Successful External Cephalic Version in Early Labour: A Case Report and Literature Review

Presentation: A 35 year old woman, gravida 7 para 7, all vaginal deliveries, presented with labour pains at 39 weeks’ gestation with intact membranes. Cardiotocograph (CTG) was reassuring. Diagnosis: Breech presentation was confirmed by an ultrasound. Treatment: The patient was offered options of External Cephalic Version (ECV) versus (vs) Lower Segment Caesarean Section (LSCS). She opted for ECV which was successful, followed by controlled artificial rupture of membranes. She delivered a healthy baby girl vaginally and was discharged home on day 1 postpartum. Conclusion: Although intrapartum ECV is not recommended routinely, there is a place for its judicious use in selective cases. The prerequisites include an experienced obstetrician, reassuring CTG, previous vaginal delivery, no obstetric indication for performing LSCS, adequate amniotic fluid volume with intact membranes, early labour, and informed maternal consent. We recommend keeping theatre on standby while performing ECV in case an obstetric complication arises.

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Case of a huge recurrent retroperitoneal liposarcoma diagnosed in the second trimester of pregnancy

BMJ Case Reports ◽

10.1136/bcr-2021-243639 ◽

2021 ◽

Vol 14 (7) ◽

pp. e243639

Author(s):

Ryle Siegfrid O Li ◽

Sittie Aneza Camille A Maglangit ◽

Jemimah T Cartagena-Lim ◽

Rodney B Dofitas

Keyword(s):

Surgical Oncology ◽

Second Trimester ◽

Lower Segment ◽

Baby Girl ◽

Current Case ◽

Healthy Baby ◽

Lower Segment Caesarean Section ◽

Retroperitoneal Liposarcoma ◽

Retroperitoneal Tumour ◽

Lipomatous Tumour

We document a case of a 24-year-old gravida 2, para 1 (1001), on her second trimester, who was referred to the surgical oncology service for a palpable right hemiabdominal mass. She previously underwent wide excision of a retroperitoneal atypical lipomatous tumour 2 years ago. Her current case was successfully managed by a multidisciplinary team of doctors from the preoperative phase, the actual surgery up to the adjuvant treatment. She had a two-staged surgery: an elective lower-segment caesarean section at 34 weeks age of gestation for which she delivered a healthy baby girl and, 2 weeks after, she had excision of the huge retroperitoneal tumour recurrence. Histopathology revealed a 35 cm×25 cm×22 cm dedifferentiated liposarcoma, for which she was started on adjuvant systemic chemotherapy.

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SPINAL ANAESTHESIA USING TAYLOR’S APPROACH SAVES THE DAY IN OBESE PARTURIENT.

10.36106/gjra/8514690 ◽

2021 ◽

pp. 228-228

Author(s):

Vishal Vashist ◽

Roohani Mahajan ◽

Bhanu Gupta

Keyword(s):

Caesarean Section ◽

General Anesthesia ◽

General Anaesthesia ◽

Spinal Anaesthesia ◽

Case History ◽

Breech Presentation ◽

Lower Segment ◽

Subarachnoid Block ◽

Lower Segment Caesarean Section ◽

History Of

Subarachnoid block is commonly employed for caesarean deliveries, by virtue of its simplicity in terms of performance, safety for the parturients as compared to general anesthesia. The case history of a 27-yearold female parturiant patient is presented. She was posted for emergency lower segment caesarean section in view of primigravida with breech presentation in labour . She was obese with bodyweight of 102 kg. She had a thick scaly plaque over the back in midline from L1 to L5 area, which is contraindication for administration of spinal anaesthesia via standard median and paramedian approach . Taylor’s approach for administration of the same was tried and proved successful, thus saving the patient from receiving general anaesthesia .

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Women's perception of choice and support in making decisions regarding management of breech presentation

British Journal of Midwifery ◽

10.12968/bjom.2021.29.7.392 ◽

2021 ◽

Vol 29 (7) ◽

pp. 392-400

Author(s):

Antonio Sierra

Keyword(s):

Breech Presentation ◽

Study Data ◽

External Cephalic Version ◽

Structured Interviews ◽

Management Options ◽

Lower Segment Caesarean Section ◽

Postnatal Women ◽

Phenomenological Research Design ◽

Colaizzi's Method ◽

Professional Guidelines

Background Professional guidelines recommend midwives and obstetricians actively involve women in making decisions about their care. To date, breech research has focused mainly on assessing the effectiveness of different management options. Aim This research explores women's experience of breech presentation and their perception of choice and support in making decisions with regards to breech management. Methods This study uses a phenomenological research design. Semi-structured interviews took place in hospital or women's homes. A total of six postnatal women who were diagnosed with breech presentation after 36 weeks' gestation took part in the study. Data was analysed using Colaizzi's method. Findings A total of 84 significant statements were clustered into four main emerging themes. These include women's feelings, their healthcare expectations, their preferences and their values. Results Breech discussions mostly occurred between obstetricians and women. These primarily focused on external cephalic version, Elective Lower Segment Caesarean Section and Breech Vaginal Birth. These options did not always become choices available to women.

