Gynecological outcomes of uterine niche after cesarean section: A descriptive study

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.

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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 ◽

Previous Cesarean Section ◽

Exclusion Criteria ◽

History Of ◽

Previous Cesarean

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.

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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 ◽

Previous Cesarean Section ◽

Group 10 ◽

Group 5 ◽

Previous Cesarean

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.

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Abdominal wall endometriosis: experience of the General Surgery Service of the Antônio Pedro University Hospital of the Universidade Federal Fluminense

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-6991e-20202544 ◽

2020 ◽

Vol 47 ◽

Author(s):

JORGE EDUARDO FARIA ROCHA COSTA ◽

ITALO ACCETTA ◽

FRANCISCO JOSÉ SANTOS MAIA ◽

RENATO AUGUSTO MOREIRA DE SÁ

Keyword(s):

Cesarean Section ◽

Abdominal Surgery ◽

Abdominal Wall ◽

General Surgery ◽

Previous History ◽

Reproductive Age ◽

University Hospital ◽

Significance Level ◽

Abdominal Wall Endometriosis ◽

Previous Cesarean

ABSTRACT Objective: to study the characteristics of women undergoing abdominal surgery with suspected abdominal wall endometriosis or abdominal wall tumor, and to assess the association with age, race and previous cesarean delivery. Method: retrospective and analytical study carried out from January 2000 to December 2019, at the General Surgery Service of Hospital Universitário Antônio Pedro (HUAP) at Universidade Federal Fluminense (UFF). Medical records of 100 patients with abdominal wall endometriosis and other types of abdominal wall tumors were analyzed. Age, color, previous history of cesarean section or abdominal surgery and histopathological data were verified. The patients were classified as young adults (aged between 18 and 28 years and 11 months) and adults. The SPSS program was used for data analysis, Fisher’s test with a significance level of 0.05. Results: abdominal wall endometriosis with histopathological confirmation was found in 22%, the mean age was 52.28 ± 18.66 which was lower when compared to other diagnoses. There was an association between previous cesarean section and abdominal wall endometriosis (p <0.005). Conclusion: the women with a diagnosis of abdominal wall endometriosis had undergone previous cesareans (the majority) and were in an active reproductive age. Although the brown skin women were the most frequent, there was no statistical difference.

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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 ◽

Previous Cesarean Section ◽

Medical Disorders ◽

Elective Cesarean ◽

One Year ◽

Operative Findings ◽

Previous Cesarean

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.

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CAESAREAN SECTION: PROBLEMS AND PROSPECTS IN THE REPUBLIC OF CRIMEA

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2021-2-57-68 ◽

2021 ◽

pp. 57-68

Author(s):

O.P. Miklin ◽

I.S. Glazkov ◽

I.B. Glazkova ◽

Z.S. Rumyantseva ◽

N.A. Reznichenko ◽

...

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Breech Presentation ◽

Maternity Hospital ◽

Critical Conditions ◽

Cesarean Sections ◽

Robson Classification ◽

The Republic ◽

Uterine Scar ◽

Abdominal Delivery

Caesarean section (CS) is a surgical procedure performed only in critical conditions to save the life of a mother and a child. The operation should be performed only if clinically indicated. Recently, the rate of cesarean sections is growing, but the number of deaths is not decreasing. The purpose of the study is to examine the frequency of abdominal delivery in Simferopol, Simferopol Clinical Maternity Hospital No. 2, to assess the possibilities and reserves for CS reduction in the region. Methods. The authors used retrospective analysis of birth histories according to Robson classification. Results. In 2018–2019 the frequency of cesarean sections in Simferopol Clinical Maternity Hospital No. 2 increased by 3 %. It was found out that primigravida and multipara with a uterine scar in the cephalic presentation are a reserve to decrease the indicator. It may also be promising to reduce the incidence of cesarean section in pregnant women with breech presentation. Keywords: caesarean section, Robson classification, Republic of Crimea. Операция кесарева сечения является методом, проводимым только при угрожающих состояниях с целью спасения жизни матери и ребенка. Операция должна выполняться только при строгих показаниях врача. В последнее время тенденция к родоразрешению путем кесарева сечения нарастает, однако число летальных исходов не уменьшается. Цель. Определение частоты абдоминального родоразрешения в г. Симферополь на примере ГБУЗ РК «Симферопольский клинический родильный дом № 2» и оценка возможностей и резервов ее снижения в регионе. Материалы и методы. Ретроспективный анализ историй родов по классификации Робсона. Результаты. Частота кесарева сечения в ГБУЗ РК «Симферопольский клинический родильный дом № 2» в течение 2 лет возросла на 3 %. Было установлено, что резервом снижения данного показателя являются первобеременные и повторнородящие с рубцом на матке и с плодом в головном предлежании. Перспективным может быть также снижение частоты кесарева сечения у беременных с тазовым предлежанием. Ключевые слова: кесарево сечение, классификация Робсона, Республика Крым.

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Torsion of term gravid uterus with a large leiomyoma

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20164675 ◽

2016 ◽

Vol 6 (1) ◽

pp. 284

Author(s):

Berna Aslan Çetin ◽

Pınar Yalçın Bahat ◽

Selin Dikmen ◽

Erkan Şimşek ◽

Alev Aydın

Keyword(s):

Risk Factors ◽

Cesarean Section ◽

Gravid Uterus ◽

Cesarean Sections ◽

Previous Cesarean

Torsion of gravid uterus is a rare obstetric event and it is almost always diagnosed during cesarean section. Leiomyomas and previous cesarean sections are predisposing risk factors. We report a case of 180 degree torsion of a term gravid uterus with only symptom of hematuria.

