scholarly journals Study on the Method of Enucleation of Anterior Uterine Fibroids by Transverse Incision of Lower Uterine Segment During Cesarean Section

2021 ◽  
Author(s):  
Li Xia ◽  
Jinxiao Lin ◽  
Rongli Xu ◽  
Wenqiang You ◽  
Yan Dai
Keyword(s):  
Cesarean Section ◽  
Operation Time ◽  
Anterior Wall ◽  
Control Group ◽  
Study Group ◽  
Transverse Incision ◽  
Postoperative Fever ◽  
Perioperative Bleeding ◽  
Significant Difference ◽  
Surgical Data

Abstract Introduction: A retrospective study was conducted to investigate the effectiveness and feasibility of enucleation fibroids of the anterior wall of the uterus by transverse incision of the uterus at the same time during cesarean section. Methods The medical history, surgical data, preoperative and postoperative blood system changes and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section in the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results There was no significant difference in the number of leiomyoma, pathological type, preoperative and postoperative hemoglobin, incidence of perioperative bleeding, frequency of blood transfusion, incidence of postoperative fever, uterine involution and lochia between the study group and the control group. The proportion of large fibroids in the study group was slightly higher than that in the control group (p < 0.05), and the operation time and average hospitalization time in the study group were slightly longer than that in the control group (p < 0.05).The distribution of type III-V fibroids in the study group was slightly more than that in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion It is safe and effective to enucleate the fibroids of the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. Potential to reduce the risk of pelvic adhesion and intrauterine adhesion in the future, so that some patients avoid the risk of reoperation.

scholarly journals Study on the method of enucleation of anterior uterine fibroids by transverse incision of the lower uterine segment during cesarean section

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Dai ◽  
Li Xia ◽  
Jinxiao Lin ◽  
Rongli Xu ◽  
Wenqiang You
Keyword(s):  
Cesarean Section ◽  
Operation Time ◽  
Anterior Wall ◽  
Control Group ◽  
Study Group ◽  
Transverse Incision ◽  
Postoperative Fever ◽  
Postoperative Changes ◽  
Perioperative Bleeding ◽  
Surgical Data

Abstract Introduction A retrospective study was conducted to investigate the effectiveness and feasibility of fibroid enucleation in the anterior wall of the uterus by transverse uterine incision during cesarean section. Methods The medical history, surgical data, preoperative and postoperative changes in the blood system, and complications of 90 pregnant women who underwent myomectomy of the anterior uterine wall during cesarean section at the second Department of Maternal and Child Health Hospital of Fujian Province were analyzed retrospectively. Results No significant differences were noted in the leiomyoma number, pathological type, preoperative and postoperative hemoglobin level, perioperative bleeding incidence, blood transfusion frequency, postoperative fever incidence, and duration of lochia between the study and control groups. The proportion of large fibroids was slightly higher in the study group than in the control group (p < 0.05), and the operation time and average hospitalization time were slightly longer in the study group than in the control group (p < 0.05). The distribution of type III–V fibroids was slightly more in the study group than in the control group (p < 0.05), and the distribution of type VI fibroids in the study group was less than that in the control group (p < 0.05). Conclusion Fibroid enucleation is safe and effective in the anterior wall of the uterus through the lower uterine transverse incision in cesarean section. It has the potential to reduce the risk of pelvic and intrauterine adhesions in the future.

scholarly journals Anesthetic Effect of Compound Artevacaine Hydrochloride in Patients Undergoing Oral Implantation

2021 ◽  
Vol 5 (4) ◽  
pp. 220-224
Author(s):  
Chengxi Chi ◽  
Mengmeng Zhao ◽  
Jiajing He ◽  
Yanli Wang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Research Subjects ◽  
Implant Surgery ◽  
Anesthetic Effect ◽  
Significant Difference ◽  
Oral Implant