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Ruptured Uterus Requiring Emergency Hysterectomy for Saving Mother

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v1i1.13017 ◽

2015 ◽

Vol 1 (1) ◽

pp. 46-48

Author(s):

Binita Pradhan ◽

Anagha Pradhan

Keyword(s):

Antenatal Clinic ◽

Clinic Visit ◽

Lower Segment ◽

Posterior Aspect ◽

Fetal Demise ◽

Lower Segment Caesarean Section ◽

Amniotic Fluid Volume ◽

Gynecology And Obstetrics ◽

Emergency Hysterectomy ◽

Ruptured Uterus

A 26 years woman with G3P2L0AO at 40 weeks and 6 days of gestation, but no antenatal clinic visit history presented to Gynecology and Obstetrics out patient clinic complaining decreased feeling of fetal movement since 2 days. Ultrasonography examination revealed fetal demise with amniotic fluid volume of 28 cm. Emergency lower segment caesarean section for ante partum hemorrhage was done. A vertical rupture of the posterior aspect of the uterus from fundus upto the level of cervix with hemoperitoneum of two liters was detected. A macerated dead fetus weighing 3.5 Kg was lying in the peritoneal cavity and the placenta was already partially separated. The mother after hysterectomy was treated in ICU for two days with antihyperglycemic agent additionally and discharged.Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):46-48

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The consequences of fetal reduction for quintuplets after ICSI-ET

Indian Journal of Obstetrics and Gynecology Research ◽

10.18231/j.ijogr.2021.056 ◽

2021 ◽

Vol 8 (2) ◽

pp. 270-272

Author(s):

Paapa Dasari ◽

Ashraf M Ali

Keyword(s):

Postpartum Haemorrhage ◽

Gestational Hypertension ◽

Breech Presentation ◽

Lower Segment ◽

Fetal Reduction ◽

Lower Segment Caesarean Section ◽

Uterine Massage ◽

Intra Cytoplasmic Sperm Injection ◽

Live Fetus

A 30-year-old primigravida who conceived following ICSI (Intra Cytoplasmic Sperm Injection) was admitted at 34 weeks of pregnancy with singleton fetus in breech presentation with Gestational diabetes and Gestational hypertension. To start with Quintuplets were diagnosed and she underwent fetal reduction of 3 foetuses at 14 weeks of pregnancy. Follow up USG revealed only one live fetus after one week. At LSCS (Lower Segment Caesarean Section) performed at 37 weeks, the placenta was found to be adherent and was manually removed. There was profuse bleeding after removal of placenta which was not controlled with uterine massage and uterotonics. Placental examination showed 3 fetus payraeceae. Intrauterine examination revealed an adherent fetus which was removed following which the haemorrhage stopped. In pregnancies following fetal reduction, postpartum haemorrhage can result due to retained fetus papyraceus and hence it is essential to make sure all papyraceae were removed.

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Primary lower segment caesarean section in multipara: materno-fetal outcomes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20185439 ◽

2018 ◽

Vol 8 (1) ◽

pp. 279

Author(s):

Grishma P. Agrawal

Keyword(s):

