EVALUATION OF RESULTS OF SIMULTANEOUS MYOMECTOMY AND CESAREAN SECTION

2018 ◽  
Vol 8 (1) ◽  
pp. 45-51 ◽  
Author(s):  
A. G. Yaschuk ◽  
L. A. Dautova ◽  
A. A. Tyurina ◽  
A. G. Imelbaeva
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Blood Loss ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Uterine Fibroids ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
One Stage ◽  
Duration Of Hospitalization

Introduction. Myoma of the uterus is the most common neoplasm of the female reproductive system. The frequency of combination of uterine fibroids and pregnancy varies from 1.6% to 10.7%, often fibroids occur in pregnant women of late reproductive age. Traditionally, myomectomy during caesarean section was not recommended because of the risk of bleeding and postoperative complications. To assess the safety and feasibility of a one-stage myomectomy in a caesarean section, this study was conducted.Materials and methods. From 2010 to 2015, we examined 260 pregnant women with uterine myoma, who had a cesarean section with a single-stage myomectomy. The data obtained during the survey were compared with the data of 96 women from the control group. We study assessment of intraoperative blood loss, pre- and postoperative hemoglobin levels, duration of hospitalization.Results. Statistically significant differences in intraoperative blood loss, changes in hemoglobin levels and in the duration of hospitalization between the examined groups of women were not revealed. A prognostic model has been developed to assess risk factors for intraoperative blood loss of more than 1000 ml.Conclusion. The size, localization of myomatous nodes are not risk factors for high blood loss in abdominal delivery with a one-stage myomectomy. The factor of risk of hemorrhage is multiple uterine fibroids, whereas the size of myomatous nodes less than 5 cm can be regarded as a protective factor for blood loss. The study showed that a one-stage myomectomy with a caesarean section is safe and can be performed with the surgeon’s experience. 

Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I

2021 ◽  
Vol 20 (1) ◽  
pp. 11-20
Author(s):  
Yu.S. Raspopin ◽  
◽  
E.M. Shifman ◽  
A.A. Belinina ◽  
A.V. Rostovtsev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
High Risk ◽  
Caesarean Section ◽  
Blood Loss ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Control Group ◽  
Study Group ◽  
Group I

Prevention of postpartum haemorrhage is one of the important tasks of modern obstetrics, anesthesiology and intensive care. Objective. To assess the efficacy and safety of terlipressin usage as a means of postpartum haemorrhage development prevention during caesarean section in high-risk pregnant women. Patients and methods. From February to December 2020, a multicenter comprehensive cohort study, in which 5 medical centers participated, was conducted. The study included 454 pregnant women who underwent caesarean section and who were divided into two groups: control group I (n = 351) and study group II (n = 103), with the use of terlipressin injected into myometrium. Evaluation of the preventive effect of the drug was carried out in several main directions: the volume of blood loss, the need for additional methods of surgical hemostasis, the safety of intraoperative use. Results. Considerable differences were found in the assessment of significant risk factors for the development of postpartum haemorrhage, associated pathologies and comorbidity between the groups. The study group turned out to be more threatened by the postpartum haemorrhage development. In the control group, additional measures of surgical hemostasis were more often used, including hysterectomy (2.6% versus 1.9%) and relaparotomy (1.9% versus 1%). The median blood loss was statistically lower in the study group (700 ml versus 800 ml). Nevertheless, the considerable spread of data on the volume of blood loss should be noted, with a maximum blood loss of 10,000 ml in the control group and 4,500 ml in the study group. There were no serious complications in both groups. Conclusion. The study showed that the use of terlipressin can reduce the volume of blood loss in women with high risk factors for postpartum haemorrhage, as well as reduce the number of hysterectomies and relaparotomies. It is necessary to continue the prospective part of the study with an increase in the randomized sample of patients. Key words: obstetric haemorrhage, caesarean section, terlipressin

scholarly journals Caesarean myomectomy - a safe procedure: A retrospective case controlled study

1970 ◽  
Vol 2 (2) ◽  
pp. 59-62 ◽  
Author(s):  
Alexander T Owolabi ◽  
Oluwafemi Kuti ◽  
Olabisi M Loto ◽  
Oluwafemiwa N Makinde ◽  
Adebanjo B Adeyemi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Post Partum ◽  
Uterine Fibroids ◽  
Controlled Study ◽  
Control Group ◽  
High Dose ◽  
Safe Procedure ◽  
The Mean ◽  
Duration Of Operation

