A Case of Emergency Cesarean Section on Client with Pseudopregnancy

2020 ◽  
pp. 1-6
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Medical Service ◽  
Fetal Heart ◽  
Placenta Previa ◽  
Urban Hospital ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Rural Health Center

Pseudopregnancy detection is significant while as the false pregnancy may show all symptoms. It is important to differentiate it. This is a case report of a pseudopregnancy which led to an emergency cesarean section. A 28-year-old woman who claimed to 7-month pregnancy was brought to the rural health center by husband families complaining of vaginal bleeding. The woman refers to an urban hospital by Emergency Medical Service with the diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate, prior to assessing by sonography. No fetus or signs of uterine or abdominal pregnancy were found. Wrong auscultation of the mother's heart rate instead of fetal heart rate seems to be the main error. It is required to pay more attention to the methods of differentiation of fetal heart rate from the mother's heart rate. This report enlightens false pregnancy and early differentiation.

scholarly journals Cesarean Audit for fetal distress- A indispensable tool to reduce Obstetrician Distress

2021 ◽  
Vol 5 (1) ◽  
pp. 01-04
Author(s):  
Anuradha Singh
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Emergency Cesarean ◽  
Audit Period ◽  
Nicu Admission ◽  
Operative Findings

Background and Objectives: Overuse of cesarean section and its implications are of growing concern. Suspected fetal distress has been the commonest indication for cesarean in last few decades heart rate changes shown by fetus without being adversely affected and CTG has been criticized to create unnecessary higher rate of operative deliveries. There is need to know which fetal heart rate abnormality is important and leading to two adverse neonatal outcome to decrease unnecessary operative deliveries. Therefore Caesarean Audit was planned. Material and methods: A total of hundred women were included who underwent emergency cesarean section for suspected fetal distress in labour or without labour detected by cardiotocography or intermittent auscultation were included for analysis. Details were noted in pre designated proforma. Results: During the audit period, total number of caesarean done due to fetal distress analysed during the period were 100.The most common fetal heart rate abnormality was nonspecific in form of single or transient deceleration seen in 63% of cases where records were also incomplete, it was followed by persistent deceleration on cardiotocography which was present in 16% of the cases. In 57 women who were primigravida 14 (24%) patients had nonspecific fetal heart rate patterns and intra operative findings were normal in this group. These were avoidable cesareans. Various Intraoperative findings, observed ,maximum no. of cases had meconium stained liquor seen in 63% of the cases followed by abruption in 9 cases followed by other findings like loop of cord around the neck of foetus, thin scar or scar dehiscence . Maternal resuscitation was carried out only in 53% of cases. Detection delivery interval of less than 30 minutes was present in 4% of cases. In fetal outcomes 16% of babies diagnosed with fetal distress, had poor outcome where Apgar score < 7 and 12 babies had asphyxia related NICU admission. 82% of babies had absolutely normal fetal outcome among which majority (78%) did not require any form resuscitation. which were thus avoidable cases. Conclusions: Correct Knowledge about Standardized fetal heart rate interpretations on CTG and there standardized management protocols like Maternal resuscitative measures ,follow up to ensure fast detection delivery interval should be practiced strictly in all cases of non reassuring Fetal Heart rate patterns. There should be consistent efforts in reducing the rate of cesarean sections particularly primary cesarean deliveries and in order to understand the degree to which cesarean delivery is preventable it is important to know no why cesareans are being performed. Therefore caesarean audit is need of the hour

scholarly journals The Successful Use of Nitroglycerin for Uterine Hyperstimulation with Fetal Heart Rate Abnormality Caused by a Controlled-Release Dinoprostone Vaginal Delivery System (PROPESS): A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 478
Author(s):  
Sho Takakura ◽  
Hiroaki Tanaka ◽  
Naosuke Enomoto ◽  
Shintaro Maki ◽  
Tomoaki Ikeda
Keyword(s):  
Heart Rate ◽  
Controlled Release ◽  
Vaginal Delivery ◽  
Delivery System ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Cervical Ripening ◽  
Emergency Cesarean ◽  
Uterine Hyperstimulation ◽  
Uterine Relaxation

The PROPESS, a controlled-release dinoprostone vaginal delivery system, is a pharmacological cervical ripening intervention and promotes cervical change causing uterine contraction. During insertion of the PROPESS, uterine hyperstimulation could occur and result in fetal heart rate (FHR) abnormality. We report a case of uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS in a pregnant woman. Postural change, oxygenation, fluid infusion, and the immediate PROPESS removal were ineffective to address the adverse event, so we administered nitroglycerin for acute uterine relaxation. The nitroglycerin resulted in uterine relaxation, and the FHR abnormality was resolved immediately, thereby preventing an emergency cesarean section. Therefore, nitroglycerin could be considered an effective option for uterine hyperstimulation accompanied with FHR abnormality caused by the PROPESS.

