scholarly journals Study on maternal and perinatal outcome of pregnancy with history of previous caesarean section

2016 ◽  
Vol 15 (3) ◽  
pp. 392-398
Author(s):  
Latifa Akhter ◽  
Md Jahangir Hossain Bhuiyan ◽  
Saleha Begum ◽  
Bilkis Ferdousi
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Medical Science ◽  
Previous Caesarean Section ◽  
Perinatal Complications ◽  
Operative Complications ◽  
History Of ◽  
Antepartum Complications ◽  
Post Operative Complications

Background: This is a Prospective observational study conducted in Department of Obstetrics and Gynaecology, BSMMU, Dhaka.Objective: The purpose of this study was to evaluate maternal and perinatal outcome of pregnancy with history of previous caesarean section.Method: Data were collected as per questionnaire by researchers herself by interviewing the patients and by observing the operations, investigation records and post-operative follow-up. A total number of 150 patients admitted with pregnancy with history of one or more previous caesarean section.Outcome measure: To find out antepartum complications, per-operative and post-operative complications specially related to previous caesarean section and to find out perinatal mortality and morbidity.Results: Among 150 patients who were delivered after one or more previous caesarean section, 88 (52%) patients had antepartum complications, the majority (88%) pregnancies were term pregnancy. The per-operative problem was difficulty to reach lower uterine segment due to adhesion with bladder was 16%. Overall post-operative complications were 20% cases. The common complications were wound infection (86%). Perinatal complications were 20 (30%) cases.Conclusion: The wide spread improvement in anaesthesia, surgical technique, antibiotics and blood transfusions have decreased the morbidity and mortality from caesarean section, but it is not without hazard.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.392-398

STUDY OF OBSTETRIC OUTCOMES IN ELECTIVE AND EMERGENCY CAESAREAN SECTION IN PATIENTS WITH PRIOR LOWER SEGMENT CAESAREAN SECTION

2021 ◽  
pp. 57-60
Author(s):  
Dipak S. Kolate ◽  
Meenal M. Patvekar ◽  
Shriraj Katakdhond ◽  
Yogesh Thawal ◽  
Kale DhanaLaxmi ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Maternal Morbidity ◽  
Caesarean Delivery ◽  
Emergency Caesarean Section ◽  
Obstetric Outcomes ◽  
Fetal Outcomes ◽  
Emergency Caesarean ◽  
Management Protocol ◽  
History Of

Background:Acomprehensive study of maternal morbidity and mortality with perinatal outcome in patients with prior LSCS undergoing elective or emergency caesarean section was carried out. With the sky rocketing caesarean section rates worldwide an increasing number of women face the issue of mode of delivery in their current pregnancy. There are conicting reports regarding the safety of a trial for vaginal birth after caesarean delivery (VBAC) in terms of uterine rupture, maternal and perinatal morbidity. The purpose of this study was to evaluate the obstetric and fetal outcomes of patients presenting at term with a history of previous one or more LSCS. Methods:Asix months prospective, observational study was conducted where all patients who had a term pregnancy with a history of previous one or more LSCS were included after obtaining their consent for participation. The obstetric and fetal outcomes of these patients with elective or emergency LSCS in the present pregnancy were noted and tabulated. Adescriptive analysis of these outcomes was carried out. Results: 100 Patients at term, with a history of previous one or more LSCS were studied. 38 patients underwent an elective repeat caesarean delivery and 62 in emergency.Scar dehiscence was seen in 35.5 % of the patients who were presented in emergency with uterine contractions or lower abdominal pain and those were not candidate for a trial for VBAC.All of the complications were signicantly higher in emergency group in terms of both maternal (83.9 % Vs 31.6%) and perinatal outcome (6.5% Vs 0 %). Conclusion:With an increase in the proportion of patients with a history of previous LSCS, it is essential for health care institutions to have proper antenatal counseling regarding plan of delivery and vigilance while operating patients with prior history of LSCS , especially in emergency situation. There should be a well dened management protocol in an effort to decrease the number of complications and bring down the overall maternal morbidity & mortality .