Objective(s): The aim of the study is to determine whether myomectomy at the time of caesarean section leads to increase incidence of intrapartum and postpartum complications. Methods: Fourteen women, with uterine fibroids in pregnancy who were treated by caesarean myomectomy between January 2001 and June 2007, were compared retrospectively with fourteen women, without uterine fibroids who had routine caesarean section during the same period. Myomectomy for all types of myoma was performed at caesarean section after the delivery of the baby. Haemorrhage was controlled with the use of Foleys catheter tourniquet and high dose oxytocin infusion. The cases and control were analysed for age of the patient, parity, pre and post-operative haematocrit levels, duration of operation, blood loss, blood transfusions, and incidence of postpartum fever. Results: Caesarean myomectomy resulted in the mean blood loss of 589 ml (range 300-1300 ml) compared with 518 ml (range 350-850 ml) in the control group (p=0.376). The mean duration of operation was longer in the cases of caesarean myomectomy (66.8 mins) than those of the controls (56.4 mins). There were no significant differences between the two groups in the incidence of intraoperative haemorrhage, the need for blood transfusion, post partum fever, and length of hospital stay. Conclusions: This study shows that myomectomy during caesarean section is a safe procedure in experienced hands and is not as dangerous as generations of obstetricians have been trained to believe. Further research is necessary to establish the cost effectiveness of the procedure. Key words: myomectomy, cesarean section, hemorrhage      doi:10.3126/njog.v2i2.1457 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 59 - 62

scholarly journals Incision and Prediction of Risk Factors Related to Surgical Site Infection Following Cesarean Section in Chinese Women

2021 ◽  
Author(s):  
Qiuxiang Huang
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Pregnant Women ◽  
Chinese Women ◽  
Severe Infection ◽  
Control Group ◽  
Site Infection ◽  
Gynecology And Obstetrics ◽  
Group Data

Cesarean Section (CS) is one of the most frequently executed surgical procedures in gynecology and obstetrics. After a cesarean section, surgical site infection (SSI) increases hospital stay, lengthens maternal morbidity, and upsurges treatment costs. The current study determines the prevalence and risk factors for surgical site infection following cesarean section in China. A retrospective study was conducted on 23 cases of pregnant women who underwent cesarean section and incision severe infection and detection from March 2017 to January 2020 at Wuhan Maternal and Child Healthcare Hospital in China as the study group, and 20 cases of uninfected cesarean section during the same period were selected as the control group. Data were compared with the controls based on study variables and the presence of SSI. The mean age was 31±2.6. High fever and blood loss were observed in serous SSI-infected patients. The incidence rate of severe surgical site infection was 0.15 %. SSI was observed to be expected in pregnant women who had premature rupture of membrane before surgery (p < 0.001), who underwent postoperative antibiotic therapy (p < 0.001), and the patients who had gestational diabetes mellitus (p <0.001) and hematoma (p < 0.001) during surgery. Hence, following a cesarean section, surgical site infection is common. This research discovered several modifiable risk factors. SSI is associated with multifactorial rather than a single one. The development and strict implementation of a procedure by all health care practitioners can successfully reduce and prevent infection rates following cesarean section.

Influence of the category of urgency of the caesarean section on the adaptive capabilities of pregnant and parturient women

2017 ◽  
pp. 10-15
Author(s):  
I.A. Usevych ◽  
◽  
V.L. Kolesnik ◽  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Maximum Level ◽  
Psychological Problems ◽  
Control Group ◽  
Pregnancy And Childbirth ◽  
Adaptive Capabilities ◽  
Section Operation ◽  
History Of