scholarly journals Marginal umbilical cord insertions in a bipartite placenta responsible for placenta abruption: a case report

2021 ◽  
Vol 12 (5) ◽  
pp. 309-310
Author(s):  
Elie Nkwabong ◽  
Sylvie Borassi
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
Umbilical Cord ◽  
Fetal Heart ◽  
Past History ◽  
Placenta Previa ◽  
Blood Clot ◽  
Normal Pregnancy ◽  
African Woman ◽  
Emergency Cesarean

Hemorrhage is one of the major causes of maternal death. Main causes of APH are placenta previa, placenta abruption and uterine rupture. Rare causes of placenta abruption include marginal and velamentous umbilical cord insertions. We hereby present a case of placenta abruption due to marginal umbilical cord insertions occurring on a bipartite placenta. A 40-year-old nulliparous African woman, 35 weeks pregnant consulted for dark red pervaginal bleeding, which occurred recently. Past history was unremarkable. Her pregnancy was well followed up. A recent ultrasound scan revealed a fundal inserted placenta. Physical examination revealed a fundal height of 37 cm, no uterine activity, normal fetal heart tones and a blood-stained vulva. Our diagnosis was a mild placenta abruption. An obstetrical ultrasound carried out revealed a normal pregnancy and a retroplacental blood clot of 11mm. A safe baby was born through an emergency cesarean section which revealed a normally inserted bipartite placenta with a 10% placenta detachment located on one placenta half and two cords inserted marginally. The postoperative period was uneventful and she was discharged five days after cesarean section. This case report shows that marginal cord insertion, which can lead to placenta abruption, can be also observed on a bipartite placenta.

Cervical Length Monitoring in Placenta Previa to Predict Emergency Cesarean Section for Antepartum Hemorrhage [06M]

2020 ◽  
Vol 135 ◽  
pp. 136S
Author(s):  
Aarti Chitkara ◽  
Sujata Siwatch ◽  
Rashmi Bagga ◽  
Subas Chandra Saha ◽  
Tulika Singh
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Cervical Length ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean

scholarly journals EP22.07: The fetal heart rate parameter in adherent placenta previa

2019 ◽  
Vol 54 (S1) ◽  
pp. 379-380
Author(s):  
Y. Choe ◽  
H. Boo ◽  
Y. Park ◽  
J. Hoh ◽  
K.Y. Ryu
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Placenta Previa ◽  
Rate Parameter ◽  
Adherent Placenta

scholarly journals A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Emma R. Allanson ◽  
Robert C. Pattinson ◽  
Elizabeth A. Nathan ◽  
Jan E. Dickinson
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
Heart Rate Monitoring ◽  
Post Intervention ◽  
Fetal Heart Rate Monitoring ◽  
Resource Setting ◽  
The Impact

Abstract Introduction Rates of cesarean section (CS) are increasing and abnormal fetal heart rate tracing and concern about consequent acidosis remain one of the most common indications for primary CS. Umbilical artery (UA) lactate sampling provides clinicians with point of care feedback on CTG interpretation and intrapartum care and may result in altered future practice. Materials and methods From 3rd March - 12th November 2014 we undertook a before and after study in Pretoria, South Africa, to determine the impact of introducing a clinical package of fetal heart rate monitoring education and prompt feedback with UA cord lactate sampling, using a hand-held meter, on maternal and perinatal outcomes. Results Nine hundred thirty-six consecutive samples were analyzed (pre n = 374 and post n = 562). There was no difference in mean lactate (4.6 mmol/L [95%CI 4.4–4.8] compared with 4.9 mmol/L [95%CI 4.7–5.1], p = 0.089). Suspected fetal compromise was reduced in the post-intervention period: 30·2% vs 22·1%, aOR 0·71, 95% CI 0·52–0·96, p = 0·027. Cesarean section rates were significantly reduced in the univariate analysis: pre- 40·3% vs post-intervention 31·6% (p = 0·007). This reduction remained significant when adjusted for previous cesarean section, primiparity, maternal HIV infection and preterm birth (aOR 0·72, 95%CI 0·54–0·98, p = 0·035). Neonatal outcomes did not differ between the two groups. Conclusion The introduction of a clinical practice package of fetal heart rate monitoring education combined with routine UA cord lactate sampling has the potential to reduce the cesarean section rate without increasing adverse neonatal outcomes in a low-resource setting.

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