Incisional hernia of elective midline caesarean section: Incidence and risk factors

Objective: To analyze the incidence and risk factors for development hernia after elective lower midline caesarean section(ElMCS).Method: A prospective cohort study of 284 women for development of incisional hernia after repeated elective midline CS. Patients enrollment done from April 13th 2001 and December 12th 2002. follow up to two years for hernia development. Hernias were identified radiographically or during physical exam. 2-year hernia rates were calculated. Patients were distributed in two groups, study group consisted of women who had incisional hernia and control group consisted from women who had not within 2-years postoperatively. Within the two groups potential risk factors (age, body mass index (BMI), parity, number of previous cesareans, chronic cough, diabetes mellitus(DM), heart disease, low serum albumin, type of previous incision, anesthesia type, presence of postoperative fever and wound complications) were collected and statistically analyzed with the development of incisional hernia (IH). Setting: Prince Hashem Ben Al-Hussein Hospital, Jordanian Royal Medical Services of Jordan / Zarqa. Results: The 2-year hernia was 5.6 % .Independent risk factors of IH development include: increase in number of previous CSs, wound complications and obesity. Conclusion: An incisional hernia is higher than previously estimated in women undergoing ElMCS. Counseling on the family size will reduce the chance for further CS with its associated risk. Also measures to reduce wound infection after surgery may reduce the incidence of incisional hernia following ElMCS. DOI: http://dx.doi.org/10.3329/bjog.v25i1.13724 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(1) : 9-14

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Risk Factors for Incisional Hernia Recurrence and Surgical Site Infection in Solid Organ Transplant Population - Single Center Experience

10.29011/2575-9760.001344 ◽

2020 ◽

Keyword(s):

Risk Factors ◽

Incisional Hernia ◽

Organ Transplant ◽

Solid Organ Transplant ◽

Hernia Recurrence ◽

Solid Organ ◽

Site Infection ◽

Single Center ◽

Single Center Experience ◽

Incisional Hernia Recurrence

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Maternal and neonatal risk factors for neonatal respiratory distress syndrome in term neonates in Cyprus: a prospective case–control study

Italian Journal of Pediatrics ◽

10.1186/s13052-021-01086-5 ◽

2021 ◽

Vol 47 (1) ◽

Author(s):

Paraskevi Stylianou-Riga ◽

Theodora Boutsikou ◽

Panayiotis Kouis ◽

Paraskevi Kinni ◽

Marina Krokou ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Hypertension ◽

Caesarean Section ◽

Distress Syndrome ◽

Elective Caesarean Section ◽

Case Control ◽

Male Gender ◽

Term Neonates ◽

Systemic Hypotension ◽

Neonatal Respiratory Distress

Abstract Background Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus. Methods In a prospective, case-control design we recruited term neonates with NRDS and non-NRDS admitted to the NICU of Archbishop Makarios III hospital, the only neonatal tertiary centre in Cyprus, between April 2017–October 2018. Clinical data were obtained from patients’ files. We used univariate and multivariate logistic and linear regression models to analyse binary and continuous outcomes respectively. Results During the 18-month study period, 134 term neonates admitted to NICU were recruited, 55 (41%) with NRDS diagnosis and 79 with non-NRDS as controls. In multivariate adjusted analysis, male gender (OR: 4.35, 95% CI: 1.03–18.39, p = 0.045) and elective caesarean section (OR: 11.92, 95% CI: 1.80–78.95, p = 0.01) were identified as independent predictors of NRDS. Among neonates with NRDS, early-onset infection tended to be associated with increased administration of surfactant (β:0.75, 95% CI: − 0.02-1.52, p = 0.055). Incidence of pulmonary hypertension or systemic hypotension were associated with longer duration of parenteral nutrition (pulmonary hypertension: 11Vs 5 days, p < 0.001, systemic hypotension: 7 Vs 4 days, p = 0.01) and higher rate of blood transfusion (pulmonary hypertension: 100% Vs 67%, p = 0.045, systemic hypotension: 85% Vs 55%, p = 0.013). Conclusions This study highlights the role of elective caesarean section and male gender as independent risk factors for NRDS in term neonates. Certain therapeutic interventions are associated with complications during the course of disease. These findings can inform the development of evidence-based recommendations for improved perinatal care.