Psychological problems during pregnancy and childbirth for today is a little studied subject of modern obstetrics. The possibilities for solving psychological problems that arise in cases of emergency obstetric situations are almost not used by Ukrainian specialists through the marriage of knowledge and skills to provide crisis psychological help to obstetric patients. The objective: to determine the level of psychoemotional load in pregnant and parturient women, depending on the category of urgency of cesarean section. Material and methods. The main group of the study was presented: 1 group - pregnant women, who had planned a cesarean section operation according to the ІV category of urgency and who had already had a caesarean section in the anamnesis; ІІ group – pregnant women who planned an operation according to the IV category of urgency and who had no previous caesarean section in their history; ІІІ group – pregnant and parturient women who underwent surgery, respectively, in the I–III category of urgency; Control group – 30 pregnant women in the period of 37–41 weeks of pregnancy. A survey was conducted using the questionnaires of J.Teylor, Ch.Spielberger and SAN-test. Results. On the eve of labor in pregnant women there is an increase in the psychoemotional load, which can be determined using the above questionnaires. There is a direct dependence on the category of urgency of cesarean section and the level of psychoemotional load. Also revealed the correlation dependence of the voltage of the adaptation reserves of the pregnant woman on the presence of a history of caesarean section. Conclusion. Almost 50 percent of pregnant women, in cases of cesarean section, respectively, 1–3 categories of urgency in the preoperative period have the maximum level of psychoemotional load according to the questionnaires used. Pregnant women who have undergone a caesarean section in anamnesis are more adapted and have less psycho-emotional stress than women who have a cesarean section for the first time. Key words: cesarean section, psychoemotional state, pregnancy, childbirth, scale J. Teylor, scale Ch. Spielberger, SAN-test.

scholarly journals ANALISIS FAKTOR RISIKO YANG BERHUBUNGAN DENGAN KEJADIAN PLASENTA PREVIA

2021 ◽  
Vol 6 (2) ◽  
pp. 100
Author(s):  
Nurul Huda Mursalim ◽  
Saharuddin Saharuddin ◽  
Azizah Nurdin ◽  
Jelita Inayah Sari
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Placenta Previa ◽  
Case Control ◽  
Control Group ◽  
Chi Square ◽  
Purposive Sampling ◽  
Chi Square Test ◽  
History Of

Tujuan penelitian ini adalah untuk mengetahui hubungan variabel dependen yaitu umur, paritas, riwayat sectio sesarea, riwayat gemelli dengan variabel independen yaitu plasenta previa di RSUD Batara Guru dan RS Hikmah Sejahtera Kabupaten Luwu Tahun 2018-2019. Pada studi ini memanfaatkan metode analitik observasional dengan pendekatan case control. Sampel ditentukan melalui perbandingan kelompok kasus sebanyak 50 sampel dengan kelompok kontrol 50 sampel. Teknik sampling menggunakan purposive sampling. Untuk mengetahui hubungan faktor risiko memanfaatkan uji chi square. Hasil terbanyak didapatkan 78 ibu hamil risiko rendah, 76 ibu hamil dengan multipara, ibu hamil dengan tidak ada riwayat sectio sesarea didapatkan 76 ibu hamil dan ibu yang tidak memiliki riwayat gemelli ada 97 ibu hamil. Hasil penelitian menujukkan dari uji chi square antara umur dengan plasenta previa didapatkan (P= 0.008 < 0,05) untuk hubungan paritas dengan plasenta previa didapatkan (P= 0,815 > 0,05) hubungan riwayat sectio sesarea didapatkan sebesar (P= 0.035 < 0,05) dan untuk hubungan riwayat gemelli sebesar (P= 1,000 > 0,05). Kesimpulan dari penelitian ini adalah tidak terdapat hubungan faktor risiko paritas, riwayat gemelli pada kejadian plasenta previa dan didapatkan hubungan faktor risiko antara umur, riwayat sectio sesarea dengan kejadian plasenta previa di RSUD Batara Guru dan RS Hikmah Sejahtera Kabupaten Luwu Tahun 2018-2019. Kata kunci: Umur, paritas, riwayat sectio sesarea, riwayat gemelli, plasenta previa ABSTRACTThe major objective of this study was to investigate the risk factors that affect the occurrences of placenta previa, such as ages, parity, caesarean section history, and gemelli history of pregnant women. This study was conducted at Batara Guru Hospital and Hikmah Sejahtera Hospital of Luwu Regency in 2018 to 2019. The methodological approach taken in this study was observational analytic by using a case control approach. The samples used in this research consisted of 50 samples for the case group and 50 samples for the control group. The sampling technique used was a purposive sampling. A chi square test was performed in this experiment in order to understand the risk factors. From this research, it was apparent that 78 pregnant women were with the low risk of getting placenta previa, 76 pregnant women were with multiparous, 76 pregnant women were with no history of cesarean section, and 79 pregnant women were without a gemelli history. Based on the chi square test, the results of this study indicated that various relationships were obtained such as the relationship between ages and placenta previa occurrences with (P = 0.008 <0.05), the correlation among parity and placenta previa occurrences with (P = 0.815> 0.05), the correlation among caesarean section history and placenta previa occurrences with (P = 0.035 <0,05), and the correlation among gemelli history and placenta previa occurrences with (P = 1,000> 0.05). This research concludes that there was no relationship between parity and gemelli history factors and the occurrences of placenta previa. In contrast, it was evident that there were close relationships between the ages and caesarean section history factors and the occurrences of placenta previa at Batara Guru Hospital and Hikmah Sejahtera Hospital of Luwu Regency in 2018 to 2019.Keywords: ages, parity, caesarean sectio history, gemelli history, placenta previa