Objective: To investigate and analyze the anesthetic effect of compound artevacaine hydrochloride in patients undergoing oral implantation. Methods: In this study, 60 patients receiving oral implant surgery in our hospital were selected as the research subjects, and the operation time was from July 2019 to March 2021. Patients were randomly selected and divided into groups for the study. 30 patients receiving lidocaine hydrochloride anesthesia were used as the control group, and 30 patients receiving compound artevacaine hydrochloride anesthesia were used as the research group. The anesthetic effect and safety of the two groups were compared and analyzed. Results: The anesthetic effect of the study group was significantly better than that of the control group (P < 0.05). The blood pressure and heart rate in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups before anesthesia (P > 0.05). There was no significant difference in the incidence of ADR between the two groups (P > 0.05). Conclusions: For patients undergoing oral implant surgery, choosing compound artevacaine hydrochloride as anesthetic drug has obvious anesthetic effect and can stabilize patients' life indexes. The anesthetic effect is obvious, and there is no obvious adverse reaction, and the clinical value is obvious.

scholarly journals The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

scholarly journals Addition of azithromycin to cefazolin pre elective CS reduces post operative infections

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M E Mohamed ◽  
H A Allam ◽  
M A Abdelgaber
Keyword(s):  
Cesarean Section ◽  
Antibiotic Prophylaxis ◽  
Postoperative Infection ◽  
Elective Cesarean Section ◽  
Control Group ◽  
Postoperative Fever ◽  
Post Surgery ◽  
Percentage Points ◽  
Absolute Reduction ◽  
Significant Difference

Abstract Introduction The results of the Cesarean Section Optimal Antibiotic Prophylaxis(C/SOAP) trial describe an absolute reduction of 5.9 percentage points in the rate of the primary composite outcome of endometritis, wound infection,or other infection occurring within 6 weeks after non elective cesarean section with the use of adjuvant azithromycin prophylaxis. The absolute reduction in maternal postpartum use of antibiotics was 4.3 percentage points. The study drug was administered after the first incision in 12.4%of the patients who received azithromycin and in12.3% of those who received placebo. The authors did not indicate when the standard prophylaxis(mainly cefazolin) was delivered. Objective The aim of our study is to evaluate the efficacy of addition of azithromycin to cefazolin pre-operative in reducing the risk of postoperative infection after elective CS. Methods Four hundred patients were randomized to two groups. Control Group included 200 women undergoing elective CS. Patients received standard antibiotic prophylaxis cefazolin (at a dose of 1 gm) and azithromycin (at a dose of 1 gm) 2 hours preoperatively. Study Group included 200 women undergoing elective CS. Patients received only standard prophylaxis antibiotic (cefazolin). Results Our study showed that majority of the mothers were housewives (70% in cefazolin-azithromycin group and 85.5% in cefazolin group), with a statistically high significant difference between the two groups regarding occupation (p &lt; 0.001). But, there was no statistically significant difference regarding residence (p &gt; 0.05) between both studied groups. Regarding demographic characteristics, majority of the mothers had similar mean age/years; 25.5 years in cefazolin-azithromycin group and 24.7 years in cefazolin group, with no statistically significant difference between both studied groups (p &gt; 0.05) but body mass index illustrated statistically a significant difference (p &lt; 0.05). On the other hand, preoperative hemoglobin showed no statistically significant difference between both studied groups (p &gt; 0.05). Regarding obstetric history, there were statistically significnat differences between both studied groups regarding parity and previous cesarean sections (p &lt; 0.05) and a high significant difference regarding previous abortions (p &lt; 0.001). Conclusion At the end of this study, we observed that, with regards to postoperative fever, wound healing duration, infection post-surgery and per-vaginal discharge, addition of azithromycin to cefazolin (Zinol) is effective than cefazolin only in reducing the risk of postoperative infection after elective CS and maternal use of healthcare resources.

scholarly journals Simultaneous Bilateral Thoracoscopic Pneumonectomy for Early Multiple Primary Lung Cancer Feasibility Analysis

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Zhonglong Zheng ◽  
Tao Li ◽  
Yang Chen ◽  
Yang Zhang ◽  
Pan Zhang
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Primary Lung Cancer ◽  
Operation Time ◽  
Time Range ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Multiple Primary

