scholarly journals Comparison of maternal morbidity in Emergency and Elective Cesarean Section

2020 ◽  
Vol 2 (3) ◽  
pp. 10-13
Author(s):  
Selami Erdem ◽  
Serhat Ege ◽  
İhsan Bagli
Keyword(s):  
Maternal Morbidity ◽  
Elective Caesarean Section ◽  
Fetal Distress ◽  
Elective Cesarean Section ◽  
Bladder Injury ◽  
Maternal Complications ◽  
Increased Risk ◽  
Elective Cesarean ◽  
Group 2 ◽  
Group 1

Objective: We aimed to compare emergency and elective cesarean patients in our hospital in terms of epidemiological features and maternal morbidity. Material and Methods: We randomly retrospectively reviewed the records of 302 caesarean cases. Demographic features and indications for emergency (group 1) and elective caesarean section (C/S) (group 2) were recorded. The groups were compared in terms of indications and intraoperative and postoperative morbidity. Results: It was found that the mean hematocrit decrease in group 1 was not different from group 2 (5.70 ± 1.16 and 5.62 ± 0.67). When the groups are examined according to cesarean indications; In group 1 patients, fetal distress, cephalopelvic disproportion (CPD), non-progress of labor, abruptio placentae were significantly higher compared to group 2, whereas in group 2 patients the previous 1 C / S and previous 2 C / S indications were significantly higher. Intraoperative hemorrhage and bladder injury were more common in group 1 patients compared to group 2 patients. When the groups are examined according to postoperative maternal complications; In group 1 patients, transfusion, prolonged bladder catheterization, admission to intensive care unite (ICU), was significantly higher compared to group 2. Conclusion: It was found that many intraoperative and postoperative complications were more common in the emergency C/S group. it was also detected that all cases with bladder injuries had previous cesarean sections. Therefore, the presence of experienced personnel in these cases may be important for reducing morbidity due to the increased risk of complications.

scholarly journals The Safty Profile of Blood Salvage Applied for Collected Blood With Amniotic Fluid During Cesarean Section

2021 ◽  
Author(s):  
Xiaoying Rong ◽  
Xiangyang Guo ◽  
Hong Zeng ◽  
Jun Wang ◽  
Mi Li ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Amniotic Fluid ◽  
Venous Blood ◽  
Fetal Hemoglobin ◽  
Elective Cesarean Section ◽  
Suction Device ◽  
Increased Risk ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background: The guidelines of National Health Service(NHS) also recommended for use in obstetrics at increased risk of bleeding, requiring two sets to reduce amniotic fluid contamination, however, when comes to massive hemorrhage, it is may difficult to operate because the complex operation may delay time. The aim of the study was to detect the effect of amniotic fluid recovery on intraoperative cell salvage in obstetrics and provide evidence for clinical applications.Method: Thirty-four patients undergoing elective cesarean section were randomly divided into two groups. In group 1, the cumulative blood from the operation field, including the amniotic fluid, was collected using a single suction device for processing. In group 2, after suctioning away the amniotic fluid using another suction device for the cumulative blood from the operation field. From each group, four samples were taken, including maternal venous blood (sample I), blood before washing (sample II), blood after washing (sample III) and blood after filtration with a leukocyte filter (sample IV) , to detect serum potassium (K+), hemoglobin (Hb), white blood cell (WBC), fetal hemoglobin (HbF), alpha fetoprotein (AFP) and squamous cell (SC) levels.Results: The AFP, K+ and WBC levels of sample III and sample IV were significantly lower than sample I in group 1 and group 2 (P<0.05). Significantly more SCs were found in sample III than in sample I in group 1 and group 2 (P<0.05), but SCs of sample IV had no statistical difference compared to sample I in group 1 and group 2 (P>0.05). There was no significant difference in the K+, Hb, WBC, AFP and SC levels of sample IV between group 1 and group 2 (P>0.05). The HbF levels of sample III and sample IV were significantly higher in group 1 than in group 2 (P<0.05).Conclusion: There is little or no possibility for AF contamination to enter the re-infusion system when used in conjunction with a leucodepletion filter. In future, one set of suction device can be considered in obstetric emergency.Trial registration: ChiCTR1800015684, 2018.4.15

scholarly journals SAT0306 SEMIQUANTITATIVE AND QUANTITATIVE ANALYSIS OF LUNG CT IN THE ASSESSMENT OF INTERSTITIAL LUNG DISEASE IN IDIOPATHIC INFLAMMATORY MYOPATHIES WITH A FOCUS ON ANTISYNTHETASE.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1098.2-1098
Author(s):  
S. Barsotti ◽  
C. Roncella ◽  
A. Valentini ◽  
L. Cavagna ◽  
R. Castellana ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Special Focus ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Increased Risk ◽  
Group 2 ◽  
Lung Ct ◽  
Group 1

