scholarly journals Intra-operative uterine scar condition and fetomaternal outcome in patients of previous lower segment caesarean section (LSCS) with scar tenderness

2017 ◽  
Vol 5 (11) ◽  
pp. 4911
Author(s):  
Nidhi Gupta ◽  
Renuka Sinha
Keyword(s):  
Signs And Symptoms ◽  
Caesarian Section ◽  
New Delhi ◽  
Lower Segment ◽  
Average Hospital ◽  
Lower Segment Caesarean Section ◽  
Uterine Scar ◽  
Nicu Admission ◽  
One Year ◽  
A Prospective Study

Background: During past few years, there is increasing trend in trial of labor in cases of previous lower segment caesarian section (LSCS). It needs vigilant approach in identifying signs and symptoms of giving way of previous scar. This study is to see the intra-operative uterine scar condition and feto-maternal outcome in patients of previous LSCS with scar tenderness.Methods: This is a prospective study done in Safdarjung hospital, New Delhi. It includes 120 patients of previous lower segment caesarian section with scar tenderness operated as emergency cases over a period of one year. It excludes elective repeat LSCS.Results: During this period repeat emergency LSCS was done in 862 cases and scar tenderness was seen in 120 cases (13.92 %). Out of 120 cases enrolled for the study intra-operative scar was intact in 69 cases (57.5%). Scar was thinned out in 27 cases (22.5%). Scar dehiscence was found in 21 cases (17.5%). Rupture occurred in 3 cases (2.5%) out of which 2 were Fresh still births. NICU admission was done in 11 cases (9.17%). 1 neonatal death occurred. No maternal death was recorded. Average hospital stay was 6 days. Blood transfusion was needed in 23 cases (19.2%).Conclusions: Scar tenderness is a very important tool for predicting scar integrity. All cases of previous LSCS should have institutional delivery.

scholarly journals Evaluation of postoperative outcome of different techniques of lower segment caesarean section

2019 ◽  
Vol 8 (3) ◽  
pp. 951
Author(s):  
Lata Rajoria ◽  
Manisha Kala ◽  
Nupur Hooja ◽  
Smriti Bhargava ◽  
Brijesh Dadhich
Keyword(s):  
Caesarean Section ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Cost Effective ◽  
Care Hospital ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
One Year ◽  
Obstetric Surgery

Background: Caesarean section is the most commonly performed obstetric surgery. A change in the operative technique affects the postoperative outcome. The study was undertaken to study the postoperative outcome of the patient who underwent caesarean section by Pfannensteil Kerr and Misgav Ladach method of lower segment caesarean section.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Postoperative condition of the women was assessed after caesarean section in women with Pfannensteil Kerr and Misgav Ladach method and compared.Results: Most cases in the Misgav Ladach method had breast fed early, had quicker return of bowel activity and earlier ambulation in comparison to the Pfannensteil Kerr method. This difference was statistically significant. Women with the Pfannensteil Kerr method had more postoperative pain, nausea and vomiting. The duration of hospital stay was less in Misgav  technique.Conclusions: Since Misgav Ladach method was a better technique than Pfannensteil Kerr, adopting it routinely would result in considerable reduction in maternal morbidity, decreased hospital stay, better patient satisfaction level and more cost effective.

scholarly journals Evaluation of Uterine Scar on Repeat Second Cesarean Section in Patients with Previous Cesarean Section

1970 ◽  
Vol 3 (1) ◽  
pp. 16-19
Author(s):  
N Nargis ◽  
AK Al-Mahmood ◽  
D Akhter
Keyword(s):  
Cesarean Section ◽  
Tertiary Care ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
History Of ◽  
Uterine Scar ◽  
One Year ◽  
Operative Findings ◽  
A Prospective Study ◽  
Previous Cesarean

To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19

scholarly journals A study of effectiveness of injection Depot medroxyprogesterone in postpartum women

