scholarly journals AUDIT OF CESAREAN SECTION IN A RURAL TEACHING HOSPITAL AS PER WHO GUIDELINES (ROBSON’S TEN GROUP CLASSIFICATION SYSTEM)

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Priyanka Sharma ◽  
Apra Attri
Keyword(s):  
Cesarean Section ◽  
Breech Presentation ◽  
Background Rate ◽  
Medical College ◽  
Nulliparous Women ◽  
Group 5 ◽  
Group 2 ◽  
Rural Teaching ◽  
Presentation Group ◽  
Group 1

Background:  Rate of cesarean section (CS) is one of the most frequently used indicators of healthcare quality at the national and international levels for clinical governance.  Audit of indications of CS and to propose measures to reduce the rate of CS in our institution Methods: Prospective observational study was conducted at Department of Obstetrics and Gynaecology at Dr Rajendra Prasad Government Medical College Kangra at Tanda (HP) Results: In our study, previous CS (group 5) contributed the most (30.44%) of overall CS.Second largest contributor was nulliparous women with cephalic presentation at term (group 1 and 2).Induction of labor (group 2) was associated with higher CS (23.66%), as compare spontaneous labor (group1). Women with breech presentation (group 6 and 7) also showed high CS rate. Conclusion: In conclusion, RTGCS permits the easy identification of the leading contributing groups to CS increases. RTGCS is an internationally accepted classification that is much needed to scientifically study the effects of the rising CS rate. It identifies the contributors to differences in the CS rate but does not provide any explanation for these differences across various subgroups. Keywords: RTGCS, CS, NVD, Women.

Analysis of caesarean section rates using Robsons ten group classification: the first step

2017 ◽  
Vol 6 (8) ◽  
pp. 3481 ◽  
Author(s):  
Sowmya Koteshwara ◽  
Sujatha M. S.
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Group Classification ◽  
Cross Sectional ◽  
Medical College ◽  
Relative Contribution ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Background: The Caesarean section (CS) rate is steadily increasing worldwide including India. The overall CS rates are reported but rarely the women are classified. According to WHO Robson ten –group classification is useful as a global standard for assessing, monitoring and comparing cesarean section rates. Our objective was to classify women delivering in our hospital according to various categories as per the 10-group classification (Robsons classification) and analyzing the CS rate in each group.Methods: This was a cross sectional study conducted at JSS Medical College, Mysore. The data was collected for all women delivering in hospital from January 2016-December 2016 and the women were classified according to Robsons 10 group classification. The proportion of women delivering in each group, the CS rate of each group, and the relative contribution to CS rate from each group was calculated.Results: Among a total of 5016 women delivering during the study period 37.65% of women were delivered by CS. Maximum no of pregnant women belonged to primigravida group (group 1 and 2). Major contributor to CS rate were primigravida (group 2) at 32.2%. Next contributors were group 5 and group 1 at 28.9 % and 18.6% respectively. Overall the three groups 1, 2 and group 5 contributed to 79.7% of the CS rate while the other group contributed to only 21.3% of CS rate.Conclusions: Applying Robsons criteria to classify pregnant women allowed for easy classification to identify the category of women most likely to have CS. Reducing primary CS rate and increasing VBAC rates will help to reduce CS rate. 

scholarly journals Prevalence of Cesarean Section Based on Robson’s Classification in Selected Delivery Centers of Shiraz University of Medical Sciences

2020 ◽  
Vol 21 (7) ◽  
Author(s):  
Zohreh Rookesh ◽  
Mahnaz Zarshenas ◽  
Marzieh Akbarzadeh
Keyword(s):  
Cesarean Section ◽  
Descriptive Statistics ◽  
World Health ◽  
Medical Sciences ◽  
Nulliparous Women ◽  
High Prevalence ◽  
The World ◽  
Group 5 ◽  
Group 2 ◽  
Health Organization

Background: Cesarean section is performed to save the lives of the mother and the fetus. According to the World Health Organization (WHO), the expected cesarean section rate in different countries should be 10% - 15%, which is about 72.1% in Iran. Objectives: Therefore, due to the high prevalence of cesarean section, the present study was conducted to determine the prevalence of cesarean section based on Robson’s classification in selected hospitals of Shiraz University of Medical Sciences. Methods: This descriptive-prospective study was conducted among 1787 women who had undergone a cesarean section in Hazrat Zeinab and Hafez hospitals of Shiraz in 2018. The data were collected by the researcher from the data recorded in the two delivery centers, and all the women were classified into 10 Robson groups. Cesarean section was calculated for each group of Robson’s classification. Data were analyzed using descriptive statistics (frequency and percentage) in SPSS, version 22. Results: Findings showed that 63.4% of the deliveries were performed through cesarean section, and the highest frequency (46.6%) was related to group 5, followed by group 2 (19.5%). Conclusions: Given the high Prevalence of cesarean section observed in this study, it is recommended that the rate of cesarean section should be reduced in nulliparous women (group 2), and vaginal delivery should be increased after cesarean section (group 5).

scholarly journals Rates and Indications of Cesarean Section Using the Robson Classification in a University Hospital in Southern Thailand 2014-2016

