scholarly journals Secondary Postpartum Hemorrhage Following Cesarean Section

2018 ◽  
Vol 9 (1) ◽  
pp. 23-25
Author(s):  
Surayea Bul Bul ◽  
Zobaida Sultana Susan ◽  
Raunak Jahan ◽  
Abu Nayeem ◽  
Farzana Rahman ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Causes Of Death ◽  
Severe Anaemia ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Pregnancy And Childbirth ◽  
Child Bearing ◽  
Secondary Postpartum Hemorrhage

Background : Complications of pregnancy and childbirth have always been one of the leading causes of death and disability among women of reproductive age in developing countries .Globally, postpartum haemorrhage is the single most important cause of maternal death, accounting for about 25% of the total and claiming an estimated 1,50,000 lives annually. Among the postpartum hemorrhage, the primary postpartum hemorrhage is more prevalent, but sufferings from secondary postpartum hemorrhage have been emerging. With the rising trend of cesarean section rate, the incidence of secondary postpartum hemorrhage is also rising.Objective: The objectives of this study is to evaluate secondary postpartum hemorrhage cases following cesarean section and vaginal delivery with the aim of reducing the maternal mortality at child bearing age.Methods: This is a cross sectional observational study in the department of Obstetrics and Gynaecology, DMCH , by purposive sampling method. Total 100 cases of secondary PPH were observed during 1st January 2013 to 31 December 2013.Result: In this study, among the cases 67% were following cesarean section and 33% were following vaginal delivery, mean age of the patients were 29 year, parity ranges from 1 to 5. Regarding the outcome of secondary PPH, severe anaemia, anaemic heartfailure, renal failure and DIC were common in cesarean sections along with hazards of massive blood transfusion and jaundice. 7 patients were died in post cesarean cases and 2 died in post vaginal delivery cases. Causes of death were due to hemorrhagic shock & septicemia.Conclusion: In this is study, the rate of secondary PPH is 67% following cesarean section which is very much alarming . The outcome of secondary PPH following cesarean section is worse than vaginal delivery.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 23-25

scholarly journals ETHICAL DILEMMA OF CESAREAN SECTION ON MATERNAL REQUEST (CSMR)

2021 ◽  
Vol 71 (2) ◽  
pp. 535-39
Author(s):  
Abeera Choudary ◽  
Asifa Siraj ◽  
Humaira Tariq ◽  
Faiqa Chughtai ◽  
Uzma Urooj
Keyword(s):  
Pain Relief ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Birth Outcome ◽  
Military Hospital ◽  
Cross Sectional ◽  
Maternal Request ◽  
Lower Segment Cesarean Section ◽  
Child Bearing ◽  
Negative Perceptions

Objective: To study the demographic characteristics of pregnant ladies and factors contributing towards rise in cesarean section on maternal request to aid the obstetricians in decision making. Study Design: Cross sectional analytical survey. Place and Duration: Gynecology Department of Pak Emirates Military Hospital, Rawalpindi, from Nov 2019 to Mar 2020. Methodology: One hundred and fifteen women of child bearing age requesting cesarean section were included in the study. Demographic details were noted. A study proforma was filled for determinants of primary and secondary tocophobia and factors that may be improved for vaginal delivery.Results: A total of 115 patients with mean age of 27.99 years were included. Amongst them, 88 (76.5%) were Punjabi with 92 (80%) living in rural area. Primigravida were 11 (9.6%), 83 (72.2%) had previous lower segment cesarean section and 3 (2.6%) had vaginal delivery. For primary tocophobia, 22 ( 24.4%) experienced anxiety. Fear of labor pains was seen in 20 (19.2%) and lack of control in 27 (26%). For secondary tocophobia, 15 (37.5%) were fearful of prolonged labor and 5 (22.5%) of sub optimal birth outcome. In women with previous one cesarean section, 13 (14.8%) correlated negatively with birth experience and 20 (22.7%) found timed cesarean section convenient. For vaginal delivery, pain relief was preferred by 19 (20.2%) and 31 (33%)wanted pain relief and attendant. Conclusion: Better understanding of fears behind maternal request for cesarean section can lead to improved attitudes towards vaginal delivery. The negative perceptions of pregnant ladies should be addressed in antenatal.........