Background:Interstitial lung disease (ILD), is common in patients with idiopathic inflammatory myopathies (IIM) and strongly impact on patients’ morbidity and mortality. Patients with anti-aminoacyl-transfer RNA-synthetases (anti-ARS) antibodies are associated with an increased risk of ILD.Objectives:Defining the radiological characteristics of IIM patients, with special focus on serological groups, through qualitative, semiquantitative and quantitative analysis of lung CT.Methods:This was a prospective study conducted from 2016 to 2019. Ninety-eight IIM patients (35 men, 63 women) were included. Myositis specific autoantibodies (MSA) were assessed with Myositis Prophyle III (Euroimmune, Lubeck).Each patient had a baseline CT; the total score of Warrick (WS) was obtained at semiquantitative analysis. The radiological scores ILD% (interstitial lung disease %) and PVRS% (pulmonary vascular related structure) were the result of quantitative analysis in 61 patients (CALIPER). Pulmonary function tests (PFTs) included TLC%, FVC% and DLCO% (65 patients). The analysis was conducted in the whole group and divided in subgroups based on their MSA pattern: in particular anti-ARS (Group 1) and patients negative to MSA (Group 2) were analysed.Results:Positive correlations between ILD% and PVRS% (Rho=0.916; ρ=0.000), WS and ILD% (Rho=0.663; ρ=0.000) and WS and PVRS% (Rho=0.637; ρ<0.001) were found.The most relevant inverse correlations were found between ILD% and DLCO% (Rho=-0.590; ρ=0.001), PVRS% and DLCO% (Rho=-0.549; ρ<0.001) and WS and DLCO% (Rho=-0.471; ρ<0.001).Statistically significant higher values of WS, ILD% and PVRS% were found in Group 1 (WS=15, ILD%=11 and PVRS%=3.5), compared to Group 2 (WS=2.5, ILD%=0.84 and PVRS%=2.2). NSIP pattern resulted dominant represented in the two groups (80% Group 1, 75% Group 2). No statistically significant differences of DLCO%, FVC% and TLCO% were found.Conclusion:The inverse correlations between the radiological scores and the functional data TLC% and DLCO% (ρ<0.001) confirm the role of lung CT in the clinical management of ILD in IIM patients, and may represent a promising tool for clinical trials. For the first time anti-ARS and serological negative patients were defined through qualitative, semiquantitative and quantitative analysis of lung CT. Further study should be conducted in order to define the prognostic value of the quantitative analysis of lung CT in the follow up of IIM patients.Disclosure of Interests:None declared

Calcium phosphate product level as a predictor for arteriovenous fistula re-operations in patients with chronic renal failure

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 284-290 ◽  
Author(s):  
Mehmet Erin Tüysüz ◽  
Mehmet Dedemoğlu
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Calcium Phosphate ◽  
Arteriovenous Fistula ◽  
Product Level ◽  
Increased Risk ◽  
High Calcium ◽  
Phosphate Product ◽  
Group 2 ◽  
Group 1

Objectives There is an increased calcium phosphate product level causing the formation of calcification in the arterial wall and thus decreased quality of fistula in patients with chronic renal failure. The purpose of our study is to verify the relationship between arteriovenous fistula re-operation and high calcium phosphate product level. Methods Seventy-nine consecutive patients with chronic renal failure between April 2016 and February 2018 were included in the study. Patients having calcium phosphate product level ≥50 mg2/dl2 were defined as group 1, whereas those having <50 mg2/dl2 were defined as group 2. Primary outcome of interest was the need for re-operation during the follow-up and to determine the risk factors for re-operation. To determine independent predictors for re-operation, multivariate logistic regression model was used. Results The rates of redo and tredo operation were significantly higher in group 1 compared to group 2 ( p = 0.01 and 0.04). In multivariate analysis, phosphate (OR: 1.84, 95% CI: 1.00–3.40, p = 0.05) and triglyceride (OR: 1.01, 95% CI: 1.00–1.02, p = 0.04) levels for redo operation and calcium phosphate product level (OR: 1.11, 95% CI: 1.01–1.22, p = 0.03) for tredo operation were found to be independent predictors. Conclusions High calcium phosphate product level leads to increased risk of arteriovenous fistula re-operation by causing arterial stiffness in this patient group. Additionally, these re-operations place additional burden on morbidity and cost efficacy. Thus, we recommend keeping the calcium phosphate product level at the optimal level in these patients to avoid both the risk of arteriovenous fistula re-operation and the other cardiovascular problems.

scholarly journals Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

2018 ◽  
Vol 7 (2) ◽  
pp. 343 ◽  
Author(s):  
Heena D. Pahuja ◽  
Megha P. Tajne ◽  
Anjali R. Bhure ◽  
Savita M. Chauhan
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Epidural Block ◽  
Elective Cesarean Section ◽  
Significant Difference ◽  
Elective Cesarean ◽  
Mean Time

