Prenatal ultrasound diagnosis of velamentous insertion of the umbilical cord: clinical cases and literature review

Ultrasound Diagnosis ◽

Cesarean Sections ◽

Vasa Previa ◽

Obstetrical Management ◽

Previous Cesarean ◽

Singleton Pregnancies

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.

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

10.21203/rs.2.11165/v4 ◽

2020 ◽

Author(s):

Yizhi Wang ◽

Jiarui Li ◽

Husheng Wang New ◽

Xipeng Wang

Keyword(s):

Cesarean Section ◽

Color Doppler ◽

Three Dimensional ◽

Clinical Effectiveness ◽

Cesarean Sections ◽

Vaginal Repair ◽

Significant Difference ◽

Average Size ◽

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.

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

10.21203/rs.2.11165/v3 ◽

2020 ◽

Author(s):

Yizhi Wang ◽

Jiarui Li ◽

Xipeng Wang

Keyword(s):

Cesarean Section ◽

Color Doppler ◽

Three Dimensional ◽

Clinical Effectiveness ◽

Cesarean Sections ◽

Vaginal Repair ◽

Significant Difference ◽

Average Size ◽

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.

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

10.21203/rs.2.11165/v2 ◽

2019 ◽

Author(s):

Yizhi Wang ◽

Jiarui Li ◽

Xipeng Wang

Keyword(s):

Cesarean Section ◽

Color Doppler ◽

Three Dimensional ◽

Clinical Effectiveness ◽

Cesarean Sections ◽

Vaginal Repair ◽

Study Objective ◽

Significant Difference ◽

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.

Color Doppler ultrasound diagnosis of thrombosis of a duplicated superficial femoral and popliteal vein

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-2007-988958 ◽

2007 ◽

Vol 28 (S 1) ◽

Author(s):

J Fernandez Sanchez ◽

M Nicolai ◽

H Marx ◽

C Blatzonis

Keyword(s):

Doppler Ultrasound ◽

Color Doppler ◽

Popliteal Vein ◽

Ultrasound Diagnosis

Clinical value of color doppler ultrasound in prenatal diagnosis of umbilical cord entry abnormity

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.325.10518 ◽

2016 ◽

Vol 32 (6) ◽

Cited By ~ 2

Author(s):

Jiandong Sun ◽

Li Wang ◽

Yinghui Li

Keyword(s):

Prenatal Diagnosis ◽

Umbilical Cord ◽

Doppler Ultrasound ◽

Color Doppler ◽

Clinical Value

Pregnancy complicated by previous cesarean section: a retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184491 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4470

Author(s):

Poornima M.

Keyword(s):

Retrospective Study ◽

Cesarean Section ◽

Medical Records ◽

Neonatal Outcome ◽

Perinatal Morbidity ◽

Cesarean Sections ◽

Exclusion Criteria ◽

History Of ◽

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.

Analysis of Cesarean Sections using Robson’s Ten Group Classification System

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.2.3823 ◽

2021 ◽

Vol 37 (2) ◽

Author(s):

Rashida Parveen ◽

Mehnaz Khakwani ◽

Anum Naz ◽

Rabia Bhatti

Keyword(s):

Cesarean Section ◽

Classification System ◽

Fetal Distress ◽

Group Classification ◽

Care Hospital ◽

Cesarean Sections ◽

Group 10 ◽

Group 5 ◽

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.

Safety of Scar on Repeat Second Cesarean Section in Patients with Previous One Cesarean Section

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1024 ◽

2009 ◽

Vol 1 (2) ◽

pp. 26-28

Author(s):

Shahnaz Kouser ◽

Shaheen Kouser ◽

Bushra Anwar

Keyword(s):

Cesarean Section ◽

Tertiary Care ◽

Teaching Hospitals ◽

Cesarean Sections ◽

Medical Disorders ◽

Elective Cesarean ◽

One Year ◽

Operative Findings ◽

ABSTRACT Objective To evaluate the safety and integrity of scar at repeat cesarean section, in patients with previous one cesarean section performed at different settings. Study design A reterospective study in a tertiary care obstetric unit over a period of one year (2006). Material and methods All patients with previous one cesarean section, undergoing emergency and elective cesarean sections were enrolled at our institution. The variables noted were age, parity, residential area, location of previous cesarean section and associated complaints, e.g uterine contractions, vaginal leaking/ bleeding and comorbid medical disorders. Outcome measures Operative findings in terms of thinning of scar, dehiscence or rupture were recorded. The effects of skill level of surgeon and set-up of previous cesarean section were analyzed. Results Two hundred and seventy cesarean sections were performed for different indications in patients with previous one cesarean section over a period of one year. Out of all patients, extreme thinning of scar was noted in 36 (13.3%) patients. Seven patients(2.6%) had scar dehiscence. Only 3 (42.8%) patients with scar dehiscence had associated complaint of scar tenderness, while 22 (61%)of 36 cases of scar thinning were having scar tenderness. All 7 cases of scar dehiscence had their previous cesarean sections at teaching hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Conclusion The study concludes relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it will still be safe to subject the patients to trial of labor after meticulous scrutinization and individualization. At the same time adequate surgical training of doctors (trainees and community doctors) through different formats is recommended.