scholarly journals Vaginal repaired cesarean section diverticulum is beneficial in women with two prior cesarean sections

2020 ◽  
Author(s):  
Yizhi Wang ◽  
Jiarui Li ◽  
Husheng Wang New ◽  
Xipeng Wang

Abstract Background: The aim of this study was to evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs). Methods : From January 2012 to December 2014, 248 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital. These included 193 women with one previous cesarean section and 55 women with two previous cesarean sections. Excision and suture of CSD was performed through a vaginal approach. The duration of menstruation, the length, width and depth of the CSD and thickness of the remaining muscular layer (TRM) were evaluated before and after surgery by transvaginal three-dimensional (3D) color Doppler ultrasound. Results: A total of 221 (89.11%) women were followed-up for more than 3 months, and 168 (67.74%) women were followed-up for more than 6 months. There were significant differences in the average duration of menstruation (7.77±2.05 and 8.02±2.06 days VS 13.99±3.71 days), the average size of CSD (5.54*9.19*5.60 and 5.75*9.04*6.18 mm VS 7.99*12.43*6.62 mm) and the TRM (7.61±2.52 and 7.60±3.00 mm VS 2.51±1.02 mm) after surgery compared with those figures before surgery. The results of this study reveal that vaginal repair could shorten the duration of menstruation and improve anatomical defects (P< 0.05). Moreover, there was no significant difference in the effect of clinical repair between women with one or two previous cesarean sections (P> 0.05). Conclusion: In CSD patients, the clinical effectiveness of vaginal repair was equivalent between women with one or two previous cesarean sections.

2020 ◽  
Author(s):  
Yizhi Wang ◽  
Jiarui Li ◽  
Xipeng Wang

Abstract Background: The aim of this study was to evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs). Methods: From January 2012 to December 2014, 248 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital. These included 193 women with one previous cesarean section and 55 women with two previous cesarean sections. Excision and suture of CSD was performed through a vaginal approach. The duration of menstruation, the length, width and depth of the CSD and thickness of the remaining muscular layer (TRM) were evaluated before and after surgery by transvaginal three-dimensional (3D) color Doppler ultrasound. Results: A total of 221 (89.11%) women were followed-up for more than 3 months, and 168 (67.74%) women were followed-up for more than 6 months. There were significant differences in the average duration of menstruation (7.77±2.05 and 8.02±2.06 days VS 13.99±3.71 days), the average size of CSD (5.54*9.19*5.60 and 5.75*9.04*6.18 mm VS 7.99*12.43*6.62 mm) and the TRM (7.61±2.52 and 7.60±3.00 mm VS 2.51±1.02 mm) after surgery compared with those figures before surgery. The results of this study reveal that vaginal repair could shorten the duration of menstruation and improve anatomical defects (P< 0.05). Moreover, there was no significant difference in the effect of clinical repair between women with one or two previous cesarean sections (P> 0.05). Conclusion: In CSD patients, the clinical effectiveness of vaginal repair was equivalent between women with one or two previous cesarean sections.


