scholarly journals The Impact of Timing of Elective Cesarean Delivery at Term in Neonatal Respiratory Morbidity.

2020 ◽  
Vol 4 (2) ◽  
pp. 653-660
Author(s):  
Ajmone TROSHANI ◽  
Evda VEVECKA
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Primary Outcome ◽  
Elective Caesarean Section ◽  
Respiratory Morbidity ◽  
Emergency Caesarean ◽  
Emergency Cesarean ◽  
Increased Risk ◽  
Elective Cesarean ◽  
The Impact

The aim is to investigate the association between elective caesarean sections and neonatal respiratory morbidity and the importance of timing of elective caesarean sections Methods; Cohort study with prospectively collected data of all elective Caesarean sections on mothers with a gestational age of 37+0 weeks and more, that were performed in our Hospital from 1 January 2011 to 1 January 2017. Multiple pregnancies, fetuses with congenital anomalies, intrauterine deaths, and emergency Caesarean sections were excluded. Primary outcome measures of neonatal respiratory morbidity included transient tachypnea of newborn, respiratory distress syndrome, persistent pulmonary hypertension of the newborn. Results; 4290 infants were delivered by elective caesarean section at 37+0 and then after Compared with newborns from vaginal delivery, and emergency cesarean section an increased risk of respiratory morbidity was found for infants delivered by elective caesarean section at 37 +0 weeks’ gestation to 37+6 weeks (odds ratio 5.7 95% confidence interval 4.3 to 8.9), 38+0 weeks’ gestation to 38+6 weeks (2.8, 2.1 to 4.2 ), and 39+0 weeks’ gestation (2.1, 1.5 to 2.8). Also increasing the incidence of admission to the NICU with decreasing gestational age at term birth below the 39 weeks of gestation Conclusions: Compared with newborn delivered vaginally or by emergency caesarean sections, those delivered by elective caesarean section around term have an increased risk of respiratory morbidity. The relative risk increased with decreasing gestational age.

scholarly journals Maternal and Fetal Outcome in Emergency versus Elective Caesarean Section

2020 ◽  
Vol 18 (2) ◽  
pp. 186-189
Author(s):  
Naveen Darnal ◽  
Ganesh Dangal
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Elective Caesarean Section ◽  
Fetal Outcome ◽  
Emergency Caesarean Section ◽  
P Value ◽  
Age Group ◽  
Common Indication ◽  
Emergency Caesarean ◽  
Emergency Cesarean

Background: Caesarean section is one of the most performed surgical procedures all over the world. It is associated with high morbidity and mortality as compared to vaginal delivery. The present study was carried out to evaluate the maternal and neonatal outcome and complications in two groups of pregnant women who underwent elective and emergency cesarean section, so that measures can be taken to reduce morbidity and mortality in near future.Methods: It was hospital based descriptive cross-sectional study carried out at Paropakar Maternity and Women’s Hospital from October to December 2018. There were 340 patients enrolled in the study 170 in elective and 170 in emergency caesareans selected randomly. Ethical approval was obtained from the Institutional Review Board and informed consent was taken from the patients and patients’ guardians. Data were collected daily from the Operation Theater. Results: The rate of caesarean section in the hospital was 30.7%. Proportion of emergency caesarean section was 1324 (74.4%) and elective caesarean section was 456 (25.6%). Emergency Caesarean section was more common in younger age group and in primigravida while elective Caesarean section was more common in advanced age group and in multigravida. The most common indication for emergency Caesarean section was Fetal Distress and the most common indication for elective Caesarean section was previous cesarean with refused vaginal delivery after cesarean section. The maternal outcome in terms of post-operative wound infection, (post-partum hemorrhage, urinary tract infection need for blood transfusion, fever and need for maternal intensive care unit admission was significantly (p- value <0.05) higher in emergency Caesarean section than in elective Caesarean section .The fetal outcome in terms of birth asphyxia, meconium stained liquor and need for Neonatal ICU admission were significantly (p – value <0.05) higher in emergency Caesarean section than in elective Caesarean section. Conclusions: Maternal and fetal complications were significantly higher in the emergency caesarean section as compared to elective caesarean section group.Keywords: Fetal outcome; emergency cesarean section; elective cesarean section; maternal outcome.

