The consequences of fetal reduction for quintuplets after ICSI-ET

A 30-year-old primigravida who conceived following ICSI (Intra Cytoplasmic Sperm Injection) was admitted at 34 weeks of pregnancy with singleton fetus in breech presentation with Gestational diabetes and Gestational hypertension. To start with Quintuplets were diagnosed and she underwent fetal reduction of 3 foetuses at 14 weeks of pregnancy. Follow up USG revealed only one live fetus after one week. At LSCS (Lower Segment Caesarean Section) performed at 37 weeks, the placenta was found to be adherent and was manually removed. There was profuse bleeding after removal of placenta which was not controlled with uterine massage and uterotonics. Placental examination showed 3 fetus payraeceae. Intrauterine examination revealed an adherent fetus which was removed following which the haemorrhage stopped. In pregnancies following fetal reduction, postpartum haemorrhage can result due to retained fetus papyraceus and hence it is essential to make sure all papyraceae were removed.

Download Full-text

SPINAL ANAESTHESIA USING TAYLOR’S APPROACH SAVES THE DAY IN OBESE PARTURIENT.

10.36106/gjra/8514690 ◽

2021 ◽

pp. 228-228

Author(s):

Vishal Vashist ◽

Roohani Mahajan ◽

Bhanu Gupta

Keyword(s):

Caesarean Section ◽

General Anesthesia ◽

General Anaesthesia ◽

Spinal Anaesthesia ◽

Case History ◽

Breech Presentation ◽

Lower Segment ◽

Subarachnoid Block ◽

Lower Segment Caesarean Section ◽

History Of

Subarachnoid block is commonly employed for caesarean deliveries, by virtue of its simplicity in terms of performance, safety for the parturients as compared to general anesthesia. The case history of a 27-yearold female parturiant patient is presented. She was posted for emergency lower segment caesarean section in view of primigravida with breech presentation in labour . She was obese with bodyweight of 102 kg. She had a thick scaly plaque over the back in midline from L1 to L5 area, which is contraindication for administration of spinal anaesthesia via standard median and paramedian approach . Taylor’s approach for administration of the same was tried and proved successful, thus saving the patient from receiving general anaesthesia .

Download Full-text

Efficacy of Tranexamic Acid in Reducing Blood Loss during and After Caesarean Section: A Case control Study

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i1.35154 ◽

2020 ◽

Vol 18 (1) ◽

pp. 22-25

Author(s):

Kavita Sinha ◽

Subhash Pandey ◽

Dipendra Khadka

Keyword(s):

Caesarean Section ◽

Blood Loss ◽

Tranexamic Acid ◽

Apgar Score ◽

Postpartum Haemorrhage ◽

Group Versus ◽

Control Group ◽

Study Group ◽

Lower Segment ◽

Lower Segment Caesarean Section

Introduction: The incidence of caesarean section is increasing day by day. One of the most common complications is primary or secondary postpartum haemorrhage. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in varieties of surgery. Aims: To study the efficacy of tranexamic acid in reducing blood loss during and after the lower segment caesarean section. Methods: Arandomized, case controlled, prospective study was conducted on 100 women undergoing lower segment caesarean section carried out in the Department of Obstetrics and Gynaecology, Nepalgunj Medical College, Kohalpur from Sept 2019 to Feb 2020.Fifty of them were given tranexamic acid immediately before lower segment caesarean section and were compared with 50 others to whom tranexamic acid was not given. Blood loss was collected and measured during two different time interval. The first period was considered from placental delivery to end of lower segment caesarean section and second from the end of lower segment caesarean section to 2 hours postpartum period. Vital signs at time of delivery, at 1 hour and 2 hour postpartum and APGAR score at 1 min and 5 min were studied in both the groups. Results: Tranexamic acid significantly reduced the quantity of blood loss from the placental delivery to 2 hours post-partum: 360.9 ml in the study group, versus 443 ml in the control group (p=0.0008).It also significantly reduced the quantity of blood loss from the end of lower segment caesarean section to 2 hours postpartum:71.5 ml in the study group versus 112.6 ml in the control group (p=0.0002).There was 18% less incidence of postpartum haemorrhage , who received tranexamic acid(p=0.02).There were no significant adverse drug reaction and difference in APGAR score in both the groups. No complications or side effects were reported in either group. Conclusion: Tranexamic acid is safe and effective in reducing blood loss among women undergoing lower segment caesarean section.