2019 ◽  
Author(s):  
Yizhi Wang ◽  
Jiarui Li ◽  
Xipeng Wang

Abstract Study Objective: To evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs). Design: Observational cohort study. Setting: Shanghai First Maternity and Infant Hospital. Patients: A total of 248 patients with CSD who underwent vaginal repair between January 2012 and December 2014. Interventions: Vaginal excision and suture of CSD. Measurements: From January 2012 to December 2014, 248 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital. These included 193 women with one previous cesarean section and 55 women with two previous cesarean sections. Excision and suture of CSD was performed through a vaginal approach. The duration of menstruation, the length, width and depth of the CSD and thickness of the remaining muscular layer (TRM) C were evaluated before and after surgery by transvaginal three-dimensional (3D) color Doppler ultrasound. Results: A total of 221 (89.11%) women were followed-up for more than 3 months, and 168 (67.74%) women were followed-up for more than 6 months. There were significant differences in the average duration of menstruation (7.77±2.05 and 8.02±2.06 days VS 13.99±3.71 days), the average size of CSD (5.54*9.19*5.60 and 5.75*9.04*6.18 mm VS 7.99*12.43*6.62 mm) and the TRM (7.61±2.52 and 7.60±3.00 mm VS 2.51±1.02 mm) after surgery compared with those figures before surgery. The results of this study reveal that vaginal repair could shorten the duration of menstruation and improve anatomical defects (P< 0.05). Moreover, there was no significant difference in the effect of clinical repair between women with one or two previous cesarean sections (P> 0.05). Conclusion: In CSD patients, the clinical effectiveness of vaginal repair was equivalent between women with one or two previous cesarean sections. Trial registration: This study was approved by the Ethics Committee of Shanghai First Maternity and Infant Hospital, affiliated with Tongji University (KS1512), and was conducted in accordance with the Declaration of Helsinki. All patients signed written informed consent to participate in this study. The author(s) agreed to provide copies of the appropriate documentation if requested.


2019 ◽  
Author(s):  
Yizhi Wang ◽  
Jiarui Li ◽  
Xipeng Wang

Abstract Study Objective To evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs). Design Observational cohort study. Setting Shanghai First Maternity and Infant Hospital. Patients A total of 248 patients with CSD who underwent vaginal repair between January 2012 and December 2014. Interventions Vaginal excision and suture of CSD. Measurements and Main Results From January 2012 to December 2014, 248 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital. These included 193 women with one previous cesarean section and 55 women with two previous cesarean sections. A total of 221 (89.11%) women were followed-up for more than 3 months, and 168 (67.74%) women were followed-up for more than 6 months. Excision and suture of CSD was performed through a vaginal approach. The duration of menstruation, the size of the CSD and the thickness of the remaining muscular layer (TRM) were evaluated before and after surgery. Of the women who had one previous cesarean section, before surgery, the average duration of menstruation was 13.99±3.71 days, the average size of CSD was 7.99*12.43*6.62 mm, and the TRM was 2.51±1.02 mm. At 3 and 6 months after vaginal repair, the average duration of menstruation was 7.77±2.05 and 8.02±2.06 days; the average size of the CSD was 5.54*9.19*5.60 and 5.75*9.04*6.18 mm; and the mean TRM was 7.61±2.52 and 7.60±3.00 mm. Of the women who had two previous cesarean sections, before and at 3 and 6 months after surgery, the average duration of menstruation was 15.05±2.86, 8.06±2.11, and 7.89±2.32 days; and the size of CSD was 7.76*11.71*6.20, 6.22*10.17*5.89, and 5.42*11.58*5.08 mm; and the TRM was 3.17±1.55, 8.04±2.57, and 8.22±2.42 mm. The results of this study reveal that vaginal repair could shorten the duration of menstruation and improve anatomical defects (P< 0.05); moreover, there was no significant difference in the effect of clinical repair between women with one or two previous cesarean sections (P> 0.05). Conclusion In CSD patients, the clinical effectiveness of vaginal repair was equivalent between women with one or two previous cesarean sections.


Author(s):  
M.A. Esetov , A.M. Esetov , I.V. Ramazanova

Seven cases of ultrasound diagnosis of velamentous insertion (VCI) of the umbilical cord at singleton pregnancies on 21–34 weeks of gestation are presented. The ultrasound picture two of the VIC types is presented: fixed in 5 cases and free in 2 cases. In one case the VCI was in the lower third of the uterus and the wound has been diagnosed the vasa previa. In other cases, the VCI was in middle third of the uterus. In all cases delivery was at 37–39.1 weeks of gestation. In 4 cases Cesarean sections were performed. In two of the VCI cases elective Ce sarean sections were performed for the following indications: previous Cesarean section and vasa previa. VCI can reliably be detected prenatally by gray-scale and color Doppler ultrasound. For fixed VCI located in the middle-upper of the uterus, no change in standard obstetrical management seems to be required.