scholarly journals FRI0305 FERTILITY AND PREGNANCY OUTCOMES IN WOMEN WITH SPONDYLOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 742.2-743
Author(s):  
S. Hamroun ◽  
A. Hamroun ◽  
J. J. Bigna ◽  
E. Allado ◽  
F. Förger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Caesarean Section ◽  
Disease Activity ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Research Support ◽  
Increased Risk ◽  
The Impact

Background:Women with spondyloarthritis (SpA) are often affected by the disease during their reproductive years1. However, little is known about the impact of the disease and its treatments on fertility and pregnancy outcomes, as well as the effect of pregnancy itself on disease activity2.Objectives:The aim of the study was to determine the effects of spondyloarthritis on fertility and pregnancy outcomes in women with SpA.Methods:We searched Pubmed, Embase, and Web of Science until 1 November 2019, without any language restriction. All studies assessing fertility, pregnancy outcomes and disease activity during pregnancy in women with spondyloarthritis (axial SpA (axSpA) but also peripheral SpA, including psoriatic arthritis (PsA)) were eligible. The heterogeneity between studies was quantified (I2), and multiple meta-regressions were carried out to identify potential sources of heterogeneity. In case I2was < 50%, a random-effects model was used to pool the available data. Prevalence of events was described as percentages. The odds ratio (OR) and corresponding 95% confidence interval (CI) were used to assess the associations between the disease and the pregnancy outcomes.Results:Within 4397 eligible studies, 21 articles fulfilling the selection criteria were included in the review, assessing overall 3306 patients (2578 with axSpA and 728 with PsA) and 4104 pregnancies compared to 42248 healthy controls (in 11 studies with a control group). Among the included studies, the risk of bias was evaluated as high, moderate and low in respectively 12, 1 and 8 studies. Regarding pregnancy outcomes, several studies report an increased risk of preterm birth, small for gestational age (pooled OR 2,05, [1,09-3,89],I2=5,8% in axSpA) and caesarean section (pooled OR 1,77 [1,45-2,17],I2=27,5% in axSpA and pooled OR 1,47 [1,22-1,76],I2=0,0% in PsA), without any other unfavourable pregnancy outcome (miscarriage, stillbirth, gestational diabetes or preeclampsia). Further analysis found a significant higher risk for elective caesarean (pooled OR 2,64, [1,92-3,62],I2=0,0% in axSpA and pooled OR 1,47, [1,15-1,88],I2=0,0% in PsA), without increased risk for emergency caesarean. There was no substantial heterogeneity in the majority of meta-analyses.Conclusion:Although based on observational data, this work is to our knowledge, the first systematic review and meta-analysis concerned with this subject. SpA and PsA seem to be associated with an increased risk of preterm birth, small for gestational age and elective caesarean section. The analysis of the impact of pregnancy on disease activity in this setting is currently ongoing.References:[1]Van den Brandt S. Arthritis Res Ther 2017;19(1):64.[2]Ursin K. Rheumatology. 201;57(6):1064-1071.Fig. 1.Association between caesarean section and axSpAFig. 2.Association between small for gestational age and axSpADisclosure of Interests:SABRINA HAMROUN: None declared, Aghilès Hamroun: None declared, Jean Joël Bigna: None declared, Edem Allado: None declared, Frauke Förger Grant/research support from: Unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK, Anna Moltó Grant/research support from: Pfizer, UCB, Consultant of: Abbvie, BMS, MSD, Novartis, Pfizer, UCB

scholarly journals Caesarean section and severe upper and lower respiratory tract infections during infancy: Evidence from two UK cohorts

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246832
Author(s):  
Neora Alterman ◽  
Jennifer J. Kurinczuk ◽  
Maria A. Quigley
Keyword(s):  
Caesarean Section ◽  
Respiratory Tract ◽  
Hospital Admission ◽  
Gestational Age ◽  
Lower Respiratory Tract ◽  
Hazard Ratio ◽  
Upper Respiratory Tract ◽  
Emergency Caesarean ◽  
Increased Risk ◽  
Tract Infections

