scholarly journals Relaparotomy Post Cesarean Delivery: Characteristics and Risk Factors.

2021 ◽  
Author(s):  
Alina Weissmann-Brenner ◽  
Barzilay Eran ◽  
Meyer Raanan ◽  
Levin Gabriel ◽  
Harmatz Danielle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Low Birthweight ◽  
Assisted Reproductive Technologies ◽  
Placenta Previa ◽  
Univariate Analysis ◽  
Multivariate Regression Analysis ◽  
Reproductive Technologies ◽  
Second Stage Of Labor ◽  
Second Stage

Abstract Purpose: Relaparotomy following cesarean delivery (CD) is performed at a rate of 0.2-1% of CD. The objective of the present study was to identify risk factors for relaparotomy following CD, and to examine whether there is a difference in the risk of relaparotomy between CD performed during different daytimes. Methods: A retrospective study including all CD over ten years. Cases that underwent laparotomy within one week following CD were compared to those that did not. CDs for placenta accreta were excluded.Results: Sixty-four patients underwent relaparotomy following CD. In univariate analysis relaparotomy was significantly higher pregnancies following assisted-reproductive technologies (39.1%vs. 16.9%), hypertensive disorders of pregnancy (18.8%vs. 7%), twin pregnancies (29.7%vs. 10%), preterm deliveries (34.4%vs. 17.6%), low birthweight (2815gr vs. 3047gr), placenta previa (7.8% vs. 1.3%) low body mass index (22.4 vs. 24.5) and urgent CD (54.7% vs. 40.8%), especially during the second stage of labor. In a multivariate regression analysis, the adjusted odds ratio for relaparotomy was 10.24 in CD due to placenta previa, and 5.28 in CD performed at the second stage of delivery.At relaparotomy, active bleeding was found in 50 patients (78.1%), nearly half received packed cells, 12.5% developed consumptive coagulopathy, and 17.2% needed hospitalization in the intensive care unit. 6.3% underwent a second relaparotomy, mainly due to bleeding.Conclusion: Hypertensive disease, placenta previa, and urgent CDs mainly those performed at the second stage of labor are risk factors for relaparotomy after CD.

Risk Factors and Maternal Morbidity Associated with Unintentional Hysterotomy Extension at the Time of Cesarean Delivery

2018 ◽  
Vol 36 (10) ◽  
pp. 1054-1059 ◽  
Author(s):  
Katherine H. Bligard ◽  
Jennifer K. Durst ◽  
Molly J. Stout ◽  
Shannon Martin ◽  
Alison G. Cahill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Maternal Morbidity ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Skin Antisepsis ◽  
Potential Risk Factors ◽  
Associated Risk Factors

Objective Our aim was to estimate the incidence of unintentional hysterotomy extension at the time of cesarean delivery and to identify associated risk factors and maternal morbidity. Study Design We conducted a secondary analysis of a randomized controlled trial evaluating chlorhexidine-alcohol versus iodine-alcohol for skin antisepsis in women undergoing cesarean delivery. We included patients with a low transverse hysterotomy. The primary outcome was the incidence of unintentional hysterotomy extension. Logistic regression was performed to identify independent factors associated with hysterotomy extension. Maternal morbidity was compared between patients with and without extension. Results Of 1,038 patients meeting the inclusion criteria, 71 (6.8%; 95% confidence interval [CI]: 5.4–8.5%) experienced a hysterotomy extension. Of several potential risk factors assessed, the second stage of labor was the only independent predictor of hysterotomy extension (adjusted odds ratio: 10.2; 95% CI: 2.6–39.8). Hysterotomy extension was associated with increased operative time (73 vs. 55.3 minutes; p< 0.01), need for blood transfusion (relative risk: 5; 95% CI: 1.6–15.2), and rate of additional surgical injury (RR: 17; 95% CI: 6.9–41.8). Conclusion Hysterotomy extensions are not infrequent at the time of cesarean delivery and are associated with increased maternal morbidity. Cesarean delivery during the second stage of labor is the main independent risk factor for hysterotomy extension.

scholarly journals Risk Factors for Postpartum Hemorrhage and its Severe Forms with Blood Loss Evaluated Objectively – A Prospective Cohort Study