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Risk Factors for Surgical Site Occurrence or Infection and Recurrence After Incisional Hernia Repair in Abdominal Transplant Population

Transplantation Proceedings ◽

10.1016/j.transproceed.2021.01.014 ◽

2021 ◽

Vol 53 (2) ◽

pp. 762-767

Author(s):

Fareed Cheema ◽

Oya Andacoglu ◽

Li-Ching Huang ◽

Sharon E. Phillips ◽

Flavio Malcher

Keyword(s):

Risk Factors ◽

Incisional Hernia ◽

Hernia Repair ◽

Incisional Hernia Repair

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Prevention of Hypotension following Spinal Anaesthesia in Caesarean Section - then and now

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i4.6242 ◽

2012 ◽

Vol 8 (4) ◽

pp. 415-419

Author(s):

J K Mitra

Keyword(s):

Risk Factors ◽

Clinical Practice ◽

High Risk ◽

Caesarean Section ◽

Spinal Anaesthesia ◽

Limited Data ◽

First Line ◽

High Risk Patients ◽

Risk Patients ◽

Poor Efficacy

Hypotension during spinal anaesthesia for caesarean section remains a common scenario in our clinical practice. Certain risk factors play a role in altering the incidence of hypotension. Aortocaval compression counteraction does not help to prevent hypotension. Intravenous crystalloid prehydration has poor efficacy; thus, the focus has changed toward co-hydration and use of colloids. Phenylephrine is established as a first- line vasopressor, although there are limited data from high-risk patients. Ephedrine crosses the placenta more than phenylephrine and cause possible alterations in the foetal physiology.http://dx.doi.org/10.3126/kumj.v8i4.6242 Kathmandu Univ Med J 2010;8(4):415-19

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Hernias in the Emergency Department

10.2310/gastro.4113 ◽

2017 ◽

Author(s):

Mary C. Westergaard ◽

Daniel Berhanu ◽

Ciara J. Barclay-Buchanan

Keyword(s):

Risk Factors ◽

Inguinal Hernia ◽

Incisional Hernia ◽

Abdominal Wall ◽

Abdominal Mass ◽

Abdominal Wall Hernia ◽

The United States ◽

Abdominal Hernia ◽

Indirect Inguinal Hernia ◽

Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia. Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

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Hernias in the Emergency Department

10.2310/fm.4113 ◽

2018 ◽

Author(s):

Mary C. Westergaard ◽

Daniel Berhanu ◽

Ciara J. Barclay-Buchanan

Keyword(s):

Risk Factors ◽

Inguinal Hernia ◽

Incisional Hernia ◽

Abdominal Wall ◽

Abdominal Mass ◽

Abdominal Wall Hernia ◽

The United States ◽

Abdominal Hernia ◽

Indirect Inguinal Hernia ◽

Benign Condition

Hernia is defined as an abnormal protrusion of an organ or tissue through a pathologic defect in its surrounding wall. Overall, hernia is common and is generally believed to be a benign condition associated with some morbidity, although it is not thought to be associated with significant mortality. Between 2001 and 2010, 2.3 million inpatient abdominal hernia repairs were performed in the United States, of which 567,000 were performed emergently. In some cases, a hernia can be a deadly condition. In 2002, hernia was listed as the cause of death for 1,595 US citizens. This review covers the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes of hernia. Figures show anatomic locations of the various abdominal wall, groin, lumbar, and pelvic floor hernias; a direct inguinal hernia; an indirect inguinal hernia; point-of-care sonograms showing a ventral wall hernia and an abdominal wall hernia; and the differential diagnosis of an abdominal mass based on anatomic location. Tables list risk factors for the development of inguinal hernia, sex-based differences in inguinal hernia development, risk factors for the development of incisional hernia, factors to consider when assessing the patient for a hernia, and factors associated with the highest rates of incarceration in patients with groin hernia. Key words: emergent hernia, hernia incarceration, incisional hernia, inguinal hernia, strangulated hernia This review contains 6 highly rendered figures, 5 tables, and 66 references.