Background Several studies have reported that birth by caesarean section is associated with increased risk of lower respiratory tract infections in the child, but it is unclear whether this applies to any caesarean section or specifically to planned caesareans. Furthermore, although infections of the upper respiratory tract are very common during childhood, there is a scarcity of studies examining whether caesarean is also a risk factor for this site of infection. Methods We obtained data from two UK cohorts: the Millennium Cohort Study (MCS) and linked administrative datasets of the population of Wales through the Secure Anonymised Information Linkage (SAIL) databank. The study focused on term-born singleton infants and included 15,580 infants born 2000–2002 (MCS) and 392,145 infants born 2002–2016 (SAIL). We used information about mode of birth (vaginal delivery, assisted vaginal delivery, planned caesarean and emergency caesarean) from maternal report in the MCS and from hospital birth records in SAIL. Unplanned hospital admission for lower respiratory tract infection (LRTI) was ascertained from maternal report in the MCS and from hospital record ICD codes in SAIL. Information about admissions for upper respiratory tract infection (URTI) was available from SAIL only. Cox regression was used to estimate hazard ratios for each outcome and cohort separately while accounting for a wide range of confounders. Gestational age at birth was further examined as a potential added, indirect risk of planned caesarean birth due to the early delivery. Findings The rate of hospital admission for LRTI was 4.6 per 100 child years in the MCS and 5.9 per 100 child years in SAIL. Emergency caesarean was not associated with LRTI admission during infancy in either cohort. In the MCS, planned caesarean was associated with a hazard ratio of 1.39 (95% CI 1.03, 1.87) which further increased to 1.65 (95% CI 1.24, 2.19) when gestational age was not adjusted for. In SAIL, the adjusted hazard ratio was 1.10 (95% CI 1.05, 1.15), which increased to 1.17 (95% CI 1.12, 1.22) when gestational age was not adjusted for. The rate of hospital admission for URTI was 5.9 per 100 child years in SAIL. Following adjustments, emergency caesarean was found to have a hazard ratio of 1.09 (95% CI 1.05, 1.14) for hospital admission for URTI. Planned caesarean was associated with a hazard ratio of 1.11 (95% CI 1.06, 1.16) which increased to 1.17 (95% CI 1.12, 1.22) when gestational age was not adjusted for. Conclusions The risk of severe LRTIs during infancy is moderately elevated in infants born by planned caesarean compared to those born vaginally. Infants born by any type of caesarean may also be at a small increased risk of severe URTIs. The estimated effect sizes are stronger if including the indirect effect arising from planning the caesarean birth for an earlier gestation than would have occurred spontaneously. Further studies are needed to confirm these results.

scholarly journals Evaluation of Postoperative Analgesic Consumption After Emergency and Elective Cesarean Section

2018 ◽  
pp. 1
Author(s):  
Hakan Tapar ◽  
Serkan Karaman ◽  
Serkan Dogru ◽  
Tugba Karaman ◽  
Hatice Yilmaz Dogru
Keyword(s):  
Caesarean Section ◽  
General Anesthesia ◽  
Elective Caesarean Section ◽  
Pain Scale ◽  
Emergency Caesarean Section ◽  
Elective Cesarean Section ◽  
Analgesic Consumption ◽  
Emergency Caesarean ◽  
Post Operative Pain ◽  
Elective Cesarean

<p><strong>OBJECTIVE:</strong> This study compares post-operative pain and analgesic consumption among patients who have undergone either an emergent or elective caesarean section.</p><p><strong>STUDY DESIGN:</strong> A total of 115 patients, comprised of 48 emergency caesarean section and 67 elective caesarean section patients, were enrolled in this prospective study. Pain intensity was evaluated with a numeric pain scale in the 1st, 2nd, 6th, 12th and 24th post-operative hours and total post-operative tramadol consumption within 24 hours was recorded for each patient.</p><p><strong>RESULTS:</strong> Total tramadol consumption for emergency caesarean section patients under general anesthesia was 222.91±56.52 mg and for elective caesarean section patients under general anesthesia was 181.71±55.38 mg (p&lt;0.05). In patients under spinal anesthesia, total tramadol consumption was found to be 169.58±59.52 mg and 160.62±70.47 mg in emergency and elective cases respectively (p&gt;0.05).</p><p><strong>CONCLUSION:</strong> Analgesic consumption for emergency caesarean section patients under general anesthesia was observed to be high.<br /><br /></p>

scholarly journals The Management of Myelomeningocele Study: Short-Term Neonatal Outcomes

