scholarly journals Induction of Labor with Vaginal Dinoprostone (PGE2) in Patients with a Previous Cesarean Section: Obstetric and Neonatal Outcomes

2021 ◽  
Vol 10 (22) ◽  
pp. 5221
Author(s):  
Nuria López-Jiménez ◽  
Fiamma García-Sánchez ◽  
Rafael Hernández Pailos ◽  
Valentin Rodrigo-Álvaro ◽  
Ana Pascual-Pedreño ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Previous History ◽  
Population Group ◽  
Induction Of Labor ◽  
Neonatal Outcomes ◽  
Previous Cesarean Section ◽  
La Mancha ◽  
History Of ◽  
Previous Cesarean

Background: Vaginal dinoprostone (PGE2) is currently used as the prostaglandin of choice in many obstetric units. However, few studies have evaluated its safety, especially in women who previously had a cesarean section. Objective: To evaluate the efficacy and safety of PGE2 in pregnant women who are undergoing induction of labor (IOL), and who have had a previous cesarean section. Materials and Methods: A prospective observational study was conducted in La Mancha Centro Hospital in Alcázar de San Juan, Spain, from 1 February 2019 to 30 August 2020. Obstetric and neonatal outcomes, following IOL with PGE2, in 47 pregnant women who wanted a trial of labor after cesarean (TOLAC), and 377 pregnant women without a history of cesarean section, were analyzed. The outcomes were analyzed by bivariate and multivariate analyses using binary and multiple linear regression. Results: A total of 424 women were included in this study. The percentage of cesarean sections in the TOLAC group was 44.7% (21), compared with 31.6% (119) in the group without a history of cesarean section (adjusted odds ratio: 1.4; 95% CI: 0.68–2.86). In the multivariate analysis, no statistically significant differences were observed between both groups for obstetric and neonatal outcomes (p > 0.05). However, two uterine ruptures (4.3%) occurred in the group of patients with a history of cesarean section who underwent IOL with PGE2. Conclusions: The induction of labor with vaginal dinoprostone (PGE2), in patients with a previous history of cesarean section, was not associated with worse obstetric or neonatal outcomes compared with the group of patients without a history of cesarean section in our study sample. However, further research is needed regarding this IOL method, and it should be used with caution in this population group.

The course of pregnancy, delivery and the condition of newborn in women with uterus scar after previous cesar section

2020 ◽  
pp. 42-46
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Vaginal Delivery ◽  
Early Pregnancy ◽  
Previous Cesarean Section ◽  
Pregnancy And Childbirth ◽  
Birth Record ◽  
History Of ◽  
Previous Cesarean

The objective: Analysis of pregnancy, delivery and the condition of newborns in women with uterus scar after previous Cesarean section. Materials and methods. Observations and retrospective analysis of individual maps of pregnant women, birth record and condition of newborns in 180 women with uterus scar after previous Cesarean section from 2014-2019. Results. It was found that women in I group had no history of miscarriage, and in II group this indicator was 6.7%. We were determined that the threat of early pregnancy was observed twice often in II group as in I group. Failure uterus scar during pregnancy was diagnosing in 21.1% of women of I group against 18.9% of women of II group, as well as during childbirth in 10% of women of II group against none of women of I group. In addition, 76.7% of women of I group were born by vaginal delivery against 24.4% of women of II group. In addition, 10% of newborns in women of I group on the Apgar scale were rated 6-7 points against 65.5% in a state of varying degrees of hypoxia in women of II group. Conclusion. Pregnancy and childbirth in women with uterus scar after previous Cesarean section were accompanying by complications of fetal and neonatal disorders. More pronounced changes were observing during pregnancy, delivery and changes in the condition of newborns in women of II group against with women of I group, which can be explaining by better pre-pregnancy preparation of women of I group and better monitoring during pregnancy. Keywords: сesarean section, pre-pregnancy preparation of women, the condition of newborns.

scholarly journals Predicting Value of Different Ultrasound Markers for Diagnosing Morbidly Adherent Placenta and Associated Complications

2019 ◽  
Vol 8 (2) ◽  
pp. 169-173
Author(s):  
Mojgan Barati ◽  
Mahvash Zargar ◽  
Mahin Najafian ◽  
Najmie Saadati ◽  
Maryam Rekabizadeh
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Previous History ◽  
Bladder Rupture ◽  
Predictive Values ◽  
Morbidly Adherent Placenta ◽  
Adherent Placenta ◽  
History Of ◽  
Sensitivity Specificity ◽  
Previous Cesarean