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Risk factors and between-hospital variation of caesarean section in Denmark: a cohort study

BMJ Open ◽

10.1136/bmjopen-2017-019120 ◽

2018 ◽

Vol 8 (2) ◽

pp. e019120 ◽

Cited By ~ 5

Author(s):

Sonja Wehberg ◽

Rikke Guldberg ◽

Kim Oren Gradel ◽

Ulrik Schiøler Kesmodel ◽

Lis Munk ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Caesarean Section ◽

Breech Presentation ◽

Emergency Caesarean Section ◽

Secondary Outcome ◽

Maternity Unit ◽

Cephalopelvic Disproportion ◽

Hospital Units ◽

Hospital Variation

ObjectivesThe aim of this study was to estimate the effects of risk factors on elective and emergency caesarean section (CS) and to estimate the between-hospital variation of risk-adjusted CS proportions.DesignHistorical registry-based cohort study.Settings and participantsThe study was based on all singleton deliveries in hospital units in Denmark from January 2009 to December 2012. A total of 226 612 births by 198 590 mothers in 29 maternity units were included.Primary and secondary outcome measuresWe estimated (1) OR of elective and emergency CS adjusted for several risk factors, for example, body mass index, parity, age and size of maternity unit and (2) risk-adjusted proportions of elective and emergency CS to evaluate between-hospital variation.ResultsThe CS proportion was stable at 20%–21%, but showed wide variation between units, even in adjusted models. Large units performed significantly more elective CSs than smaller units, and the risk of emergency CS was significantly reduced compared with smaller units. Many of the included risk factors were found to influence the risk of CS. The most important risk factors were breech presentation and previous CS. Four units performed more CSs and one unit fewer CSs than expected.ConclusionThe main risk factors for elective CS were breech presentation and previous CS; for emergency CS they were breech presentation and cephalopelvic disproportion. The proportions of CS were stable during the study period. We found variation in risk-adjusted CS between hospitals in Denmark. Although exhaustive models were applied, the results indicated the presence of systematic variation between hospital units, which was unexpected in a small, well-regulated country such as Denmark.

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Maternal outcomes following second stage caesarean section in a tertiary hospital in Malaysia: A 6-year retrospective review

Polish Annals of Medicine ◽

10.29089/2020.20.00163 ◽

2021 ◽

Author(s):

Nurul Nafizah Mohd Rashid ◽

Nik Mohamed Zaki Nik Mahmood ◽

Mohd Pazudin Ismail ◽

Adibah Ibrahim ◽

W Fadhlina W Adnan ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Post Partum ◽

Neonatal Morbidity ◽

Tertiary Hospital ◽

Outcome Data ◽

High Rate ◽

Maternal Outcomes ◽

Total Blood ◽

Second Stage

Introduction: The trend for second stage caesarean section (SSCS) has been rising, and it carries a high rate of maternal and neonatal morbidity. Aim: To determine the prevalence of caesarean section (CS) performed during the second stage of labour and identify maternal outcomes and associated risk factors in these women. Material and methods: This retrospective study was performed in the Hospital University Sains Malaysia (HUSM). Medical records of 207 women with singleton cephalic pregnancies at term who underwent a SSCS between January 1, 2010 and December 31, 2015 were reviewed, and demographic and outcome data were collected. Results and discussion: During the study period, 8,197 (19.3%) out of 42,546 babies were delivered by CS, including 257 (4.1%) SSCSs. Nearly half (49.3%) the women were nulliparous, 182 (87.9%) experienced spontaneous labour and 123 (59.4%) received oxytocin augmentation. Furthermore, 26 (12.6%) of women had post-partum haemorrhage (≥1000 mL), of whom 22 (10.6%) required blood transfusion. Only 1 (0.5%) woman was admitted to the intensive care unit postoperatively, but 163 (78.7%) had an overall hospital stay length of 3 days. Furthermore, 38 (18.4%) and 33 (15.9%) of women experienced extended uterine tear and uterine atony, respectively. Parity (P < 0.001), attempted instrumentation (P < 0.001) and baby’s weight (P < 0.004) were statistically significantly associated with total blood loss. Parity (P < 0.012) and attempted instrumentation (P < 0.001) were risk factors for extended uterine tear. Conclusions: The overall outcomes from SSCS were better compared with studies performed in other centres. Current practices must be maintained or improved to provide the best patient caree.

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