachi

Keyword(s):

Magnetic Resonance Imaging ◽

Risk Factors ◽

Magnetic Resonance ◽

Maternal Death ◽

Medical Records ◽

Resonance Imaging ◽

Tubal Ectopic Pregnancy ◽

Positive Pregnancy Test ◽

Ectopic Pregnancies ◽

Prompt Diagnosis

Non-tubal ectopic pregnancies are risk factors for maternal death and require prompt diagnosis and treatment. However, there are no established guidelines for their treatment because their rarity and care is individualized. We retrospectively reviewed the medical records of non-tubal ectopic pregnancies at our institution between May 2009 and September 2020. Thirty-four relevant cases were identified, including 14 interstitial, seven cervical, six peritoneal, three caesarean scars, two ovarian, and two rudimentary horn pregnancies; 23 of the 34 cases were diagnosed before treatment using ultrasound or magnetic resonance imaging. All patients were examined before nine weeks of gestation, and 17 were examined for a positive pregnancy test without any symptoms. In conclusion, in our hospital, non-tubal ectopic pregnancies were identified early, resulting in successful treatment without serious complications.

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Radiation-induced meningioma: a descriptive study of 253 cases

Journal of Neurosurgery ◽

10.3171/jns.2002.97.5.1078 ◽

2002 ◽

Vol 97 (5) ◽

pp. 1078-1082 ◽

Cited By ~ 146

Author(s):

Siegal Sadetzki ◽

Pazit Flint-Richter ◽

Tehila Ben-Tal ◽

Dvora Nass

Keyword(s):

Ionizing Radiation ◽

Present Report ◽

Previous History ◽

Latency Period ◽

Content Type ◽

Established Risk Factor ◽

History Of ◽

Radiation Induced ◽

The Mean ◽

Fine Print

Object. Ionizing radiation is the only established risk factor recognized today in the causation of meningioma. The aim of the present report is to describe the demographic and clinical characteristics of a large series of 253 patients with radiation-induced meningiomas (RIMs). These parameters were compared with those of 41 patients with meningiomas in whom there was no previous history of irradiation (non-RIM group) and with other series of patients presented in the literature. Methods. The cases of RIM were recruited from a cohort of appproximately 11,000 individuals who had been treated with ionizing radiation during childhood for tinea capitis and from a group of individuals who, as adults, applied for compensation because of that treatment. The non-RIM group was identified through the Israeli Cancer Registry. Exposure to radiation was carefully validated among all cases of RIM and absence of previous irradiation was verified for all patients in the non-RIM group. Significantly, a lower patient age at diagnosis, higher prevalence of calvarial tumors, higher proportion of multiple meningiomas, and a nonsignificant higher recurrence rate were observed among patients with RIM compared with the non-RIM group. The mean latency period from date of radiation exposure to development of a meningioma among the RIM group was approximately 36 years. Conclusions. The findings of this study agree with those of other studies indicating the demographic, clinical, and even genetic variability between RIM and non-RIM cases. The existence of two different subtypes of meningiomas may have profound implications for screening, early diagnosis, and therapy of meningiomas.

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An analysis of tubal ectopic pregnancy in a rural tertiary care hospital in India: a retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193636 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3466

Author(s):

Chandana Galidevara ◽

Swaramya C.