2021 ◽  
Vol 43 (02) ◽  
pp. 113-118
Author(s):  
Anderson Borovac-Pinheiro ◽  
Filipe Moraes Ribeiro ◽  
Rodolfo Carvalho Pacagnella
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Blood Loss ◽  
Prospective Cohort Study ◽  
Postpartum Hemorrhage ◽  
Prospective Cohort ◽  
Early Recognition ◽  
Univariate Analysis ◽  
Second Stage Of Labor ◽  
Second Stage

Abstract Objective To identify risk factors related to postpartum hemorrhage (PPH) and severe PPH with blood loss quantified objectively. Methods This is a complementary analysis of a prospective cohort study that included pregnant women delivering vaginally. The total blood loss was obtained through the sum of the volume collected from the drape with the weight of gauzes, compresses and pads used by women within 2 hours. Exploratory data analysis was performed to assess mean, standard deviation (SD), frequency, percentage and percentiles. The risk factors for postpartum bleeding were evaluated using linear and logistic regression. Results We included 270 women. The mean blood loss at 120 minutes was 427.49 mL (±335.57 mL). Thirty-one percent (84 women) bled > 500 mL and 8.2% (22 women) bled > 1,000 mL within 2 hours. Episiotomy, longer second stage of labor and forceps delivery were related to blood loss > 500 mL within 2 hours, in the univariate analysis. In the multivariate analysis, only forceps remained associated with bleeding > 500 mL within 2 hours (odds ratio [OR] = 9.5 [2.85–31.53]). Previous anemia and episiotomy were also related to blood loss > 1,000mL. Conclusion Prolonged second stage of labor, forceps and episiotomy are related to increased incidence of PPH, and should be used as an alert for the delivery assistants for early recognition and prompt treatment for PPH.

scholarly journals Analisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II Di RSUD Dr. H. Moch Anshari Saleh Banjarmasin

2019 ◽  
pp. 39-46
Author(s):  
Dewi Pusparani Sinambela ◽  
St. Hateriah
Keyword(s):  
Univariate Analysis ◽  
Data Retrieval ◽  
Bivariate Analysis ◽  
P Value ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Long Time ◽  
Second Stage Labor

Latar Belakang: Lama Kala II dalam persalinan yaitu jangka waktu mulai dari serviks berdilatasi penuh sampai dengan kelahiran bayi tidak boleh melebihi 2 jam pada primigravidan dan 1 jam pada multigravida. Pemilihan posisi melahirkan sangat dianjurkan untuk memberikan rasa nyaman pada ibu, posisi dapat membantu penurunan janin ke dasar panggul dan mempercepat proses persalinan. Dari data yang diperoleh bulan Januari 2018 jumlah persalinan kala II lama sebanyak 0,30% dari 240 persalinan normal.Tujuan: Menganalisis Perbedaan Posisi Meneran Miring Kiri dan Setengah Duduk Pada Ibu Bersalin Dengan Lama Kala II.Metode: Jenis penelitian ini adalah Analisis kuantitatif. Rancangan penelitian menggunakan quasi eksperiment. Populasi penelitian semua ibu bersalin di RSUD Dr. H. Moch Anshari Saleh Banjarmasin. Pengambilan sebanyak 30 responden. Pengambilan data dilakukan dengan menggunakan ceklist. Analisa data yang dilakukan adalah Analisa Univariat dan Analisa Bivariat dengan uji Fisher Exact Test.Hasil: Responden yang menggunakan posisi meneran miring kiri 15 orang (50%) dan setengah duduk sebanyak 15 orang (50%). Jumlah responden primipara yang mengalami persalinan kala II 60 menit sebanyak 12 orang (40,0%), primipara yang mengalami kala II 60 menit sebanyak 2 orang (6,7%) dan responden multipara yang mengalami kala II 30 menit sebanyak 16 orang (53,3%), multipara yang mengalami kala II 30 menit sebanyak 0 orang (0%) dari hasil uji Fisher Exact Test dengan nilai p sebesar 0,483.Simpulan: Tidak ada perbedaan posisi miring kiri dengan posisi setengah duduk terhadap kemajuan persalinan kala II di RSUD Dr. H. Moch. Anshari Saleh Banjarmasin. Kata Kunci: Lama Kala II, Persalinan, Posisi Meneran.   Analysis of Different Left and Half Posisition Straining on Mother with Second Duration of Labour In RSUD Dr. H. Moch Anshari Saleh BanjarmasinABSTRACT Background: The duration of second stage of labor is the period from the full dilated cervix to the birth of the baby should not exceed 2 hours in primigravida and 1 hour in multigravida. Position selection is very beneficial for giving comfort to the mother, the position can help lower the fetus to the pelvic floor and improve labor. From the data obtained in January 2018 the number of prolonged second stage deliveries was 0.30% of 240 normal deliveries.Objective: Analyze the Differences in Position Meniring Left and Half Seated at the Maternity with Long Time II.Method: This type of research is quantitative analysis. The study design used quasi experiment. The study population of all mothers giving birth at Dr. RSUD H. Moch Anshari Saleh Banjarmasin. Taking as many as 30 respondents. Data retrieval is done using a checklist. Data analysis performed was Univariate Analysis and Bivariate Analysis with Fisher Exact Test.Results: Respondents who used the left oblique piercing position were 15 people (50%) and half sat as many as 15 people (50%). The number of primiparous respondents who increased labor at second time 60 minutes was 12 people (40.0%), primipara who added second stage 60 minutes as many as 2 people (6.7%) and multiparous respondents who used second time 30 minutes as many as 16 people (53.3%), multiparas who replaced time II 30 minutes as many as 0 people (0%) from the results of the Fisher Exact Test with a p value of 0.483.Conclusion: There was no difference in left oblique position with sitting position towards the progress of second stage labor in Dr. Hospital. H. Moch. Ansari Saleh Banjarmasin.  Keywords : Second Duration, Labour, Straining Position 

