scholarly journals Fetal prognosis in cesarean section

2021 ◽  
Vol 68 (3) ◽  
pp. 347-353
Author(s):  
Maria Saba ◽  
◽  
Dimitrie Nanu ◽  

When deciding on a caesarean section, perinatologists should consider the consequences for the newborn. Studies show that caesarean section modifies adaptation to extrauterine life and is associated with risks of neonatal complications. Other determining factors for the condition and future of the newborn (gestational age, the existence of labor before cesarean section, anesthesia etc.) are not to be neglected. This article reviews the elements of the neonatal respiratory adaptation physiology, which are essential to understanding the clinical complications attributed to the mode of birth, and proposes a reconsideration of neonatal morbimortality after cesarean section.

2021 ◽  
pp. 20-24
Author(s):  
Ashraf M Ali ◽  
Sonal Garg ◽  
Papa Dasari

Background: Over the past few decades, the indications for Caesarean delivery have broadened thus increasing the rate of caesarean section beyond the set level of WHO. The indications vary in different health care facilities. It is essential to determine the factors responsible for increasing caesarean section rates. To Objectives: nd out the cesarean section rate based on urgency as per RCOG and gestational age as per the categorization of pregnancy by ACOG in a tertiary health care facility catering to large South Indian population. It also aimed to determine the associated conditions contributing for caesarean section. Retrospective analysis of women who underwent caesar Methods: ean section from Jan-2017 to June 2017. Data was analyzed with respect to gestational age, Urgency of caesarean section, maternal fetal indications, clinical characteristics and associated conditions. Neonatal outcomes measured were gestational age, birth weight and NICU admissions. Data was expressed as proportions and percentages. The CS Results: rate was 24.5% among7, 346 deliveries and 81% were emergency CS. Preterm Caesarean sections were done in 18% and term 81.5%. Category II CS were the commonest (49%) followed by Category I (32%). Scarred uterus was the most common indication (85%) for elective caesarean section and fetal distress was most common indication (55.7%) for emergency caesarean sections. The associated factors were prior Caesarean section (32%), Medical disorders in 21% and 2.4% prolonged infertility and ART conceptions. Obstetric conditions including mal presentation were responsible in 19%. On the whole fetal indications accounted for 62%. Conclusion: Fetal indications, especially fetal distress is the most common reason for caesarean section which may have contributed for increased rate of caesarean section. Hence following strict criteria for diagnosis of fetal distress and adopting policies for intrauterine resuscitation prior to decision making for cesarean section would contribute to reduction of CS rate at tertiary health care centers.


2020 ◽  
Vol 27 (04) ◽  
pp. 807-811
Author(s):  
Shazia Siddiq ◽  
Saima Yasmin Qadir ◽  
Hajra Sultana ◽  
Asma Khurshid

Objectives: To determine the frequency of uterine rupture after one successful vaginal birth after caesarean section. Study Design: Cross Sectional Study. Setting: Department of Obstetrics and Gynecology of Nishtar Hospital Multan. Period: From12-May-2017 to 11-May-2018. Material & Methods: Total number of 135 patients of 16-45 years with singleton pregnancies were admitted for 2nd Vagina Birth after cesarean Section at gestational age ≥ 28 weeks of gestation. Data in shape of parity, gestational age and BMI was taken. These patients were assessed for frequency of uterine rupture after one successful vaginal birth after caesarean section. Data was analyzed with statistical analysis program (SPSS version 21). Frequency and percentage was calculated for qualitative variables like parity and uterine rupture. Mean ± SD was calculated for quantitative variables like age, BMI and gestational age. Results: Mean age of patients was 29.88+5.34 years. Mean body mass index (BMI) of study patients was 25.17+4.88 kg/m2. Mean gestational age at the time of delivery was 39.01+2.54 weeks. Uterine rupture after vaginal birth occurred in 2 (1.48%) patients. There was no association of gestational age, parity and gestational age with the frequency of uterine rupture. Conclusion: Women with prior successful VBAC are at low risk of maternal and neonatal complications during subsequent trail of VBAC with lower risk of uterine rupture and perinatal complications.


2020 ◽  
pp. 54-57
Author(s):  
L. V. Tkachenko ◽  
T. V. Skladanonskaya ◽  
T. I. Kostenko ◽  
N. I. Sviridova ◽  
T. A. Verovskaya ◽  
...  

The article presents data from a retrospective analysis of 8,706 childbirth histories of the Volgograd Clinical Perinatal Center No. 2 for 2018–2019 years. To analyze the frequency and indications for caesarean section, the 10-group classification by M. Robson was used. The results obtained allowed us to determine the groups with the highest frequency of cesarean section and outline ways to reduce the frequency of abdominal birth in these groups.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.


2019 ◽  
Vol 7 (12) ◽  
pp. 1951-1956 ◽  
Author(s):  
Małgorzata Radoń-Pokracka ◽  
Beata Adrianowicz ◽  
Magdalena Płonka ◽  
Paulina Danił ◽  
Magdalena Nowak ◽  
...  

AIM: The study aimed to investigate the association between advanced maternal age (AMA) and the risk of adverse maternal, perinatal and neonatal outcomes about parity in singleton pregnancies.METHODS: We retrospectively analysed 950 women who gave birth in the Department of Obstetrics and Perinatology of the University Hospital in Kraków for six months (between 1st January and 30th June 2018). The patients were divided into 3 groups according to their age (30-34 years old, 35-39 years old and over 40 years old). Each of these groups was subsequently subdivided into 2 groups depending on parity (primiparae and multiparae). Maternal, perinatal and neonatal outcomes were compared between the groups and the subgroups.RESULTS: Comparison of the three age groups revealed that advanced maternal age might constitute a predisposing factor for preterm birth, caesarean section and large for gestational age (LGA). From these parameters, statistical significance was reached in case of greater risk of LGA (OR = 2.17), caesarean section (OR = 2.03) and elective C-section (OR = 1.84) in women over 40 years old when compared to the patients aged 30-34. Furthermore, AMA increases the risk of postpartum haemorrhage (OR = 6.43). Additionally, there is a negative correlation between maternal age and gestational age at delivery (R = -0.106, p < 0.05).CONCLUSIONS: Advanced maternal age can undoubtedly be associated with several adverse perinatal outcomes. At the same time, the risk of perinatal complications begins to increase after the age of 35 but becomes significant in women aged ≥ 40.


2010 ◽  
Vol 51 (1) ◽  
pp. 103-105 ◽  
Author(s):  
Markus Richter ◽  
Hans-Georg Topf ◽  
Michael Gröschl ◽  
Thorsten Fröhlich ◽  
Anja Tzschoppe ◽  
...  

2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000


2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Roy Somers ◽  
Yves Jacquemyn ◽  
Luc Sermeus ◽  
Marcel Vercauteren

We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.


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