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

Care Hospital ◽

Common Procedure ◽

Tubal Ectopic Pregnancy ◽

Retrospective Data Analysis ◽

History Of ◽

Wound Discharge ◽

Ectopic Pregnancies

Background: The objective of this study was to analyse distribution of predisposing risk factors for ectopic pregnancy and to study the various modalities of management instituted along with surgical characteristics.Methods: This is a retrospective data analysis of tubal ectopic pregnancies (EP) managed in a tertiary rural referral centre over three years.Results: A total of 160 women were managed for tubal EP. Majority of the women belonged to the age group of 21-30 years (73%). Multigravidae constituted 71.3% of the women and overall, 90.6% women conceived spontaneously. History of ovulation induction was present in 3.7% of women, IUI in 1.2% and IVF in 4.4%. Risk factors encountered in the study include previous EP (9.4%), history of tubal sterilisation (6.9%), caesarean section (13.1%), PID (7.5%), miscarriage (25%), tubal recanalization (3.7%). Conservative management was instituted in 16.8%. Amongst the women managed surgically, 67.5% underwent laparotomy with the remaining being managed laparoscopically. Of the surgically managed patients 72.9% had ruptured EP. There was a predominance of right sided ectopic in our study (79%) and ampullary region of the fallopian tube was the most common site of tubal EP (81.2%). The most common procedure performed was total salpingectomy (56.4%). Supportive treatment with blood transfusion was required amongst 18.8% of the women who had EP. In the postoperative period, fever was noted in 13.5% of women and 2.5% needed intensive care unit admission for hemodynamic stabilisation. The incidence of wound discharge was 12% of women who underwent surgery.Conclusions: This study underpins the importance of early diagnosis, appropriate clinical managementwith timely intervention to improve outcomes associated with EP and to prevent severe morbidity and mortality.

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A case of placenta increta in placenta previa: a rare case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212992 ◽

2021 ◽

Vol 10 (8) ◽

pp. 3245

Author(s):

Badal Das ◽

Debobroto Roy ◽

Malay Sarkar ◽

Krishna Pada Das ◽

Nazmin Khatun ◽

...

Keyword(s):

Rare Case ◽

Placenta Previa ◽

Previous History ◽

Placenta Increta ◽

Decidua Basalis ◽

Adherent Placenta ◽

Rare Case Report ◽

History Of ◽

Scarred Uterus ◽

Caesarean Hysterectomy

Placenta increta, one type of morbidly adherent placenta, is characterized by entire or partial absence of the decidua basalis, and by the incomplete development of the fibrinoid or Nitabuch’s layer and villi actually invading the myometrium. When the internal os is covered partially or completely by placenta, it is described as a placenta previa. Simultaneously these two complications occurring in a post LSCS scarred uterus is a very rare scenario and anticipated frequently to cause catastrophic obstetric outcome. A 32-years-old woman of second gravida, para 1, with previous history of LSCS 7 years back, with living issue one, admitted in our hospital at 35 weeks 5 days gestation with asymptomatic placenta previa with placenta increta. The case was diagnosed effectively by ultrasonography. Intra-operatively, compression sutures and bilateral uterine artery ligature was tried to control hemorrhage which were failed and a quick decision of caesarean hysterectomy was done. Preserving both ovaries, total hysterectomy was the only option to save the mother in our case. Other options attempting to preserve uterus could have ended up with grave consequences in this case. This was a very rare case of asymptomatic placenta previa with placenta increta in a post LSCS scarred uterus and it was successfully managed by judicious caesarean hysterectomy.

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Magnitude and associated factors of caesarean section deliveries among women who gave birth in Southwest Ethiopia: institutional-based cross-sectional study

Archives of Public Health ◽

10.1186/s13690-021-00682-5 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Ayenew Mose ◽

Haimanot Abebe

Keyword(s):