2020 ◽  
Author(s):  
Jarawee Sukmanee ◽  
Tippawan Liabsuetrakul ◽  
Krantarat Peeyananjarassri
Keyword(s):  
Cesarean Section ◽  
Healthcare Providers ◽  
Breech Presentation ◽  
University Hospital ◽  
Cross Sectional ◽  
Robson Classification ◽  
Nulliparous Women ◽  
Southern Thailand ◽  
Multiparous Women ◽  
Group 1

Objective: To identify the rates and indications of cesarean section (CS) using the Robson classification during 2014- 2016 in a university hospital in southern Thailand. Material and Methods: A cross-sectional study of women who delivered between January 1, 2014 and December 31, 2016 was conducted. The data were analyzed using the Robson classification. Results: A total of 10,474 births were included in the analysis. The overall CS rate was 55.5%. The trends of CS rates in most Robson classification groups over the 3-year period were static. The CS rates in nulliparous or multiparous women with induction of labor decreased over the 3-year period, while the rate in multiparous women with fetal breech presentation increased. Women with previous cesarean section (Robson group 5) were the largest contributor to the overall CS rate (32.1%), followed by the nulliparous women with a single cephalic pregnancy, ≥37 weeks gestation in spontaneous labor (Robson group 1) (24.5%). Cephalopelvic disproportion and fetal distress were the most common indications for CS in Robson group 1. Conclusion: The CS rates in our study were high in all groups during the 3-year period, with static trends in most groups. The Robson classification is a feasible tool for monitoring CS rates in our setting. Feedback of these findings to healthcare providers and policy makers is advised.

Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

2019 ◽  
Vol 17 (4) ◽  
pp. 354-364
Author(s):  
Hassan Al-Thani ◽  
Moamena El-Matbouly ◽  
Maryam Al-Sulaiti ◽  
Noora Al-Thani ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Lower Extremity ◽  
Hazard Ratio ◽  
Lower Extremity Amputation ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Extremity Amputation ◽  
Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

scholarly journals Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Liu ◽  
Jing Li ◽  
Wanyu Zhang ◽  
Yihong Guo
Keyword(s):  
Birth Weight ◽  
Ovarian Stimulation ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
The Impact ◽  
Ivf Et ◽  
Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

scholarly journals Morphological Characterization of Isolates of Phomopsis vexans of Bangladesh

2013 ◽  
Vol 8 (1-2) ◽  
pp. 123-130
Author(s):  
MM Islam ◽  
M Asaduzzaman ◽  
ME Hoque ◽  
MB Meah
Keyword(s):  
Morphological Characterization ◽  
Cultural Properties ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Phomopsis Vexans ◽  
Group 1

Forty four isolates of Phomopsis vexans from different eggplant cultivars collected from core eggplant growing regions of Bangladesh which were characterized using mycological characteristics. Variation exists among the isolates of Phomopsis vexans of Bangladesh covering two types of farm having two ecosystems and the isolates were grouped into five distinct groups based on their cultural properties. The highest sized ? conidia were observed in group -1 and the lowest size in-group -2. The highest sized ? conidia were recorded in group -5 and the lowest in-group –2. The highest pycnidial size noted in-group -3 and the smallest sized pycnidia were recorded in group –1. DOI: http://dx.doi.org/10.3329/jsf.v8i1-2.14635 J. Sci. Foundation, 8(1&2): 123-130, June-December 2010

Timing of melatonin treatment: differential effects on oestrus and coat growth in goats

1997 ◽  
Vol 65 (2) ◽  
pp. 267-273 ◽  
Author(s):  
I. A. Forsyth ◽  
F. E. Gebbie ◽  
J. Arendt
Keyword(s):  
Goat Milk ◽  
Normal Weight ◽  
Ovarian Activity ◽  
Plasma Prolactin ◽  
Dairy Goats ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

AbstractTo avoid winter scarcity of fresh goat milk, simple methods of advancing the season of kidding would be commercially valuable. A combination of long-day light treatment followed by melatonin is successful but other aspects of seasonality including coat growth are also reset. To investigate whether effects on breeding season and coat growth can be dissociated, British Saanen dairy goats (no. = 30) were randomly allocated to one of six groups. Control goats were untreated. Goats in the other five groups received 2 months of treatment with 20 h light: 4 h darkness (20L: 4D) and were then given 3 mg melatonin orally at 16.00 hfor 2 months. The treatments started on 11 January (group 1), 29 March (group 2), 14 June (group 3), 30 August (group 4) and 8 November (group 5). Weekly blood samples were taken for the measurement of progesterone to monitor ovarian activity and prolactin. Side patches (10 cm ×10 cm) were clipped monthly from alternate sides and weighed to measure coat growth. The onset of ovarian activity was advanced from a median date of 15 November in controls to 24 May in group 1 (P < 0·01), 16 August in group 2 (P < 0·05) and 18 October in group 3 (? < 0·05). Groups 4 and 5 showed no significant change in the onset of oestrus (median onset dates 8 November and 1 November, respectively). Group 1 goats came into season again with controls in November. In all except group 5, treatment interacted with time to affect significantly the growth of the coat. The pattern of coat growth was most altered (P < 0·001) in groups 1 and 2. This was associated with effects on plasma prolactin concentrations of light stimulation and melatonin suppression. Group 1 goats resynchronized with control goats to show a coat of normal weight in the winter following treatment. Division of milking goat herds into spring and autumn kidding groups is, therefore, a practical possibility, but effects on overall milk yield require study.