Objectives: This study was conducted to evaluate the importance of different sonographic findings in the detection of the morbidly adherent placenta (MAP) among pregnant women and then to assess the correlation between delivery complications and ultrasonographic findings. Materials and Methods: This analytical and prospective study was conducted on 150 pregnant women with a previous history of a cesarean section from 2015 to 2017. The sonographic findings included the location of the placenta, retroplacental aliasing, bulging toward the bladder, lacuna, and the lack of sonolucent area behind the placenta. Finally, these patients were followed until delivery and their complications were assessed as well. Results: Of 150 previous cesarean sectioned patients, 101 (67.3%) cases had not sonographic findings of MAP. No morbidity was found in those with no sonographic findings of MAP. Fifty-nine pregnant mothers had the sonographic criteria of MAP prior to delivery, of whom 39 (80%) patients had MAP during the cesarean section. In 39 patients with confirmed MAP, 27 cases underwent a hysterectomy and 12 received special procedures for uterus reservation. In addition, 8 cases had bladder rupture, 25 cases experienced ICU hospitalization, and 33 cases needed a blood transfusion. Of these 39 confirmed MAP, 31 (79.48%) and 8 patients (20.51%) had previa and an anterior placenta without previa, respectively. Finally, no mortality was reported in the current study. Conclusions: In general, the most important sonographic factors on predicting MAP were the location of placenta, the aliasing and bulging while lacuna and the lack of sonolucent area had less value. The results demonstrated 93%, 100%, 90%, 79.59%, and 100% accuracy, sensitivity, specificity, as well as positive and negative predictive values for the prediction of MAP by ultrasonography, respectively.

scholarly journals Pregnancy complicated by previous cesarean section: a retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 4470
Author(s):  
Poornima M.
Keyword(s):  
Retrospective Study ◽  
Cesarean Section ◽  
Medical Records ◽  
Neonatal Outcome ◽  
Perinatal Morbidity ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Exclusion Criteria ◽  
History Of ◽  
Previous Cesarean

Background: Previous Cesarean section (CS) is one of the important causes of CS in subsequent pregnancies. Moreover, repeated cesarean sections increase maternal as well as perinatal morbidity and mortality. We conducted this study to find out outcome of pregnancies in women who had a history of previous CS.Methods: This was a retrospective study of patients of previous caesarean section for either maternal or fetal indications. The duration of study was 3 years. Total 215 patients were included in this study on the basis of a predefined inclusion and exclusion criteria. The indications, maternal and neonatal outcome were studied from medical records of the patients. Statistical analysis was done using SSPE 22.0 software.Results: Out of 215 studied cases majority of the patients belonged to age group of 21-30 years (75.35%) and were 2nd gravida (61.86%). 164 (76.28%) patients attended ANC OPD at least for 3 times during pregnancy. 73 (33.95%) patients had Hb of less than 10 gms while blood transfusion was required to be given in 11 (5.12%) patients. cesarean section was required in 172 (80%) patients out of which 166 (77.21%) patients had undergone emergency LSCS while in 6 (2.79%) patients elective LSCS was done. Scar tenderness was the most common indication for repeat cesarean section. There was no maternal mortality in any patients while there was 1 still birth and 1 neonatal death.Conclusions: Previous cesarean section is one of the important causes of CS in subsequent pregnancies hence decision of doing CS, especially primigravida, must be taken in accordance with strict guidelines and the practice of “cesarean section on demand” should be discouraged.

The effect of placental elasticity on intraoperative bleeding in pregnant women with previous cesarean section

2020 ◽  
Vol 48 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Harun Egemen Tolunay ◽  
Hasan Eroğlu ◽  
Onur Kaya ◽  
Dilek Şahin ◽  
Aykan Yücel
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Real Time ◽  
Strain Ratio ◽  
Tissue Elasticity ◽  
Previous Cesarean Section ◽  
Third Trimester ◽  
Intraoperative Bleeding ◽  
Tissue Elastography ◽  
Previous Cesarean

AbstractBackgroundWe aimed to evaluate the efficiency of placental elasticity in predicting the amount of intraoperative bleeding via real-time tissue elastography technique.MethodsPregnant women in the third trimester of pregnancy who had planned delivery via cesarean section due to the recurrent cesareans were enrolled in the research (n = 78). Elastographic measurements of placental tissues of all cases were carried out by real-time elastographic ultrasonography. It is a tissue elastography software (Esaote MyLabSeven) that uses a 8-1-MHz multifrequency AC2541 Probe.ResultsA significant relationship was found between placental elasticity and intraoperative bleeding. There was a significant correlation between alterations in the preoperative and postoperative hemoglobin (Hb) and hematocrit (Hct) levels and placental strain ratio (SR) (P < 0.001, r: 0.831; P < 0.001, r: 0.733, respectively).ConclusionThese findings may reflect an alteration at the tissue elasticity level. We hope that the use of real-time elastographic ultrasonography technique may give an idea about the amount of bleeding during the cesarean section.

Pregnancy outcome after induction of labor in women with previous cesarean section

2014 ◽  
Vol 28 (4) ◽  
pp. 386-391 ◽  
Author(s):  
Eran Ashwal ◽  
Liran Hiersch ◽  
Nir Melamed ◽  
Maya Ben-Zion ◽  
Alex Brezovsky ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnancy Outcome ◽  
Induction Of Labor ◽  
Previous Cesarean Section ◽  
Previous Cesarean
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