2021 ◽  
Vol 10 (8) ◽  
pp. 3128
Author(s):  
Priya G. Dhameliya ◽  
Parul T. Shah ◽  
Shlok V. Patel ◽  
Dhanvi J. Deliwala ◽  
Kinjal Kotahri
Keyword(s):  
Postpartum Women ◽  
Contraceptive Methods ◽  
Lower Segment ◽  
Postpartum Contraception ◽  
Normal Delivery ◽  
Lower Segment Caesarean Section ◽  
Obstetrics And Gynaecology ◽  
Lower Socioeconomic ◽  
A Prospective Study

Background: Depot medroxyprogesterone (DMPA) injection 150 mg intramuscular was used in postpartum women for contraception in this study, once every 3 months. The aim of the study acceptance and compliance of DMPA, observe side effects related to usage of DMPA and establish its effectiveness as a postpartum contraception method.Methods: This is a prospective study carried out at Obstetrics and Gynaecology department over a period of 9 months and follow up was done. Only patients of full term normal delivery and Lower segment caesarean section (LSCS) were included. They were counselled properly and after their willingness for enrolment they were included in study after taken consent.Results: Out of 50 cases selected maximum patients, 48% were in the age group of 26 to 30, 38% were from lower socioeconomic class. Amenorrhoea and irregular spotting were found in 68% and 42%respectively. There was no case of failure of this contraceptive method in this study.Conclusions: DMPA is an effective and safe method of contraception in lactating period. Proper counselling will increase acceptance of DMPA. Awareness in patients regarding its benefits as compared to other contraceptive methods. 

scholarly journals UTERINE RUPTURE DURING PREGNANCY – CASE REPORT

2021 ◽  
Vol 2 (2) ◽  
pp. 72-76
Author(s):  
Mihai Cristian Dumitrașcu ◽  
Răzvan Fodoroiu ◽  
George Cătălin Nenciu ◽  
Aida Petca ◽  
Răzvan Petca ◽  
...  
Keyword(s):  
Uterine Rupture ◽  
Signs And Symptoms ◽  
Caesarian Section ◽  
Uterine Wall ◽  
Emergency Laparotomy ◽  
Previous Caesarean Section ◽  
Third Trimester ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Uterine Scar

Uterine rupture is a life-threatening complication in pregnancy with no specific signs and symptoms, that requires fast diagnosis and surgical treatment. The main risk factors for uterine rupture are previous caesarean section deliveries and myomectomies, which can lead to improper uterine wall healing. We report a case of a 37-year-old secundigravida in 29 weeks of pregnancy, with prior caesarian delivery that was admitted in our ward for altered general status and abdominal pain. The patient underwent emergency laparotomy during which we found a massive 3500ml hemoperitoneum, 1000 g dead fetus and a rupture in the posterolateral uterine wall. The uterine scar from the previous caesarian section was intact. Uterine rupture is a complication with a growing incidence in past years that is very difficult to predict, which can occur at any time during pregnancy, especially during labour, but also in the second or early third trimester. Fast diagnosis and proper management is imperious because of the catastrophic outcomes uterine rupture is associated with.

scholarly journals CLINICAL PROFILE OF NEONATES WITH RESPIRATORY DISTRESS

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Sandeep Kulhari ◽  
Deepak Choudhary
Keyword(s):  
Intensive Care Unit ◽  
Respiratory Distress ◽  
Respiratory Rate ◽  
Neonatal Intensive Care ◽  
Challenging Problem ◽  
Lower Segment ◽  
Term Neonates ◽  
Lower Segment Caesarean Section ◽  
Common Causes ◽  
A Prospective Study

Background: Respiratory distress (RD) is a challenging problem and is one of the most common causes of admission in neonatal intensive care unit (NICU). Methods: A prospective study was conducted on 50 cases. Term, pre-term and post-term babies both in-borns and out-borns cases were included in the study. Results: Of the 50 cases admitted with RD, 31 babies (62%) were delivered vaginally and 19 (38%) by lower segment caesarean section (LSCS). There were 33 (66%) males and 17 (34%) females in the study. There were 23 (46%) pre-term babies, 26 (52%) term and 1 (2%) post-term neonates who were admitted with RD. The majority of cases 42 (82%) presented with increased respiratory rate, chest in drawings. 41 (82%) babies had flaring of alae nasi. Conclusion: Increased respiratory rate along with chest in drawing, flaring of alae nasi are the presentation of RD in majority of cases. Keywords: Respiratory distress (RD), Flaring of alae nasi are, Tachypnea.