scholarly journals Pregnant women suffering from uterine fibroids

2015 ◽  
Vol 125 (3) ◽  
pp. 166-168
Author(s):  
Paweł Golubka ◽  
Agnieszka Wańkowicz ◽  
Marian Przylepa ◽  
Marek Gogacz ◽  
Ivan Golubka ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Uterine Fibroids ◽  
Benign Tumors ◽  
Control Group ◽  
Cesarean Sections ◽  
Review Of Literature ◽  
Female Population ◽  
Group 2 ◽  
Research Studies

Abstract Introduction. Uterine fibroids are the most frequent benign tumors affecting sexual organs in women. It is estimated that they affect 20% of the female population, with the frequency in pregnant women ranging between 0.1-5%. In spite of the progress in the field of medicine, the actual cause of uterine fibroids has yet to be discovered. Aim. Analysis of the recent methods of dealing with uterine fibroids during pregnancy. Material and methods. A review of literature about dealing with pregnant, lying-in and parturient women suffering from uterine fibroids. Results. The research studies by Aydeniz, Vergani, Rice showed that cesarean sections are much more frequent in pregnant women with uterine fibroids than in control group (52.9% vs 27.9%; 23% vs 12%; 35.1% vs 21.5%). However, it was shown that the rate of cesarean sections was much higher in women with uterine fibroids located in the lower part of the uterus than in the fundus uteri (respectively 39% and 18%). Also, the rate increased when the diameter of the fibroid exceeded 5 cm, unlike in case of those smaller than 5 cm (respectively 35% and 17%). Conclusions. 1. The number of cesarean sections in women with uterine fibroids is higher than in control group. 2. The frequency of cesarean sections in pregnancies with uterine fibroids depends on their position and size. 3. There is no relationship between the number of complications and the amount of fibroids in pregnant women. 4. There is no agreement concerning the recommendations for removing the fibroid during cesarean section.

scholarly journals A non-bioartificial liver support system combined with transplantation in HBV-related acute-on-chronic liver failure

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peng Li ◽  
Xi Liang ◽  
Shan Xu ◽  
Ye Xiong ◽  
Jianrong Huang
Keyword(s):  
Survival Rate ◽  
Blood Loss ◽  
Liver Failure ◽  
Control Group ◽  
Observation Group ◽  
Intraoperative Blood Loss ◽  
Chronic Liver Failure ◽  
Short Term ◽  
Liver Support ◽  
Liver Support System

AbstractWe aim to determine the impact of an artificial liver support system (ALSS) treatment before liver transplantation (LT), and identify the prognostic factors and evaluate the predictive values of the current commonly used ACLF prognostic models for short-term prognosis after LT. Data from 166 patients who underwent LT with acute-on-chronic liver failure (ACLF) were retrospectively collected from January 2011 to December 2018 from the First Affiliated Hospital of Zhejiang University School of Medicine. Patients were divided into two groups depending on whether they received ALSS treatment pre-LT. In the observation group, liver function tests and prognostic scores were significantly lower after ALSS treatment, and the waiting time for a donor liver was significantly longer than that of the control group. Both intraoperative blood loss and period of postoperative ICU care were significantly lower; however, there were no significant differences between groups in terms of total postoperative hospital stays. Postoperative 4-week and 12-week survival rates in the observation group were significantly higher than those of the control group. Similar trends were also observed at 48 and 96 weeks, however, without significant difference. Multivariate Cox regression analysis of the risk factors related to prognosis showed that preoperative ALSS treatment, neutrophil–lymphocyte ratio, and intraoperative blood loss were independent predicting factors for 4-week survival rate after transplantation. ALSS treatment combined with LT in patients with HBV-related ACLF improved short-term survival. ALSS treatment pre-LT is an independent protective factor affecting the 4-week survival rate after LT.