THE EFFECTS OF SLAUGHTER WEIGHT AND SEX ON THE COOKING LOSSES FROM AND PALATABILITY ATTRIBUTES OF PORK LOIN CHOPS

1984 ◽  
Vol 64 (1) ◽  
pp. 39-43 ◽  
Author(s):  
L. E. JEREMIAH ◽  
G. M. WEISS
Keyword(s):  
Key Words ◽  
Slaughter Weight ◽  
Cooking Properties ◽  
Group 4 ◽  
Practical Standpoint ◽  
Group 3 ◽  
Pork Loin ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

A total of 130 barrows and 113 gilts were slaughtered over a range of liveweights from 65.6 to 143.9 kg. These animals were randomly assigned to six different liveweight groups (group 1, less than 79.5 kg; group 2, 79.5 through 93.1 kg; group 3, 93.2 through 106.7 kg; group 4, 106.8 through 120.4 kg; group 5, 120.5 through 134.0 kg; and group 6, 134.1 kg and over) and utilized to evaluate the effects of slaughter weight and sex on palatability and cooking properties. The composite results indicated that the slaughter weight of both barrows and gilts can, from a practical standpoint, be increased to take advantage of potential economic advantages without meaningfully altering cooking losses or palatability attributes. Key words: Pork, slaughter weight, sex, palatability, cooking losses

Abstract 15193: Pulmonary Hypertension in Pregnancy: WHO Group 1 Outcomes Improved, Time to Focus on WHO Group 2

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
William H Marshall ◽  
Stephen Gee ◽  
Woobeen Lim ◽  
Elisa A Bradley ◽  
Lauren Lastinger ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Post Partum ◽  
Systolic Pressure ◽  
Adverse Outcomes ◽  
Cardiac Events ◽  
Ventricular Systolic Pressure ◽  
Group 5 ◽  
Group 2 ◽  
In Pregnancy ◽  
Group 1

Introduction: Pregnancy is contraindicated in women with pulmonary hypertension (PH), yet many still decide to pursue pregnancy. Hypothesis: We hypothesized improved maternal mortality with PH at our center’s cardio-obstetrics program and sought to identify factors to estimate the risk of major adverse cardiac events (MACE). Methods: Pregnant women with right ventricular systolic pressure (RVSP) ≥35 mmHg or tricuspid regurgitant velocity > 2.8 m/s on transthoracic echocardiogram (TTE) were identified. Women with intermediate to high probability PH by ESC criteria (TTE or catheterization, n = 70) were classified using the 6 th World Society of PH definitions. Results: In 70 women with PH (30 ± 6 years-old, RVSP 52 ± 16 mmHg) there were 12 (17%) with WHO Group 1 PH, 45 (64%) with Group 2 PH, 4 (6%) with Group 3 PH and 9 (13%) with Group 5 PH (Figure A). Baseline characteristics were similar except: Group 1 PH had 83% on prostacyclin (PC) therapy, higher RVSP (78 ± 20 mmHg vs. Groups 2 (46 ± 9), 3 (44 ± 2 mmHg) and 5 PH (48 ± 10mmHg), p<0.01), and compared to Group 2 PH, more Group 1 PH women were diagnosed pre-pregnancy (9 (75%) vs. 12 (27%), p = 0.01) and had cardio-obstetrics care (10 (83%) vs. 16 (36%), p < 0.01) (Figure B - E). There were no peripartum deaths, however 3 (4.3%) women with Group 2 PH had late mortality (7 ± 4 months post-partum). MACE occurred in 24 (34%) women and was more likely in those with: NYHA FC ≥ 2 (95% CI 4.7-57, p < 0.01), pre-eclampsia (95% CI 1.2-13, p = 0.03), RVSP >50 mmHg (95% CI 1.3-10, p = 0.02) and LVEF <50% (95% CI 1.1-8.8, p = 0.04) (Figure F). Preterm birth occurred in 32 (49%) pregnancies, with no neonatal mortality. Conclusion: To conclude, in a large single center cohort we report 100% 1-year survival in Groups 1, 3, and 5 PH, with most Group 1 PH patients on PC therapy and under cardio-obstetrics care. We identify Group 2 PH as an under-recognized group for adverse outcomes in pregnancy, with NYHA FC, pre-eclampsia, RVSP >50 mmHg and LVEF <50% associated with increased MACE.

scholarly journals Zingerone Ameliorates Hepatotoxicity

2020 ◽  
Vol 11 (1) ◽  
pp. 280-284 ◽  
Author(s):  
Julietpoornamathy J ◽  
Parameswari C.S.
Keyword(s):  
The Body ◽  
Control Group ◽  
Medical Sciences ◽  
Toxic Compounds ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Insight Into ◽  
Group 1

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats.  A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.

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