Patient-Related Risk Factors Associated With Surgical Site Complications After Elective Hand Surgery

Hand ◽  
2020 ◽  
pp. 155894472094426
Author(s):  
Tyler Youngman ◽  
Michael Del Core ◽  
Timothy Benage ◽  
Daniel Koehler ◽  
Douglas Sammer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Surgical Complications ◽  
Multivariate Regression ◽  
Univariate Analysis ◽  
Hand Surgery ◽  
Multivariate Regression Analysis ◽  
Class Iii ◽  
Factors Associated ◽  
Surgical Site Complications

Background: The purpose of this study was to identify independent risk factors associated with an increased rate of surgical site complications after elective hand surgery. Methods: This study is a retrospective review of all patients who underwent elective hand, wrist, forearm, and elbow surgery over a 10-year period at a single institution. Electronic medical records were reviewed, and information regarding patient demographics, past medical and social history, perioperative laboratory values, procedures performed, and surgical complications was collected. Surgical site complications included surgical site infections, seromas or hematomas, and delayed wound healing or wound dehiscence. A univariate analysis was then performed to identify potential risk factors, which were then included in a multivariate regression analysis. Results: A total of 3261 patients who underwent elective hand surgery and met the above inclusion and exclusion criteria were included in this study. The mean age was 57 years, with 65% female and 35% male patients. The overall surgical complication rate was 2.2%. Univariate analysis of patient factors identified male sex; number of procedures >1; history of drug, alcohol, or smoking use; American Society of Anesthesiologists (ASA) class III and IV; and serum albumin <3.5 mg/dL to be significantly associated with complications. However, multivariate regression analysis identified that only ASA class III and IV (odds ratio = 3.27) was significantly associated with surgical complications. Conclusions: Patients classified as ASA class III or IV were identified to be at a significantly increased risk of complications following elective hand surgery. Health factors which triage patients into these 2 groups may represent potentially modifiable factors to mitigate perioperative risk in the elective hand surgery population.