scholarly journals The clinical study of vaginal birth after caesarean section

2020 ◽  
Vol 9 (12) ◽  
pp. 4855
Author(s):  
Amarpali K. Shivanna ◽  
Spandana S. ◽  
Rajani Vaidya
Keyword(s):  
Caesarean Section ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Modern Medicine ◽  
Care Hospital ◽  
Foetal Mortality ◽  
Maternal Morbidity And Mortality ◽  
Nicu Admission ◽  
One Year ◽  
A Prospective Study

Background: VBAC has reduced the rate of repeat caesarean section in modern medicine. VBAC-TOL is successful in 60-80% of acceptable candidates if applied to all patients presenting with prior caesarean procedure (8.2-8.5%), there is potential to increase the overall vaginal delivery rate by 5%. Though the safety of VBAC in carefully selected patients have been demonstrated in several studies, controversy continues over when to advise patients who had caesarean section to undergo TOL. The purpose of current study was to know the success of VBAC, to know the maternal morbidity and mortality and foetal outcome in VBAC group.Methods: It was a prospective study performed on women with one previous LSCS admitted to tertiary care hospital for a period of one year from August 2018 to August 2019 at DM Waynad institute of medical sciences, Waynad.Results: In the present study 292 women with one previous LSCS were selected, among them 32 women had elective LSCS for various indications, 260 women underwent TOL. Among 260 women, 152 women achieved VBAC (58.46%) and 108 women underwent LSCS following failed TOL. Maternal morbidity was 9.61%. The incidence of scar dehiscence was 2.69% and uterine rupture was 0.38%. There was no maternal and foetal mortality in this study. NICU admission was 4.6%.Conclusions: Trial of labour should be encouraged in women with one previous LSCS with no obstetric complications.

scholarly journals Ultrasonographic measurement of uterine lower segment scar thickness in cases of previous one caesarean section and obstetric outcome

2018 ◽  
Vol 7 (11) ◽  
pp. 4454
Author(s):  
Trupthi Ganapathi ◽  
Hemangi K. Chaudhari
Keyword(s):  
Caesarean Section ◽  
Uterine Rupture ◽  
Inverse Correlation ◽  
Developed Countries ◽  
Lower Uterine Segment ◽  
Obstetric Outcome ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Near Term ◽  
Uterine Scar

Background: Vaginal birth after caesarean section (VBAC) has become an integral part of modern obstetrics with more than 1lakh VBACs achieved each year nationwide. Several studies have reported perinatal risks associated with failed trial of labour and uterine rupture in women attempting VBAC, due to concerns about these complications, the rate of VBAC deliveries has continued to fall in developed countries, with an inverse increase in Caesarean Sections (CS). To better assess the risk of uterine rupture, many authors have proposed sonographic measurement of scar or lower uterine segment (LUS) thickness near term, assuming that there is an inverse correlation between LUS thickness and the risk of uterine scar defect. Therefore, this assessment for the management of women with prior CS has increased safety by selecting women with the lowest risk of uterine rupture.Methods: Present study was a prospective observational study which assessed the obstetric outcome in women with previous lower segment caesarean section willing for trial of labour. Secondly, authors aimed to ascertain the best cut off values for predicting uterine rupture.Results: Present study found that as duration between previous LSCS and next pregnancy increased there was better chance of VBAC. As the baby weight increased VBAC rate reduced. Study also showed that scar thickness of 2.55mm and above measured by transabdominal method in the third trimester can be safely given trial of VBAC.Conclusions: Authors thus conclude that measurement of lower uterine segment/ scar thickness can help obstetrician decide whether VBAC is safe or not in patients with previous one LSCS willing for VBAC. Scar thickness of more than 2.55mm can be given safe trial of labour in women with previous one lower segment caesarean section.

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