74 LAPAROSCOPIC MANAGEMENT OF A PULSION EPIPHRENIC OESOPHAGEAL DIVERTICULUM SECONDARY TO ACHALASIA.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Jeremy Tan ◽  
Baldwin Yeung ◽  
Lester Ong ◽  
Bin Chet Toh ◽  
Wai Keong Wong ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Barium Swallow ◽  
Toupet Fundoplication ◽  
Rare Entity ◽  
Upper Gi ◽  
Operative Complications ◽  
History Of ◽  
Upper Gi Endoscopy

Abstract   This is a video submission of a laparoscopic resection of an epiphrenic oesophageal pulsion diverticulum secondary to achalasia. A Heller’s cardiomyotomy is also performed together with a Toupet fundoplication. Methods The patient is a 40 year old woman with a 12 month history of worsening dysphagia, reflux symptoms, as well as occasional regurgitation of food, worse at night. Barium swallow showed a distal oesophageal diverticulum and oesophageal manometry confirmed type 1 achalasia. Upper GI endoscopy showed no other intra-luminal findings. Results The patient underwent a laparoscopic resection of the diverticulum, together with a Heller’s cardiomyotomy and Toupet fundoplication. There were no post-operative complications. She remains well and asymptomatic at 9 month follow-up. Conclusion Pulsion diverticula secondary to achalasia are a known but rare entity. A few variations exist on how to manage this condition surgically, especially with respect to the type of fundoplication. We present our preferred technique for dealing with this condition. Video https://www.dropbox.com/s/dg4edkamykugupn/Oesophagealdivert.mp4?dl=0

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

scholarly journals Evaluation of outcome in open and stapler haemorrhoidectomy in grade III/IV haemorrhoids

2020 ◽  
Vol 7 (10) ◽  
pp. 3294
Author(s):  
Manju Singh ◽  
Amit Agarwal ◽  
Kush Pandey
Keyword(s):  
Postoperative Bleeding ◽  
Treatment Modalities ◽  
Stapled Haemorrhoidopexy ◽  
College Hospital ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Hospital Stays ◽  
Grade Iii ◽  
Post Operative Complications

Background: Haemorrhoids are one of most common benign anorectal malformation worldwide. There are various surgical treatment modalities for 3rd and 4th degree haemorrhoids. Open haemorrhoidectomy was the most widely practiced and is considered the current gold standard. In search of a newer surgical technique, stapler has been introduced for haemorrhoidectomy and has revolutionised operative procedures over the last decade world-wide due to its ease and simplicity and lesser post-operative complications. The following study was done to evaluate the outcome of open versus stapled haemorrhoidectomy in terms of post-operative pain, postoperative bleeding, duration of surgery, duration of hospital stays in a medical college hospital at Raipur, Chhattisgarh.Methods: This was a prospective follow-up study, in patients undergoing surgery for grade III/IV haemorrhoids conducted in the Department of Surgery, Dr BRAM Hospital, Raipur, from August 2017 to July 2018. Fourteen patients underwent stapled haemorrhoidopexy and eighteen underwent open haemorrhoidectomy. All patients were reviewed immediately after surgery, at discharge and at 1, 3 and 10 weeks post-operatively. The two groups were compared for post-operative outcomes and complications.Results: The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled haemorrhoidopexy group had shorter duration of surgery, less postoperative pain, shorter duration of hospital stays as compared with open haemorrhoidectomy group. There were no major post-operative complications in the follow up period of 10 weeks in the stapled group.Conclusions: Stapled haemorrhoidopexy is a safer alternative to open haemorrhoidectomy with many short-term benefits.  

scholarly journals Determinants of uterine rupture in Dessie Referral Hospital, North East Ethiopia, 2016: case control design

2018 ◽  
Vol 7 (5) ◽  
pp. 1712 ◽  
Author(s):  
Amare Workie ◽  
Yemmiamrew Getachew ◽  
Kibir Temesgen ◽  
Prem Kumar
Keyword(s):  
Caesarean Section ◽  
Rural Areas ◽  
Uterine Rupture ◽  
Case Control ◽  
Previous Caesarean Section ◽  
Obstructed Labor ◽  
North East ◽  
Prolonged Labor ◽  
Dessie Referral Hospital