2021 ◽  
Vol 11 (1) ◽  
pp. 168-173
Author(s):  
Qiongyan Dai ◽  
Yun Wang

Objective: To observe the early changes of uterine incision defects after cesarean section by transvaginal color Doppler ultrasound, and to analyze the risk factors of their formation. Methods: A total of 181 women who underwent cesarean section from September 2016 to June 2018 and who underwent transvaginal ultrasound examination at 6 weeks, 3 months, and 6 months after birth were divided into two groups. (142 cases) and incision defect group (39 cases). The incision changes and the risk factors of incision defect in different periods of postpartum were analyzed. Results: Compared with the group with good incision healing, the length of the incision defect in the cesarean section at 6 months after delivery was shorter than that at 6 weeks after delivery (P < 0.05). The results of non-conditional logistic regression showed that the number of cesarean sections increased and the number of operators was lower. Seniority, postoperative infection, posterior uterine position, and incision close to the cervix are risk factors for poor healing of uterine scars. Conclusion: As the postpartum time increases, the length of the cesarean section incision defect shortens; multiple cesarean sections, puerperal infections, posterior uterus, low incision position and inexperience of the operator are the risk factors for the formation of uterine incision defects and increase uterine scars. Risk of poor healing.


Author(s):  
Poornima M.

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.


2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Anum Naz ◽  
Rabia Bhatti

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan. Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group. Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section. Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section. doi: https://doi.org/10.12669/pjms.37.2.3823 How to cite this:Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
E. A. Abdelfattah ◽  
T. M. Abd-El Dayem ◽  
H. M. Galal ◽  
S. S. Taylon

Objectives: Our aim was to study the prevalence of isthmocele in cases with previous cesarean section scar presented to El Shatby maternity university hospital and its association with gynecological complications. Material and Methods: After approval of the ethics committee of Alexandria faculty of medicine, a sample of 300 patients delivered by cesarean section since 6 months or more presented by one or more of the following symptoms: Abnormal uterine bleeding (AUB) dysmenorrhea, secondary infertility, and lower abdominal pain were selected from the gynecology clinic of El Shatby maternity university hospital. All patients were subjected to history taking, clinical, and gynecological examination. Post-menstrual 2D transvaginal ultrasonography was done. Where the niche or isthmocele was seen as triangular or dome- shaped echo-free space. Data were collected and entered to the computer using Statistical Package for the Social Science program for statistical analysis. Results: Niche was found in 44 cases. Most of them were symptomatic. Duration from the last (CS) was statistically significant. Symptoms were related to number of previous cesarean sections. Conclusion: The incidence of post-cesarean section niche in El Shatby Maternity hospital was 14.67%. Most common symptoms were AUB and dyspareunia.


2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Takako Sugiura ◽  
Yuka Sato ◽  
Naoyuki Nakanami ◽  
Kiyomi Tsukimori

Sirenomelia is a rare congenital malformation characterized by varying degrees of fusion of the lower extremities. It is commonly associated with severe urogenital and gastrointestinal malformations; however, the association of sirenomelia with anencephaly and rachischisis totalis is extremely rare. To our knowledge, the prenatal sonographic images of this association have not been previously published. Here, we present prenatal sonographic images of this association, detected during the 17th week of gestation through combined two-dimensional, four-dimensional, and color Doppler ultrasound. Two-dimensional ultrasound images showed anencephaly, spina bifida, and possible fusion of the lower limbs. Three-dimensional HDlive rendering images confirmed the final diagnosis of sirenomelia with anencephaly and rachischisis totalis. The patient opted to undergo medical termination of pregnancy and delivered a fetus with fused lower limbs, anencephaly, and rachischisis totalis confirming the in utero imaging findings. Awareness of these rare associations will help avoid misdiagnoses and facilitate prenatal counselling. This case highlights the importance of a thorough ultrasound examination.


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