Objective: To analyze the feasibility of simultaneous bilateral thoracoscopic lung resection in the treatment of multiple primary lung cancers in the early stage. Methods: The study time range is between March 2019 and March 2021. A sample of 30 patients with early multiple primary lung cancer admitted to this hospital were included, and they were divided into a study group, a control group, and samples within the group using a random number table scheme n=15, patients in the control group underwent staged bilateral thoracoscopic pneumonectomy, and patients in the study group underwent bilateral thoracoscopic pneumonectomy at the same time. The indicators of the two groups were compared and analyzed. Results: There was no significant difference in the operation time and intraoperative blood loss between the two groups (P>0.05). There were significant differences in the VAS score, total length of hospital stay, and total surgical costs on the first day after surgery (P<0.05); there was no significant difference in the two groups' postoperative recovery indicators and the incidence of complications (P>0.05). Conclusion: It is safe and feasible to treat patients with multiple primary lung cancer in both lungs at the same time with simultaneous bilateral thoracoscopic surgery, and is suitable for promotion.

scholarly journals AB0814 PREGNANCY COURSE ASSESSMENT IN PATIENTS WITH RHEUMATIC DISEASES COMPARED TO CONTROLS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1431.2-1432
Author(s):  
O. Hamdi ◽  
M. Sellami ◽  
M. Yasmine ◽  
A. Fazaa ◽  
S. Miladi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Rheumatic Diseases ◽  
Premature Delivery ◽  
Control Group ◽  
Study Group ◽  
Childbearing Age ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
The Impact

Background:Rheumatic diseases such as rheumatoid arthritis (RA) and spondyloarthritis (SA) may occur among women of childbearing age. Adverse events during pregnancy including disease flare, preterm delivery, and neonatal or fetal death have been reported.Objectives:Our aim was to assess the impact of rheumatic diseases on the course of pregnancy.Methods:We conducted a cross-sectional study involving patients with RA (2010 ACR/EULAR criteria) and SA (2009 ASAS criteria) (study group) as well as healthy controls (control group) matched by age and gender. All women included had at least one pregnancy. Data were collected through telephonic interviews. We used the Student t test to compare the study group and the control group.Results:We enrolled 57 patients (30 RA and 27 SA) and 57 controls. The mean age in the study and the control groups were respectively 43.2 ± 8.2 years [26-48] and 37.5 ± 6 years. The mean chronic inflammatory rheumatisms duration was 13.81 ± 6.2 years. A history of primary sterility was found in 3 patients (1 RA and 2 SA) and none in the control group. The mean age during the first pregnancy was significantly higher in the study group (28 ± 6.2 years versus 24 ± 7 years in the control group) (p=0.01). Eight patients (5 RA and 3 SA) had a history of spontaneous miscarriage. A terminated pregnancy was noted in 3 patients (1 RA and 2 SA). Complications during pregnancy in the study group were gestational diabetes (0.3%), premature delivery (0.3), premature rupture of membranes (0.3%), abortion threat (0.3%) and pre-eclampsia (6%). Pregnancy was more associated with complications in the study group (p=0.05). Cesarean section was more used in the study group (28 patients versus 9 in the control group; p= 0.00). The main indications of cesarean section in the study group were macrosomia (11 patients), scar uterus (6 patients), sacroiliitis (4 SA patients), twin pregnancy (2 patients), and undetermined reasons (6 patients). Fetal presentation in the study group was the seat presentation (3%), top presentation (4%), face (2%), and forehead presentation (0.3%) with no significant difference with the control group. Complications of childbirth in the study group were hemorrhage of delivery (10.3%), cord widening (6.6%), perinatal asphyxia (4.9%), and dystocia (1.9%). However, no statistically significant differences were found between the two groups in the prevalence of complications of childbirth. During pregnancy, 5 patients were on salazopyrine, 2 on corticosteroids and, 1 on non-steroidal anti-inflammatories.Conclusion:Our study showed that pregnancies with rheumatic diseases were at increased risk of having maternal complications and adverse neonatal outcomes.Disclosure of Interests:None declared

scholarly journals Combination of long- and short-axis alar sacroplasty techniques under fluoroscopic guidance for osteoporotic sacral insufficiency fracture

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Feng-Chen Kao ◽  
Yao-Chun Hsu ◽  
Tzu-Shan Chen ◽  
Pao-Hsin Liu ◽  
Yuan-Kun Tu
Keyword(s):  
Insufficiency Fracture ◽  
Thoracolumbar Spine ◽  
Compression Fracture ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Short Axis ◽  
Fluoroscopic Guidance ◽  
Sacral Insufficiency Fracture ◽  
Significant Difference