scholarly journals The Predictive Value of the Mother’s Risk Factors in Formation of Fetal Developmental Delay

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199914
Author(s):  
Maka Chigladze
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Predictive Value ◽  
Negative Impact ◽  
Deficiency Anemia ◽  
Control Group ◽  
Case Group ◽  
Retrospective Case ◽  
Standards Of Living ◽  
Poor Nutrition

The research aimed at studying the mother’s social-hygienic and medical biological risk factors and determining their predictive value. The retrospective case-control study was conducted with 142 pregnant women participating in it. In the case group there were involved 92 mothers whose pregnancy was completed by the birth of a newborn baby suffering from the intrauterine growth restriction. The control group was made of 50 pregnant women, whose pregnancy was completed by the birth of a healthy neonate. The research resulted in specifying the risk factors of high priority: the low standards of living (OR 3.61), chronic stress (OR-3.06), sleeping disorder (OR-3.33) and poor nutrition (OR-3.81). As regards the coexisting pathology the following was revealed: endocrine pathology (OR-3.27), ischemic heart disease (OR-4.35), arterial hypertension (OR-6.47), iron deficiency anemia (OR-4.11), pathology of respiratory system (OR-3.42), chronic genital inflammatory and infectious processes. The preeclampsia (92%) and low amniotic fluid (89%) were detected to have the high predictive value. The awareness of risk factors allows us to employ the timely measures for the reduction of negative impact on the fetus and neonate.

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

scholarly journals Placenta previa with posterior extrauterine adhesion: clinical features and management practice

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshikazu Nagase ◽  
Shinya Matsuzaki ◽  
Masayuki Endo ◽  
Takeya Hara ◽  
Aiko Okada ◽  
...  
Keyword(s):  
Propensity Score ◽  
Blood Loss ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Multivariate Regression ◽  
Placenta Previa ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
Intraoperative Bleeding

Abstract Background A diagnostic sign on magnetic resonance imaging, suggestive of posterior extrauterine adhesion (PEUA), was identified in patients with placenta previa. However, the clinical features or surgical outcomes of patients with placenta previa and PEUA are unclear. Our study aimed to investigate the clinical characteristics of placenta previa with PEUA and determine whether an altered management strategy improved surgical outcomes. Methods This single institution retrospective study examined patients with placenta previa who underwent cesarean delivery between 2014 and 2019. In June 2017, we recognized that PEUA was associated with increased intraoperative bleeding; thus, we altered the management of patients with placenta previa and PEUA. To assess the relationship between changes in practice and surgical outcomes, a quasi-experimental method was used to examine the difference-in-difference before (pre group) and after (post group) the changes. Surgical management was modified as follows: (i) minimization of uterine exteriorization and adhesion detachment during cesarean delivery and (ii) use of Nelaton catheters for guiding cervical passage during Bakri balloon insertion. To account for patient characteristics, propensity score matching and multivariate regression analyses were performed. Results The study cohort (n = 141) comprised of 24 patients with placenta previa and PEUA (PEUA group) and 117 non-PEUA patients (control group). The PEUA patients were further categorized into the pre (n = 12) and post groups (n = 12) based on the changes in surgical management. Total placenta previa and posterior placentas were more likely in the PEUA group than in the control group (66.7% versus 42.7% [P = 0.04] and 95.8% versus 63.2% [P < 0.01], respectively). After propensity score matching (n = 72), intraoperative blood loss was significantly higher in the PEUA group (n = 24) than in the control group (n = 48) (1515 mL versus 870 mL, P < 0.01). Multivariate regression analysis revealed that PEUA was a significant risk factor for intraoperative bleeding before changes were implemented in practice (t = 2.46, P = 0.02). Intraoperative blood loss in the post group was successfully reduced, as opposed to in the pre group (1180 mL versus 1827 mL, P = 0.04). Conclusions PEUA was associated with total placenta previa, posterior placenta, and increased intraoperative bleeding in patients with placenta previa. Our altered management could reduce the intraoperative blood loss.

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