scholarly journals Secondary postpartum hemorrhage on day 58 of cesarean section due to uterine scar rupture

2020 ◽  
Vol 9 (11) ◽  
pp. 4762
Author(s):  
Yogita B. Gavit ◽  
Deepika Sharma
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Normal Vaginal Delivery ◽  
Small Subset ◽  
Fatal Bleeding ◽  
Uterine Scar ◽  
Secondary Postpartum Hemorrhage

Secondary postpartum hemorrhage is rare and affect 0.23-3% of all pregnancies. It happens between 24 hours to 12 weeks of post-delivery. These postpartum hemorrhages occur more often during normal vaginal delivery only a small subset of postpartum hemorrhages occurs after cesarean section. Delayed postpartum hemorrhage is obstetrics emergencies that occurs following vaginal or cesarean delivery, in later condition may be caused by dehiscence of uterus incision after cesarean section which can lead to severe and fatal bleeding. We herein report a case of secondary postpartum hemorrhage after cesarean section.

scholarly journals Paediatric brought-in-dead at a tertiary health facility in South western Nigeria: Patterns and drivers

2021 ◽  
Vol 48 (2) ◽  
pp. 66-73
Author(s):  
Oladele S. Olatunya ◽  
Adefunke O. Babatola ◽  
Adewuyi T. Adeniyi ◽  
Adebukola B. Ajite ◽  
Isaac O. Oluwayemi ◽  
...  
Keyword(s):  
Health Facility ◽  
Causes Of Death ◽  
Severe Anaemia ◽  
Hospital Treatment ◽  
Cross Sectional ◽  
Over The Counter ◽  
Pediatric Health Care ◽  
Duration Of Illness ◽  
Common Causes ◽  
Southwest Nigeria

Background: ‘Brought- in-dead’ (BID) refers to the demise of an individual before presentation to a health facility. This study assessed the pattern of paediatric BID cases seen at a tertiary health facility in southwest Nigeria. Method: A cross-sectional, descriptive study was done at the Children Emergency Ward (CEW) of the hospital between January 2014 and December 2018. The patterns of BID cases and presumed causes of death were determined using a standardized checklist adapted from the WHO verbal autopsy instrument. Results: Ninety-eight BID cases were seen during the study, constituting 2.5% of total patients seen during the period. The median (IQR) age of cases was 24.0 (8.75 – 63.0) months and 72.4% were under-fives. Most had symptoms related to the haematologic (36.7%), respiratory (24.5%) or digestive (20.4%) systems. Severe anaemia 31(31.6%), gastroenteritis 19 (19.4) and aspiration 17 (17.3%) were the most common causes of death. The median (IQR) duration of illness before presentation was 3.0 (1.0 – 7.0) days but most presented from 4 – 7 days of illness. A significant relationship was found between the duration of illness and whether or not pre-hospital treatment was received (p < 0.0001). Unprescribed drugs purchased over the counter were the most commonly used treatment in 79.1% of cases (p < 0.0001). Conclusion: This study has highlighted the prevalence and pattern of paediatric BID in a tertiary health facility in southwest Nigeria and the factors that were associated with it. More efforts need to be geared towards community sensitization and pediatric health care to prevent factors drivingits menace.

Timing and Safety of Postpartum Enoxparin.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4110-4110
Author(s):  
Rachel A. Freedman ◽  
Jeffrey Zwicker ◽  
Kenneth Alan Bauer
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Postpartum Period ◽  
Retrospective Cohort ◽  
Low Molecular Weight Heparin ◽  
Control Group ◽  
Low Molecular Weight ◽  
Cesarean Sections ◽  
Vaginal Deliveries

Abstract The appropriate time to restart anticoagulation in the postpartum period is not known. Both the American College of Obstetrics and Gynecology as well as American College of Chest Physicians (ACCP) have issued guidelines regarding the use of anticoagulants during pregnancy but neither have generated recommendations regarding the timing of the first dose of low-molecular-weight heparin (LMWH) in the postpartum period. The incidence of postpartum hemorrhage was assessed in a retrospective cohort study of 95 women treated with enoxaparin and compared with 303 consecutive deliveries where anticoagulation was not administered. The rate of severe postpartum hemorrhage did not differ significantly for women treated with peripartum enoxaparin versus a control group of women undergoing vaginal delivery (3.6% versus 1.4%, P=0.72) or cesarean section (5.1% versus 3.4%, P=0.98). There were no severe postpartum hemorrhages following the re-initiation of enoxaparin postpartum. In 75% of vaginal deliveries and 49% of cesarean sections, enoxaparin was restarted within 24 hours. Two incisional hematomas were observed in the group of women who received enoxaparin within 24 hours following cesarean section. We conclude that severe postpartum hemorrhage is an infrequent complication following the administration of enoxaparin postpartum. In support of current clinical practice, enoxaparin can be safely administered 0 to 24 hours following vaginal delivery and 12 to 36 hours following cesarean section.

Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery

2017 ◽  
Vol 35 (05) ◽  
pp. 481-485 ◽  
Author(s):  
Ziya Kalem ◽  
Tuncay Yuce ◽  
Batuhan Bakırarar ◽  
Feride Söylemez ◽  
Müberra Namlı Kalem
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Elective Cesarean Section ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Emergency Cesarean ◽  
Study Results ◽  
Elective Cesarean

Objective This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. Study Design This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. Results The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. Conclusion Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.

scholarly journals Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ahmet Ozgur Yeniel ◽  
Ahmet Mete Ergenoglu ◽  
Ali Akdemir ◽  
Elmin Eminov ◽  
Fuat Akercan ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Uterine Artery ◽  
Angiographic Embolization ◽  
Artery Ligation ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Ligation ◽  
Life Threatening ◽  
Secondary Postpartum Hemorrhage ◽  
Uterine Artery Pseudoaneurysm

Uterine artery pseudoaneurysm is a rare but serious complication of cesarean section. If inadequately treated, it can lead to life-threatening postpartum hemorrhage. Herein, we report the case of a 28-year-old woman who developed secondary postpartum hemorrhage resulting from uterine artery pseudoaneurysm and cesarean scar dehiscence after cesarean section. Angiographic embolization is a safe and effective procedure for treating postpartum hemorrhage resulting from pseudoaneurysm in hemodynamically stable patients. However, uterine artery ligation may be the surgical procedure of choice for hemodynamically unstable patients when fertility preservation is desired.

scholarly journals LABOR AT TERM

2016 ◽  
Vol 23 (11) ◽  
pp. 1354-1357
Author(s):  
Quddsia Tanveer ◽  
Anees Fatima ◽  
Ummara Maqsood Sana
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cesarean Section ◽  
Apgar Score ◽  
Postpartum Hemorrhage ◽  
Neonatal Morbidity ◽  
Medical Illness ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Nulliparous Women

Objectives: To compare the obstetric outcome between primigravida andmultigravida presenting in labor at term. Study Design: Cross sectional study. Period: Sixmonths from Jan 2013 to Jun 2013. Setting: Obs/Gynae unit III, Jinnah hospital, Lahore.Patients and methods: 800 patients were included in the study which comprised 400of primigravida and 400 of multigravida. Patients having single, alive fetus with cephalicpresentation at 37-41 weeks were included in the study. Those having recurrent miscarriages,parity >5, antepartum hemorrhage, previous uterine scars and significant medical illness wereexcluded from the study. The data was collected on specially designed proforma. Observationsmode of delivery including the indication of cesarean section or instrumental vaginal deliveryif applicable. Maternal complications such as postpartum hemorrhage along with its cause,retained placenta and uterine inversion were also recorded. Fetal and neonatal observationsincluded CTG abnormalities, oligohydramnios, low birth weight, macrosomia, Apgar score < 7at 5minutes, NICU admission, fresh still birth and early neonatal death. Results: Mean age was25.57+ 3.46 years in primigravida women while it was 25.75 + 3.44 years in multigravida group.CTG abnormalities (15.5% VS 4.25%), instrumental deliveries (9.75% VS 1%), cesarean section(15.25% VS 1%) and postpartum hemorrhage (5.7% VS 1.75%) were commoner in primigravidawomen. In addition, NICU admissions, low birth weight babies and a low Apgar score at5-minute were also commoner in primigravida women. Conclusion: Nulliparous women areat greater risk of labor abnormalities, fetal distress, instrumental deliveries, cesarean section,postpartum hemorrhage and neonatal morbidity. These adverse factors should therefore belooked for and treated well in time.