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The Commonest Indications of Cesarean Sections at Ghalib Teaching Hospital in Year 2017; Cross-sectional Study

10.21203/rs.3.rs-361061/v1 ◽

2021 ◽

Author(s):

Mohammad Rafi Fazli ◽

Amena Mansouri ◽

Hania Wahidi

Keyword(s):

Cesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Teaching Hospital ◽

Cross Sectional Study ◽

High Rate ◽

Cesarean Sections ◽

Sectional Study ◽

Cross Sectional ◽

Previous Cesarean

Abstract Background: In the past few decades, the rate of cesarean section (CS) has increased worldwide which is common in high income countries. Although cesarean section has lots of socioeconomic impacts in the career of mothers and babies especially in LMICs like Afghanistan, it is also increasing in such countries. In compare to vaginal delivery the cesarean section has higher risks for maternal health. The most important aim of this study is to search the commonest indications of cesarean section at the only teaching hospital in west region of Afghanistan, Ghalib Teaching Hospital in 2017.Material and Method: This was a cross-sectional study. Among 456 pregnant women who came to Ghalib Teaching Hospital, 287(63%) had vaginal delivery and 169 (37%) had cesarean section delivery in 2017. Data was collected reviewing medical records; patients discharge certificate and a questionnaire which consisted of the data like; history of previous cesarean sections, age, and so on. Data was analyzed by epi info 7.Results: the prevalence of cesarean section in Ghalib Teaching Hospital was 37%, the median age was 28 years old, the mean age was 23.83 and the most ages were between 21-25 (42.5%). The commonest indications were severe oligohydramnios (29.5%) followed by previous cesarean section (12.4%) and elective cesarean section 10.9% (on maternal request). The least indication was cephalopelvic disproportion (3.09%). In our research we had more than one indication about 10.3%.Conclusion: according to the research the commonest indication of cesarean section was severe oligohydromnios which shows emergency indication among pregnant women. As the women in Afghanistan want many children so they usually do not consider having cesarean section deliveries. Cesarean section on maternal request also has high rate which needs appropriate guidelines and also policies to decrease this high rate of selective cesarean section. In our research 52.1% of indications of CS was fetal factors. This shows in LMICs many fathers have valued to the health of babies instead of mothers. It is highly needed to inform fathers to know about health of both babies and mothers.

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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 ◽

Color Doppler Ultrasound ◽

Cesarean Sections ◽

Vaginal Repair ◽

Significant Difference ◽

Average Size ◽

Previous Cesarean

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.

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Report of a Case of Annular Pancreas of the Newborn in Two Consecutive Siblings

PEDIATRICS ◽

10.1542/peds.48.1.148 ◽

1971 ◽

Vol 48 (1) ◽

pp. 148-150

Author(s):

R. C. Montgomery ◽

M. H. Poindexter ◽

G. H. Hall ◽

John E. Leigh

Keyword(s):

Cesarean Section ◽

Intestinal Obstruction ◽

Duodenal Obstruction ◽

Case Reports ◽

Annular Pancreas ◽

Elective Cesarean Section ◽

Cesarean Sections ◽

Elective Cesarean ◽

Previous Cesarean ◽

High Intestinal Obstruction

Annular pancreas presenting as high intestinal obstruction in the newborn has been reported on numerous occasions.14 The purpose of this paper is to report the occurrence of annular pancreas causing duodenal obstruction in the newborn in two consecutive siblings. Case Reports Case 1, D.B., a male, was born August 31, 1966. The mother was gravida III, para II. Her expected date of confinement was September 12, 1966. The pregnancy had been uneventful except that she had minimal polyhydramnios. The mother had been on no medications during her pregnancy except a prenatal vitamin and iron. On August 31, 1966 the mother underwent an elective cesarean section because of previous cesarean sections which were performed for cephalo-pelvic disproportion.

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Comparison between laparoscopic and vaginal suturing in closing the vaginal vault in Total Laparoscopic Hystrectomy

QJM ◽

10.1093/qjmed/hcaa056.026 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A A Fahmy ◽

K M Labib ◽

M A Elnahas

Keyword(s):

Comparative Study ◽

Laparoscopic Hysterectomy ◽

Maternity Hospital ◽

Total Laparoscopic Hysterectomy ◽

Vaginal Vault ◽

Surgical Removal ◽

Cesarean Sections ◽

Benign Diseases ◽

Randomized Control ◽

Previous Cesarean

Abstract Background Hysterectomy is defined as surgical removal of the uterus. It is one of the most gynecological operations all over the world. Benign diseases are responsible for more than 70% of the indications for hysterectomy. e.g: fibroids, pelvic pain and menstrual disorders. Aim of the study to compare between laparoscopic route and vaginal route in vaginal vault closure in total laparoscopic hysterectomy. Patients and Methods This comparative study was carried out between March 2018 and October 2018, at Ain Shams maternity hospital and Helwan materinity hospital, a prospective randomized control comparative study of 32 ladies undergoing total laparoscopic hysterectomy after obtaining the approval of the local ethical committee and a fully-informed written consent. Results A total of 32 patients were included in the study and they were divided into 2 groups each group consisted of 16 patients, the first group of patients underwent laparoscopic suturing and the second group underwent vaginal suturing. Each group was further subdivided into vertical (8 patients) and horizontal (8 patients). Both groups were matched for age, parity, BMI, menstrual status, comorbidities, previous cesarean sections and indications for hysterectomy. Conclusion Vaginal vault closure can be performed safely and effectively both vaginally and laparoscopically.Vaginal route for vault closure was shorter and easier than laparoscopic route.Vaginal horizontal suturing was comparable to vaginal vertical. Laparoscopic vertical was easier and faster than laparoscopic horizontal.

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