Download Full-text

Massive secondary postpartum haemorrhage from rupture of thrombosed uterine artery following lower segment caesarean section

Journal of Obstetrics and Gynaecology ◽

10.1080/01443619750114130 ◽

1997 ◽

Vol 17 (1) ◽

pp. 57-58

Author(s):

S Y Sin, E S M Fung, A Y K Wong, L Ta

Keyword(s):

Caesarean Section ◽

Uterine Artery ◽

Postpartum Haemorrhage ◽

Lower Segment ◽

Lower Segment Caesarean Section

Download Full-text

Successful External Cephalic Version in Early Labour: A Case Report and Literature Review

Journal of Biomedical Research & Environmental Sciences ◽

10.37871/jbres1333 ◽

2021 ◽

Vol 2 (10) ◽

pp. 926-928

Author(s):

Janjua NB ◽

Birmani SA ◽

Maeve White ◽

Sarah Siu ◽

Asish Das

Keyword(s):

Breech Presentation ◽

External Cephalic Version ◽

Lower Segment ◽

Baby Girl ◽

Healthy Baby ◽

Lower Segment Caesarean Section ◽

Amniotic Fluid Volume ◽

Early Labour ◽

Vaginal Deliveries ◽

Labour Pains

Presentation: A 35 year old woman, gravida 7 para 7, all vaginal deliveries, presented with labour pains at 39 weeks’ gestation with intact membranes. Cardiotocograph (CTG) was reassuring. Diagnosis: Breech presentation was confirmed by an ultrasound. Treatment: The patient was offered options of External Cephalic Version (ECV) versus (vs) Lower Segment Caesarean Section (LSCS). She opted for ECV which was successful, followed by controlled artificial rupture of membranes. She delivered a healthy baby girl vaginally and was discharged home on day 1 postpartum. Conclusion: Although intrapartum ECV is not recommended routinely, there is a place for its judicious use in selective cases. The prerequisites include an experienced obstetrician, reassuring CTG, previous vaginal delivery, no obstetric indication for performing LSCS, adequate amniotic fluid volume with intact membranes, early labour, and informed maternal consent. We recommend keeping theatre on standby while performing ECV in case an obstetric complication arises.

Download Full-text

RECURRENT SECONDARY POSTPARTUM HAEMORRHAGE AFTER LOWER SEGMENT CAESAREAN SECTION

Obstetrical & Gynecological Survey ◽

10.1097/00006254-197408000-00008 ◽

1974 ◽

Vol 29 (8) ◽

pp. 539

Author(s):

B. KEANE

Keyword(s):

Caesarean Section ◽

Postpartum Haemorrhage ◽

Lower Segment ◽

Lower Segment Caesarean Section

Download Full-text

A study of effectiveness of injection Depot medroxyprogesterone in postpartum women

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212967 ◽

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.

Download Full-text

Quintuplet Pregnancy Following Transfer of Three Embryos. A Case Report.

10.21203/rs.3.rs-138791/v1 ◽

2021 ◽

Author(s):

Aya Naim Abusheikha ◽

Naim A. Abusheikha ◽

Aseil E. Khatib

Keyword(s):

Rare Case ◽

Monozygotic Twins ◽

Multiple Gestation ◽

Assisted Conception ◽

Lower Segment ◽

Singleton Pregnancy ◽

Fetal Reduction ◽

Lower Segment Caesarean Section ◽

Monozygotic Twinning

Abstract Background: This is a rare case of a quintuplet pregnancy of two sets of monozygotic twins (MZT) co-existing with a singleton pregnancy resulting from transfer of three cleaved embryos. This has not been reported previously in humans, and should be kept in mind when replacing multiple embryos using in vitro fertilization.Case Presentation: A 27 year old female had a successful twin livebirth after fetal reduction of unexpected quintuplet pregnancy following transfer of three embryos To ameliorate the adverse implications of multiple gestation, fetal reduction to twins by intracardiac puncture and aspiration was carried out at 11 weeks’ gestation. The patient has now delivered two healthy babies (a boy and a girl) at 35 weeks and 6 days by a lower segment caesarean section. Conclusion: Clinicians should keep in mind that patients undergoing assisted conception may develop monozygotic twinning of the embryos, which may negatively impact the pregnancy and raise an ethical and psychological dilemma for the patient.

Download Full-text