Caesarean Section ◽

Tertiary Care ◽

Primary Objective ◽

Perinatal Morbidity ◽

Lower Segment ◽

Safe Delivery ◽

Lower Segment Caesarean Section ◽

Vaginal Deliveries ◽

The Status ◽

Almost All

Background: All-natural birth has a purpose and a plan; who would think of tearing open the chrysalis as the butterfly is emerging? Who would break the shell to pull the chick out?” ~ Marie Mongon. It is of particular interest, in light of increased incidence of abdominal delivery throughout the country and in the world, to judge the validity of this procedure when used for the first time in the multipara.Methods: All the cases of Primary caesarean delivery in multipara over a period of 18 months were studied with regards to the indication, associated risks factors, and perinatal morbidity and mortality. The primary objective of the study was to find out the status of primary Lower Segment Caesarean Section (LSCS) in multipara in tertiary care center.Results: The overall incidence of LSCS was 30.7%. The incidence of Primary LSCS in multipara was 23.4%. The most common indication of LSCS was Foetal Distress i.e. 40.8%. Almost all caesarean sections were done in Emergency (99.2%). 12.3% of patients underwent PPH intra-operatively with 0.7% patient requiring Obstetric hysterectomy. Majority of the neonates were admitted in NICU for Respiratory Distress (30%). Major cause of Post-operative morbidity was wound gape seen in 10.8% patients.Conclusions: The fact that a multipara has had one or more vaginal deliveries should be regarded as an optimistic historical fact, not as diagnostic criteria for spontaneous delivery of the pregnancy at hand. Hence a multiparous woman in labour requires the same attention as that of primigravida and may still require a caesarean section for safe delivery. Good antenatal and intrapartum care and early referral will help reduce the maternal and perinatal morbidity.

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Effect of Thrombocytopenia on Age and Method of Delivery among Pregnant Women in Late Trimester

10.53350/pjmhs21155977 ◽

2021 ◽

Vol 15 (5) ◽

pp. 977-979

Author(s):

Shazia Awan ◽

Shazia Rani ◽

Saira Dars ◽

Madiha Abbassi ◽

Naheed Parveen ◽

...

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Health Science ◽

Lower Segment ◽

Singleton Pregnancy ◽

Cross Sectional ◽

Lower Segment Caesarean Section ◽

Gestational Thrombocytopenia ◽

Vaginal Deliveries ◽

Gestational Duration

Aim: To evaluate the effect of thrombocytopenia in pregnant women. Study design: Descriptive cross-sectional hospital based study Place and duration of study: Department of Obstetrics & Gynaecology, Liaquat University of Medical and Health Science Jamshoro from 1st June 2018 to 31st June 2019. Methodology: One hundred and seventy-six patients were observed. Women with pre-eclampsia, platelets less than 50X1010, singleton pregnancy and pregnancy greater than 32 weeks were included. Results: Most of the participants 91(51.9%) were 26 to 30 years with mean age was 30.71±4.45 years. Gestational duration in last trimester was 50(28.4%), 98(55.7%) and 28 (15.9%) of 28 to 32 Weeks, 32 to 36 Weeks and greater than 36 weeks respectively. Mean gestational duration was 35.11±2.3 Weeks. Seventy-one were falling in range of platelets of 30x1010 to 40x1010 (40.3%). Others were 46 (26.1%) of >40x1010, 43(24.4%) of 20x10-30x1010 and 16(9.1%) of 10x10-20x1010. One hundred and 41(80.1%) had vaginal deliveries and 35(19.9%) had lower segment caesarean section deliveries. Conclusion: The young participants of thrombocytopenia were more prevalent than old age participants. Keywords: Gestational thrombocytopenia, Platelet count, Pregnancy

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Intraoperative Phenylephrine Infusion to Reduce Postoperative Shivering in Lower Segment Caesarean Section

Case Medical Research ◽

10.31525/ct1-nct04133961 ◽

2019 ◽

Author(s):

Keyword(s):

Caesarean Section ◽

Lower Segment ◽

Lower Segment Caesarean Section ◽

Phenylephrine Infusion

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Abdominal apoplexy during pregnancy

BMJ Case Reports ◽

10.1136/bcr-2020-235946 ◽

2020 ◽

Vol 13 (10) ◽

pp. e235946

Author(s):

Jasmeet Kumari ◽

Rosemary Harkin

Keyword(s):

Iliac Fossa ◽

Unknown Origin ◽

Breech Presentation ◽

Sudden Onset ◽

Left Iliac Fossa ◽

Safe Delivery ◽

Uterine Contractions ◽

Early Labour ◽

Increased Risk ◽

High Index Of Suspicion

We report a case of idiopathic spontaneous intraperitoneal haemorrhage (ISIH) in a 31-year-old patient at 37 weeks gestation in her second pregnancy. The patient presented to the labour ward with abdominal pain and uterine contractions. The initial complain was of sudden onset, severe sharp pain in left iliac fossa. She started having uterine contractions within 30 min of her presentation. Examination confirmed early labour with a footling breech presentation. Urgent caesarean section was performed that confirmed peritoneal bleeding of unknown origin with safe delivery of the baby. Mother and baby were safely discharged on day 5. ‘Abdominal apoplexy’ (ISIH), is a rare obstetric emergency with increased risk of fetal and maternal morbidity and mortality. With various clinical presentations as a possibility, diagnosis is challenging. High index of suspicion with prompt management of suspected cases can be pivotal life saving measure for the fetus and mother.

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