Abstract Background Sacral insufficiency fracture (SIF) is rarer than osteoporotic vertebral compression fracture that occurs at other levels of the thoracolumbar spine. Percutaneous sacroplasty can effectively relieve pain and improve mobility. Several sacroplasty-based techniques have been reported to date. Sacroplasty is often performed with computed tomography-guided cannula placement, which is time intensive and results in greater radiation exposure than that resulting from fluoroscopy. Herein, we report our preliminary experience with a combination of long- and short-axis alar sacroplasty techniques under fluoroscopic guidance for osteoporotic SIFs. Methods We retrospectively reviewed 44 consecutive patients with symptomatic osteoporotic SIFs who underwent alar sacroplasty between January 2013 and February 2020. The study group comprised 19 patients who underwent a combination of long- and short-axis alar sacroplasty techniques under fluoroscopic guidance. The control group comprised the remaining 25 patients who underwent short-axis alar sacroplasty under fluoroscopic guidance. Visual analog scale (VAS) scores, operation times, injected cement volumes, and postoperative complications were recorded. Results The VAS score for pain decreased in both groups; however, no significant difference was noted between the study and control groups in injected cement volume (3.55 ± 0.96 vs 2.94 ± 0.89 mL). The operation time was longer in the study group than in the control group (32 ± 7.1 vs 28.04 ± 4.99 min; P = 0.046). No major complications were noted. Conclusion A combination of long- and short-axis alar sacroplasty techniques can be effectively performed under fluoroscopic guidance for osteoporotic SIFs.

Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

2018 ◽  
Vol 3 (06) ◽  
Author(s):  
Dr.Randa Mohammed AboBaker
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Demographic Data ◽  
Length Of Hospital Stay ◽  
Chewing Gum ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Bowel Motility ◽  
Gum Chewing ◽  
Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

Impact of intrawound vancomycin powder on prevention of surgical site infection after posterior spinal surgery

2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  
Keyword(s):  
Propensity Score ◽  
Spinal Surgery ◽  
Control Group ◽  
Control Groups ◽  
Propensity Score Model ◽  
Significant Difference ◽  
Surgical Data ◽  
Vancomycin Powder ◽  
Vancomycin Group ◽  
And Control

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.

scholarly journals Effect of leg wrapping technique on prevention of spinal induced hypotension and fetal acidosis during cesarean section: Randomized controlled trial

2019 ◽  
Vol 10 (2) ◽  
pp. 70
Author(s):  
Samah Nasser Abd El-Aziz El-Shora ◽  
Amina Mohamed Rashad El-Nemer
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Intervention Group ◽  
Cost Effective ◽  
Control Group ◽  
Induced Hypotension ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Wrapping Technique

Background and aim: Hypotension during cesarean section (CS) under spinal anesthesia has been a subject of scientific study for more than 50 years and the search for the most effective strategy to achieve hemodynamic stability remains challenging. Aim: The study was carried out to apply leg wrapping technique for the prevention of spinal-induced hypotension (SIH) during CS.Methods: Randomized Controlled Trial design was utilized at cesarean delivery operating room Mansoura General Hospital in El-Mansoura City during the period from May 2018 to November 2018. A purposive sample of 88 pregnant women, assigned randomly to an intervention group (n = 44) in which their legs wrapped with elastic crepe bandage and control group (n = 44) in which no wrapping was done. Data collected for maternal, neonatal hemodynamic and signs of hypotension, the feasibility of application and cost analysis.Results: There was a statistically significant difference in the incidence of SIH and Ephedrine use among both groups (18.20% in leg wrapping group whereas 75% in control group). In addition, neonatal acidosis and NICU admission were less among leg wrapping group (11.40%, 9.10% respectively). Economically, leg wrapping technique was cost effective compared to the cost of the hospital regimen for treating SIH and admission to (NICU).Conclusion and recommendations: Leg wrapping technique was cost effective and an efficient method for decreasing SIH, neonatal acidosis and Ephedrine administration. It is recommended to apply leg wrapping technique in maternal hospitals' protocol of care for decreasing SIH during CS.

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