2020 ◽  
Vol 47 (12) ◽  
pp. 865-872 ◽  
Author(s):  
Natalie E. Rintoul ◽  
Roberta L. Keller ◽  
William F. Walsh ◽  
Pamela K. Burrows ◽  
Elizabeth A. Thom ◽  
...  
Keyword(s):  
New England ◽  
Gestational Age ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Outcome Data ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
Significant Difference ◽  
The Impact ◽  
Prenatal Surgery

<b><i>Introduction:</i></b> The Management of Myelomeningocele Study was a multicenter randomized trial to compare prenatal and standard postnatal repair of myelomeningocele (MMC). Neonatal outcome data for 158 of the 183 randomized women were published in <i>The New England Journal of Medicine</i> in 2011. <b><i>Objective:</i></b> Neonatal outcomes for the complete trial cohort (<i>N</i> = 183) are presented outlining the similarities with the original report and describing the impact of gestational age as a mediator. <b><i>Methods:</i></b> Gestational age, neonatal characteristics at delivery, and outcomes including common complications of prematurity were assessed. <b><i>Results:</i></b> Analysis of the complete cohort confirmed the initial findings that prenatal surgery was associated with an increased risk for earlier gestational age at birth. Delivery occurred before 30 weeks of gestation in 11% of neonates that had fetal MMC repair. Adverse pulmonary sequelae were rare in the prenatal surgery group despite an increased rate of oligohydramnios. There was no significant difference in other complications of prematurity including patent ductus arteriosus, sepsis, necrotizing enterocolitis, periventricular leukomalacia, and intraventricular hemorrhage. <b><i>Conclusion:</i></b> The benefits of prenatal surgery outweigh the complications of prematurity.

Neonatal respiratory morbidity following elective caesarean section in term infants

2001 ◽  
Vol 98 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Anemone van den Berg ◽  
Ruurd M van Elburg ◽  
Herman P van Geijn ◽  
Willem P.F Fetter
Keyword(s):  
Caesarean Section ◽  
Elective Caesarean Section ◽  
Respiratory Morbidity ◽  
Term Infants

scholarly journals Profile of Caesarean Section at Kathmandu Medical College

2017 ◽  
Vol 15 (2) ◽  
pp. 110-113
Author(s):  
Apurwa Prasad ◽  
Garima Bhandari ◽  
Rachana Saha
Keyword(s):  
Caesarean Section ◽  
Demographic Data ◽  
Elective Caesarean Section ◽  
Emergency Caesarean Section ◽  
Medical College ◽  
Emergency Caesarean ◽  
Clinical Indications ◽  
Depth Study ◽  
Elective Procedure ◽  
Failed Induction

Background: There is a world-wide rise in caesarean section rateduring the last three decades and has been a cause of alarm and needs an in-depth study. The objective of this study was to determine the rate and clinical indications of Caesarean Section.Methods: A hospital based study was carried out from 15th June 2015 to 15th January 2016 in Department of Obstetrics and Gynecology at Kathmandu Medical College, Sinamangal, Nepal. Patients who delivered by caesarean section were included in the study. Basic demographic data and clinical indications were noted.

Results: A total of 1172 deliveries were carried out during the study period. Total number of caesarean section was 537 accounting to 45.81%. Most of the patients were of the age group of 25-29 years (42.8%). Most of the patients were primigravida (n=274; 51%). Emergency caesarean section was 411 (76.5%) and elective caesarean section was 126 (23.4%). Multigravida (71%) underwent more elective procedure than primigravida (25. 39%).The most frequent indication was fetal distress19.55% (n=105), failed induction 19.73%(n=106), and previous caesarean section 21.3% (n=115).Conclusions: The rate of cesarean section is quite high than that recommended by WHO which is (10-15%). Most of the caesarean sections were emergency caesarean section with previous caesarean being the leading cause.

scholarly journals Frequency of Caesarean Section in Pregnancies with Borderline Amniotic Fluid Index at Term

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Natasha Bushra ◽  
Khaula Zeeshan ◽  
Sara Ejaz ◽  
Javeria Mushtaq ◽  
Khadija Waheed ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Induction Of Labour ◽  
Amniotic Fluid Index ◽  
Cross Sectional ◽  
Increased Risk ◽  
Failed Induction ◽  
One Year