scholarly journals Clinical Experience Over 15 Years with the B-Lynch Compression Suture Technique in the Management of Postpartum Hemorrhage

2021 ◽  
Vol 43 (09) ◽  
pp. 655-661
Author(s):  
Gilberto Nagahama ◽  
Henri Augusto Korkes ◽  
Nelson Sass
Keyword(s):  
Cesarean Section ◽  
Clinical Experience ◽  
Postpartum Hemorrhage ◽  
Surgical Site Infections ◽  
Suture Technique ◽  
Study Patient ◽  
Success Rates ◽  
Previous Cesarean Section ◽  
Cross Sectional ◽  
Previous Cesarean

Abstract Objective To describe the clinical experience with the B-Lynch technique in the management of postpartum hemorrhage as well as the factors related to the indication of the technique and to present the success rates of the application of the B-Lynch technique. Methods Observational, retrospective, cross-sectional, and analytical study. Patient data was obtained through the study of medical records. The study population comprised of patients who underwent hemostatic suture using the B-Lynch technique, including 104 patients within the period from January 1, 2005, to December 31, 2019. Results Of the total of 104 patients, 82.7% did not present any complications. Blood transfusion and intensive care unit admission were the most prevalent complications, with 13.5% and 15.4%, respectively. Only 1% of the patients had puerperal and surgical site infections. The factors most related to the application of the technique were the presence of previous cesarean section (30.8%), use of oxytocin (16.3%), and preeclampsia (11.6%). Puerperal hysterectomy was performed in 4.8% of the patients due to failure of the method. Conclusion The clinical experience with the B-Lynch technique was satisfactory since it presented few complications, with excellent results in hemorrhagic control. Previous cesarean section, the use of oxytocin, and preeclampsia stood out as factors related to the indication of the application of the technique, and the success rate in controlling postpartum hemorrhage was 95.2%.

scholarly journals Desire to Limit Childbearing and Its Associated Factors Among Married Women: Findings From A Cross-Sectional Survey In Karachi, Pakistan 

2020 ◽  
Author(s):  
Shama Razzaq ◽  
Saleem Jessani ◽  
Sumera Aziz Ali ◽  
Zahid Abbsai ◽  
Sarah Saleem
Keyword(s):  
Family Size ◽  
Wealth Quintile ◽  
Median Number ◽  
Married Women ◽  
Reproductive Age ◽  
Squatter Settlements ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Child Bearing

Abstract Background: Increasing population growth and uneven distribution of scarce resources is a hurdle for country’s economic growth. Hence, we aim to determine desire to limit child bearing and factors associated with limiting child bearing among currently married women aged 15 to 49 years residing in squatter settlements of Karachi, Pakistan. Methods:A multistage cluster, cross sectional survey was conducted in randomly selected households of urban squatter settlements of Karachi. A total of 4,485 married, non-pregnant, were interviewed using a structured questionnaire and adapted Operational framework of “Pullum 1980” to determine potential factors associated with limiting family size. Outcome of interest was defined as a desire to limit childbearing among married women of reproductive age group. Multivariable regression was performed using SPSS version 13.0. Results:The median age of participants was 30 years (IQR 25-35 years) and the median number of living children was 3 (IQR 2-4). Of 4485 women, 2109 (47%) expressed desire to limit childbearing in future. Multivariable logistic regression showed that women of 18 to 27 years and 28 to 37 years (AOR 0.25, 95% CI: 0.19-0.39 and AOR 0.39, 95% CI: 0.22-0.47 respectively), illiterate (AOR 0.34, 95% CI: 0.21-0.53), and low wealth quintile (AOR 0.41, 95% CI: 0.25-0.57), not using any contraceptive method (AOR 0.53, 95% CI: 0.44 to 0.63), sons less than daughters (AOR 0.74, 95% CI: 0.62-0.87), were less likely to limit childbearing. Women who practiced autonomy (AOR 1.25, 95% CI: 1.08-1.41) and perceived ideal family size as ≤ 2 children (AOR 2.62, 95% CI: 2.07-3.32) were more likely to limit childbearing.Conclusion:Age, education, low wealth quintile, having sons, autonomy and usage of contraceptives were determining factors of women’s desire for limiting childbearing. Behavior modification strategies should be devised to modify fertility intentions among women to increase contraceptive use and fertility decline.

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