Background: Uterine rupture remains a major obstetric problem particularly in less developed countries. The aim of this study was to identify determinants of uterine rupture among mothers getting delivery services in Dessie Referral Hospital from January 2016 to June 2016, North East Ethiopia.Methods: A prospective unmatched case control study was conducted recruiting 42 mothers with uterine rupture as case group and 168 for control group. Pretested, structured questionnaire was used to collect data.Results: Descriptive statistics and Logistic regression models were utilized considering 95% confidence interval and p-value of 0.05 to determine the presence and strength of association between dependent and independent variables. Majority (94.2%) of cases came from rural areas, 76.2% had obstructed labor and 55% had prolonged labor. Of 85.7% of cases have reported number of pregnancies ≥ 5. Mothers who encountered obstructed labor and previous Caesarean section scar were at higher risk of uterine rupture (AOR=22.2, 95% CI=2.8-4.1 and AOR=13.6, 95% CI=2.16-17.84 respectively). Mothers living in urban area, having Antenatal Care follow-up, shorter labor stay and primi-parity were found to have lower risk of uterine rupture.Conclusions: This study revealed that living in rural areas, absence of Antenatal Care follow-up, prolonged labor, obstructed labor, grand multiparity and previous Caesarean section scar were determinants of uterine rupture. Viable strategies have to be designed and implemented to tackle these determinants of uterine rupture.

scholarly journals Ergometrine-induced atrial fibrillation at caesarean section

2019 ◽  
Vol 12 (2) ◽  
pp. e226747 ◽  
Author(s):  
Samuel Birch ◽  
Corrine Lu
Keyword(s):  
Atrial Fibrillation ◽  
Caesarean Section ◽  
General Population ◽  
Spontaneous Rupture ◽  
Regional Hospital ◽  
Previous Caesarean Section ◽  
Autonomic Tone ◽  
Uterine Contractions ◽  
History Of ◽  
Obstetric Population

A 36-year-old woman with a history of one previous caesarean section presented to the birthing suite of a regional hospital with spontaneous rupture of membranes at 39+2/40 weeks. Syntocinon was administered to initiate uterine contractions in the absence of labour, as the patient desired vaginal birth. A caesarean section was subsequently indicated and ergometrine was administered for uterine atony. The patient immediately developed atrial fibrillation (AF). AF is the most common sustained arrhythmia in the general population, but is rare in the obstetric population. AF occurring in an intrapartum setting following the administration of syntocinon and ergometrine, is not documented in the literature. We suggest the initiation of paroxysmal AF was precipitated by an abrupt alteration in autonomic tone caused by administration of syntocinon followed by ergometrine.

Post-operative roentgenological findings and changes after mastoid obliteration

1983 ◽  
Vol 97 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Kauko Ojala ◽  
Reijo Lahti ◽  
Antti Palva ◽  
Martti Sorri
Keyword(s):  
Bone Formation ◽  
Frequent Occurrence ◽  
New Bone Formation ◽  
Mastoid Obliteration ◽  
X Ray ◽  
Radiological Features ◽  
Operative Complications ◽  
Post Operative Complications

AbstractThis study consisted of the evaluation of the plain X-ray findings of films taken at early follow-up (mean 1.5 months after surgery) and at late follow-up(4–14 years after the early films) of 211 ears which had been operated on radically and obliterated. Residual cells which were detected on the basis of the early films were associated with a more frequent occurrence of post-operative infection and were thus hallmarks of a poorer prognosis. Changes in the bone surrounding the surgical cavity and the radiological quality of the walls of the surgical cavity, the presence of new bone formation in the cavity and other radiological features did not yield useful information about post-operative complications. New bone formation was associated with a smaller amount of post-operative cavitation. Post-operative X-ray examination of the obliterated ear is a prognostically useful examination, but it does not significantly contribute further to the information available by clinical and otomicroscopic examination in regards to the complications of infection and cholesteatoma.

scholarly journals Perinatal Outcome of Deliveries after One Previous Caesarean Section

2015 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Narinder Kaur ◽  
Sushila Jain
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Previous Caesarean Section ◽  
Lower Segment Caesarean Section ◽  
History Of ◽  
Live Fetus ◽  
The Right ◽  
A Prospective Study