AbstractThe increased risk of caesarean section after induced labour is well documented. Rate of induction of labour has doubled in the past decade from 10 to 20%. Low Amniotic Fluid Index (AFI) as an isolated finding leads to increased obstetrical interventions but without any improvement in outcome.Objectives:  To determine the frequency of caesarean section due to failed induction in pregnancies at term with borderline AFI.Patients and Methods:  This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Unit-III, SIMS/Services Hospital, Lahore. The duration of study was one year from January, 2015 to December, 2015. A total of 150 patients were included in this study. AFI was measured by recent obstetric ultrasound. All patients with borderline AFI (5 – 8 cm) were included in the study. They were induced by glandin E2 gel. If induction of patients failed with two doses of glandin E2 gel, given vaginally 6 hours apart, patients were considered for cesarean section. The outcome measure was rate of caesarean section due to failed induction. All data were analyzed by SPSS version 20.Results:  Mean age of the patients was 30.34 ± 6.68 years. Mean gestational age was noted 38.34 ± 1.05 weeks. Out of 150 patients, 103 (68.7%) were para 1 – 3 and 47 patients (31.3%) were para 4 – 6. Caesarean section due to failed induction with borderline AFI was performed in 27 patients (18.0%). Stratification with regard to age, gestational age and parity was carried out and was found significant only for gestational age being > 39 weeks.Conclusion:  It is concluded that failed induction of labour at term in women with borderline AFI is not associated with increased risk of caesarean delivery.

scholarly journals Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

2018 ◽  
Vol 7 (2) ◽  
pp. 343 ◽  
Author(s):  
Heena D. Pahuja ◽  
Megha P. Tajne ◽  
Anjali R. Bhure ◽  
Savita M. Chauhan
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Epidural Block ◽  
Elective Cesarean Section ◽  
Significant Difference ◽  
Elective Cesarean ◽  
Mean Time

Background: Levobupivacaine has been purported to be as efficacious as Bupivacaine for epidural anaesthesia in recent literature.Methods: With the intent to study the same in caesarean section cases in our set up, we observed various intra- and post-operative variables in two groups (Levobupivacaine and Bupivacaine) of 60 healthy parturients. Sixty parturients for elective caesarean section were allocated randomly to receive epidural block with 10-20 ml of either 0.5% Levobupivacaine with Fentanyl 25µg or 0.5% Bupivacaine with Fentanyl 25µg to reach T6 level.Results: Mean total volume in Bupivacaine group was 15.23ml and in Levobupivacaine group was 12.76 ml. The difference was statistically significant. There was significant difference between the groups in the sensory block. The onset of analgesia was earlier in Levobupivacaine group. Mean time was 6.20 minutes in Bupivacaine group and 4.36 minutes in Levobupivacaine group. The duration of motor block was significantly short in Levobupivacaine group. Mean Time for recovery from motor block in Bupivacaine group was 2.5 hours and in Levobupivacaine group 1.5 hours. Mean time to achieve T6 height was earlier in Levobupivacaine group i.e. 16.46 minutes in Bupivacaine group and 13.26 minutes in Levobupivacaine group. Duration of postoperative analgesia was similar. There was no significant difference in neonatal outcome.Conclusions: Levobupivacaine was found to fare better than Bupivacaine in the studied intra and post-operative parameters and is hence recommended over racemic Bupivacaine for epidural block in patients undergoing elective cesarean section.

scholarly journals Anaesthetic Management of a Morbidly Obese Parturient for Elective Caesarean Section

2016 ◽  
Vol 10 (2) ◽  
pp. 64-66
Author(s):  
R Pradhan ◽  
S Shrestha ◽  
T Gurung ◽  
AB Shrestha ◽  
KR Sharma
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Epidural Anaesthesia ◽  
Gestational Hypertension ◽  
Elective Caesarean Section ◽  
Anaesthetic Management ◽  
Elective Cesarean Section ◽  
Morbidly Obese ◽  
Elective Cesarean ◽  
Spinal Epidural

Anaesthesia for an obese parturient poses a challenge to anaesthesiologists. Here we report a case of 27 years obese primigravidae at 40 weeks of gestation with gestational hypertension who underwent elective cesarean section under combined spinal epidural anaesthesia. Her intraoperative and postoperative periods were uneventful. 

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