Obstetric risk factors for failure to progress in the first versus the second stage of labor

2002 ◽  
Vol 11 (6) ◽  
pp. 409-413 ◽  
Author(s):  
E. Sheiner ◽  
A. Levy ◽  
U. Feinstein ◽  
R. Hershkovitz ◽  
M. Hallak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Failure To Progress

scholarly journals Risk Factors Affecting the Severity of Full-Term Neonatal Retinal Hemorrhage

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Zhang Yanli ◽  
Zhao Qi ◽  
Lin Yu ◽  
Guo Haike
Keyword(s):  
Risk Factors ◽  
Intracranial Hemorrhage ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Retinal Hemorrhage ◽  
Full Term ◽  
Term Infants ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Prolonged Duration

Objective. The purpose of this study was to explore the underlying clinical factors associated with the degree of retinal hemorrhage (RH) in full-term newborns. Methods. A total of 3054 full-term infants were included in this study. Eye examinations were performed with RetCamIII within one week of birth for all infants. Maternal, obstetric, and neonatal parameters were compared between newborns with RH and controls. The RH group was divided into three sections (I, II, and III) based on the degree of RH. Results. RH was observed in 1202 of 3054 infants (39.36%) in this study. The quantity and proportion of newborns in groups I, II, and III were 408 (13.36%), 610 (19.97%), and 184 (6.03%), respectively. Spontaneous vaginal delivery (SVD), prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage positively correlated with aggravation of the degree of RH in newborns. Conversely, cesarean section was protective against the incidence of RH. Conclusions. SVD, prolonged duration of second stage of labor, advanced maternal age, and neonatal intracranial hemorrhage were potential risk factors for aggravation of the degree of RH in full-term infants. Accordingly, infants with these risk factors may require greater attention with respect to RH development.

scholarly journals EPIDEMIOLOGY AND RISK FACTORS FOR PREMATURE BIRTH

2018 ◽  
Vol 28 (2) ◽  
pp. 629-636
Author(s):  
Anna Mihaylova ◽  
Nikoleta Parahuleva ◽  
Elina Petkova-Gueorguieva ◽  
Stanislav Gueorguiev
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Prenatal Care ◽  
Premature Birth ◽  
Assisted Reproductive Technologies ◽  
Preterm Births ◽  
Developed Countries ◽  
Reproductive Technologies ◽  
Risk Indicators ◽  
Etiological Factors

Premature birth is a significant medical, social and economic problem worldwide. In the 21st Century in developed countries, this problem accounts for over two thirds of neonatal deaths. In Bulgaria, statistics show that 10-12% of all pregnancies end with premature birth. Despite the number of studies in this field and the efforts made by obstetricians and gynecologists, the tendency to increase the number of preterm births has continued in the last decade. Its consequences are multiple complications who lead to a high neonatal mortality in the national and global world. Preterm birth is characterized by complex and vague etiology. A specific cause of premature birth can not be defined, but a set of risk factors is considered, divided into three main groups of etiological factors: socio-economic, medical-biological, and behavioral. Associated with preterm birth socio-economic and behavioral risk factors include poverty, unemployment, low education, poor prenatal care, harmful habits such as smoking, alcohol, drugs and other harmful substances, unhealthy family environment, severe and prolonged stress, excessive physical exercise (lifting weights), trauma (hits or violence), new pregnancies less than 6 months after previous birth, unhealthy diet and low mother BMI, etc. Essential for the preterm birth is also the medico - biological etiological factors. One of these is uterine enlargement, as the main reason for this may be the presence of: multiple pregnancies that occurred naturally or after using assisted reproductive technologies or polyhydramnios (increased amount of amniotic fluid). Other risk factors include: placenta previa, incorrect position of the fetus, myoma, uterine cervix malformations (including cerebrovascular insufficiency), preeclampsia, uterine contractions, acute infections during pregnancy (vaginal - chlamydia, trichomonas, mycoplasma , toxoplasmosis, bacterial vaginosis, viral rubella, cytomegalovirus, herpes, influenza, adenovirus infection, chronic diseases (hypertension, cardiovascular diseases, diseases of the lungs, liver or kidney anemia and etc.), genetic factors, previous premature birth, etc. These risk indicators are subject to detailed analysis in the work of a number of authors. To limit preterm births, a number of studies have been conducted to identify and identify the risk factors that are relevant to it. Identifying and recognizing their effects and impact leading to premature birth will significantly reduce the severe health, economic and social consequences as well as reduce the risk of neonatal death. In order to reduce the frequency of preterm births, adequate and specialized prenatal care is essential. They must be individually tailored for each particular case of pregnancy and take into account the complex of risk predispositions.

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