Introduction: Contrary to the WHO recommended caesarean section (CS) rate of 15%, there is an alarming trend of increasing caesarean section rates. An important reason for this is repeat caesarean section (RCS). Vaginal birth after caesarean (VBAC) is one of the methods of reducing CS rates in women with history of previous CS. This study was done with the aim to see the maternal and fetal outcome among parturient with history of single previous caesarean section and to determine the rate of VBAC at Lumbini Medical College, Nepal. Methods: This is a prospective study done for a period of ten months. Seventy parturient fulfilling inclusion criteria of term pregnancy with single live fetus and history of one Lower Segment Caesarean Section (LSCS) were enrolled in the study. Patients meeting the criteria for VBAC were given trial of labour and others were taken for elective repeat CS. This cohort was analyzed further, with respect to age, parity, period of gestation, mode of delivery, indication for CS, maternal and fetal complications and outcomes. Results: VBAC was successful in 27.14% of patients (n=19) while the rest 51 (72.85%) underwent RCS . Indications for RCS was mainly scar tenderness 7 (13.7%), fetal distress 6 (11.7%), non progress of labour 6 (11.7%), meconium stained liquor 6 (11.7%) and post-dated pregnancy 6 (11.7%). Maternal morbidity was comparable in women undergoing RCS or VBAC. There was one still birth and one early neonatal death in each group due to complications of meconium aspiration. Conclusion: Patients with previous CS are at high risk of RCS. If trial of labor is allowed under careful patient selection and supervision, the rate of vaginal delivery after caesarean section can be increased safely. As there is no added perinatal morbidity and mortality in cases of VBAC as compared to RCS, VBAC shows the right way forward to decrease the rate of caesarean section.

scholarly journals A case report on placental chorioangioma

2021 ◽  
Vol 10 (12) ◽  
pp. 4555
Author(s):  
Kalyani P. Barde ◽  
Gautam S. Aher ◽  
Urmila G. Gavali
Keyword(s):  
Case Report ◽  
Preterm Labour ◽  
Second Trimester ◽  
Perinatal Complications ◽  
Amniotic Fluid Index ◽  
Solitary Nodule ◽  
The Third ◽  
History Of ◽  
Multiple Nodules

Chorioangioma is the term used to describe an abnormal proliferation of vessels arising from chorionic tissue, which is most commonly observed in the third, and less frequently in the second trimester of pregnancy as a solitary nodule or, less commonly, as multiple nodules. We here report a case of placental chorioangioma which presented as a case of preterm labour. 21 year old primigravida presented to us at 26 weeks of gestation with history of PV leak and pain in abdomen. Ultrasound showed a single live foetus corresponding to 24-26 weeks of gestation with amniotic fluid index (AFI): 5 cm (oligohydramnios) there was evidence of 58×42 mm heterogeneously hypoechoic lesion noted over placenta likely s/o chorioangioma. Patient went into spontaneous preterm labour on day 5 and delivered vaginally. Placenta weighted 700 gm. A globular mass of size 6×7 cm was attached to foetal surface of placenta with a pedicle with confirmed the finding of ultrasonography. Placental chorioangioma is associated with high rates of perinatal complications. Most complications may appear early and delivery is problematic due to prematurity. Thus better prenatal investigations and regular follow up is required for early diagnosis and treatment.

scholarly journals A study on correlation of placenta praevia with previous caesarean section and other risk factors

2019 ◽  
Vol 7 (6) ◽  
pp. 2027
Author(s):  
Somika Kaul ◽  
Shahida Mir
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Placenta Praevia ◽  
Previous Caesarean Section ◽  
Jammu And Kashmir ◽  
Dilatation And Curettage ◽  
Obstetric Haemorrhage ◽  
Increased Risk ◽  
History Of

Background: Obstetric haemorrhage is the leading cause of preventable maternal mortality worldwide. One of the major contributors to obstetric haemorrhage is antepartum haemorrhage which is mainly caused by placenta praevia and abruptio placenta. The study aims to quantify the risk of placenta praevia based on the presence and number of caesarean sections and to assess other risk factors.Methods: This study was a prospective case control study conducted in the department of obstetrics and gynecology, Lalla Ded hospital, Srinagar, Jammu and Kashmir, India from August 2009 to October 2010. As per the inclusion and exclusion criteria of study 100 cases and 200 controls were selected and the association of placenta praevia with proposed risk factors was analysed statistically.Results: Present study showed that the risk of developing placenta praevia in future pregnancy increased steadily as the number of previous caesarean sections increased, risk being 2.1, 2.8 and 4 times with previous one, two and three caesarean deliveries respectively. Similarly, the risk of developing placenta praevia was more in women with history of previous abortion (risk being 2.8 and 6.5 times more in women with one and two abortions in the past). Previous dilatation and curettage and age more than 30 years also proved to be independent risk factors.Conclusions: To conclude advanced maternal age, previous abortion, dilatation and curettage and a history of previous caesarean section appear to increase the occurrence of placenta praevia. The study strongly emphasises the need to decrease the primary caesarean section rate.

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