Caesarean Section ◽

Urban Area ◽

Previous History ◽

Cross Sectional Study ◽

Multiple Pregnancies ◽

Sectional Study ◽

Cross Sectional ◽

Southwest Ethiopia ◽

Factors Associated ◽

History Of

Abstract Background Caesarean section is a life-saving comprehensive obstetric procedure of women and newborn performed during childbirth-related complications and should be universally accessible for all pregnant mothers globally. Appropriate use of caesarean section can reduce maternal and perinatal mortality. However, inappropriate use of caesarean section can negatively affect infant health, women health, and future pregnancies. The magnitude and factors associated with caesarean section delivery were not consistent and will vary between different hospitals of Ethiopia. Hence, this study aimed at assessing the magnitude and factors associated with caesarean section deliveries in Southwest Ethiopia. Methods and Materials An institutional-based cross-sectional study was conducted from January 1 to February 29, 2020. A systematic random sampling technique was used to select 551 study participants. A pretested, structured, and face-to-face interview was used to collect data. Data were entered into Epi-data version 4.2.0 and exported to SPSS version 23 for analysis. Bivariate and multivariate analyses were used to identify factors associated with caesarean section deliveries. P values < 0.05 result were considered as a statistically significant association. Results The magnitude of caesarean section deliveries was found to be 32.5 % (95 % CI; 28.6%-36.7 %). Mothers resided in an urban area [AOR = 2.58, (95% CI; 1.66–4.01)], multiple pregnancies [AOR = 3.15, (95% CI; 1.89–5.23), malpresentation [AOR = 3.05, (95% CI; 1.77–5.24)], and previous history of caesarean section [AOR = 3.55, (95% CI; 2.23–5.64) were factors associated with caesarean section deliveries. Conclusions Caesarean section deliveries were found high in the study area. Mothers resided in an urban area, multiple pregnancies, malpresentation, and previous history of caesarean section were factors associated with caesarean section deliveries. Therefore, counselling of mothers on the risk of giving birth through elective caesarean section without absolute and relative medical indications and giving enough time for the trial of vaginal birth after caesarean section are recommended.

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Bladder Injury during Caesarean Section, Surgical and Anaesthetic Management: A Case Report and Review of the Literature

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20210727 ◽

2021 ◽

Vol 6 (3) ◽

pp. 167-169

Author(s):

Shallu Chaudhary ◽

Major Amit Atwal

Keyword(s):

Case Report ◽

Caesarean Section ◽

Urinary Bladder ◽

Rare Complication ◽

Previous History ◽

Anaesthetic Management ◽

Bladder Injury ◽

Review Of The Literature ◽

Emergency Caesarean ◽

History Of

Urinary bladder injury is a rare complication during caesarean section but its incidence is increasing due to growing trend in caesarean deliveries. In this case report, we reported a 32 year old pregnant female with previous history of caesarean section who presented during labour. Emergency caesarean was done and the case was complicated with bladder injury intraoperatively. The injury was immediately identified and was repaired in two layers. This case highlights the anaesthetic and surgical management of inadvertent bladder injury during caesarean section. Keywords: Bladder injury, caesarean section, Emergency caesarean.

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Ectopic pregnancy: a life threatening gynaecological emergency

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164643 ◽

2016 ◽

Vol 6 (1) ◽

pp. 117

Author(s):

Shruti R. Bhoosanoor ◽

Sujani BK ◽

. Urvashi ◽

Gayatri Devi Sivasambu

Keyword(s):

Ectopic Pregnancy ◽

Medical Records ◽

Maternal Morbidity ◽

Previous History ◽

Medical College ◽

Maternal Morbidity And Mortality ◽

Life Threatening ◽

History Of ◽

The Mean ◽

Ectopic Pregnancies

Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality.Methods: This is a retrospective study of ectopic pregnancies managed at M. S. Ramaiah Medical College and Hospital, Bangalore, India over a period of 1 year from March 2015 to March 2016. The medical records of the patients managed for ectopic pregnancy during the period, under review were retrieved and data were collected from registers. There were 30 cases of ectopic pregnancies over one year.Results: Ectopic pregnancy constituted 3% of all gynecological admissions, and its incidence was 2.5%. The mean age of the patients was 26 ± 2 years, 21 of 30 (70%) had ruptured ectopic pregnancies, and the remaining nine (30%) were unruptured. The commonest (20 of 30, 66.6%) clinical presentation was abdominal pain, and the commonest (9 of 30, 30%) identified risk factor was a previous history of induced abortion.Conclusions: Ectopic pregnancy is a recognized cause of maternal morbidity and mortality and has remained a reproductive health challenge to manage.

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