Background: Levobupivacaine has been purported to be as efficacious as Bupivacaine for epidural anaesthesia in recent literature.Methods: With the intent to study the same in caesarean section cases in our set up, we observed various intra- and post-operative variables in two groups (Levobupivacaine and Bupivacaine) of 60 healthy parturients. Sixty parturients for elective caesarean section were allocated randomly to receive epidural block with 10-20 ml of either 0.5% Levobupivacaine with Fentanyl 25µg or 0.5% Bupivacaine with Fentanyl 25µg to reach T6 level.Results: Mean total volume in Bupivacaine group was 15.23ml and in Levobupivacaine group was 12.76 ml. The difference was statistically significant. There was significant difference between the groups in the sensory block. The onset of analgesia was earlier in Levobupivacaine group. Mean time was 6.20 minutes in Bupivacaine group and 4.36 minutes in Levobupivacaine group. The duration of motor block was significantly short in Levobupivacaine group. Mean Time for recovery from motor block in Bupivacaine group was 2.5 hours and in Levobupivacaine group 1.5 hours. Mean time to achieve T6 height was earlier in Levobupivacaine group i.e. 16.46 minutes in Bupivacaine group and 13.26 minutes in Levobupivacaine group. Duration of postoperative analgesia was similar. There was no significant difference in neonatal outcome.Conclusions: Levobupivacaine was found to fare better than Bupivacaine in the studied intra and post-operative parameters and is hence recommended over racemic Bupivacaine for epidural block in patients undergoing elective cesarean section.

scholarly journals Anaesthetic Management of a Morbidly Obese Parturient for Elective Caesarean Section

2016 ◽  
Vol 10 (2) ◽  
pp. 64-66
Author(s):  
R Pradhan ◽  
S Shrestha ◽  
T Gurung ◽  
AB Shrestha ◽  
KR Sharma
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Epidural Anaesthesia ◽  
Gestational Hypertension ◽  
Elective Caesarean Section ◽  
Anaesthetic Management ◽  
Elective Cesarean Section ◽  
Morbidly Obese ◽  
Elective Cesarean ◽  
Spinal Epidural

Anaesthesia for an obese parturient poses a challenge to anaesthesiologists. Here we report a case of 27 years obese primigravidae at 40 weeks of gestation with gestational hypertension who underwent elective cesarean section under combined spinal epidural anaesthesia. Her intraoperative and postoperative periods were uneventful. 

Abstract 26: Thirty Day And Six Month All-cause Mortality After Stroke In Patients With And Without Dysphagia Screening.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Thomas M Hemmen ◽  
Rema Raman ◽  
Karin Ernstrom ◽  
Debra Paulson ◽  
Valerie Lake ◽  
...  
Keyword(s):  
Aspiration Pneumonia ◽  
Morbidity And Mortality ◽  
Categorical Variables ◽  
Stroke Severity ◽  
Continuous Variables ◽  
Admission Source ◽  
Increased Risk ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Dysphagia is common after stroke and is associated with an increased risk for pulmonary complications and mortality. Current standards mandate screening for dysphagia before oral intake in all acute stroke patients. We aimed to show if this early screening affects long-term outcomes after stroke. Methods: We included all UCSD Medical Center discharges with diagnosis AIS, ICH and SAH between July 1 2008 and June 30 2011; and evaluated baseline demographics, admission diagnosis (AIS, ICH, SAH), admission source (ED or transfer) length of hospital stay (LOS), ICU-LOS, aspiration pneumonia, in-hospital, 30-day and 6-month mortality by public death records for all patients. Patients were grouped as: 1) no dysphagia screening performed, 2) Nil per os (NPO) until discharge, 3) dysphagia screening performed. Adjustments for stroke severity and CMI were not possible. Statistical comparisons were done with the Kruskal-Wallis test (continuous variables) or Fisher-Freeman-Halton test (categorical variables). For pairwise comparisons we used the Wilcoxon tests (continuous variables) or Fisher’s Exact test (categorical variables), with Holm’s adjusted p-values. Results: A total of 476 patients were included, Group 1: 47, Group 2: 119, Group 3: 310. There was no significant difference in age, gender, race/ethnicity, and diagnosis of HTN, DM, afib, prior stroke and admission source. More patients with SAH and ICH were in Group 2. Overall, LOS and ICU LOS, aspiration pneumonia, in-hospital, 30-day and 6-month mortality were found to be different among groups (p<0.0001). Pair-wise comparisons showed that all outcomes were significantly higher in Group 2, but similar between Groups 1 and 3 (NS). Conclusion: We found no difference in outcomes between patients who received dysphagia screening versus not (Group 1 vs 3). Excluding patients who were left NPO and are more likely to suffer from ICH, SAH with increased morbidity and mortality, it remains uncertain if a targeted early dysphagia screening can reduce morbidity and mortality after stroke. Further studies are needed to find the appropriate population that most benefits from dysphagia screening.

scholarly journals Obesity, Second Stage Duration, and Labor Outcomes in Nulliparous Women

2019 ◽  
Author(s):  
Antonina I. Frolova ◽  
Nandini Raghuraman ◽  
Molly J. Stout ◽  
Methodius G. Tuuli ◽  
George A. Macones ◽  
...  
Keyword(s):  
Maternal Morbidity ◽  
Secondary Analysis ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Obese Women ◽  
Stage Duration ◽  
Second Stage ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Labor Outcomes

Abstract Objective To estimate second stage duration and its effects on labor outcomes in obese versus nonobese nulliparous women. Study Design This was a secondary analysis of a cohort of nulliparous women who presented for labor at term and reached complete cervical dilation. Adjusted relative risks (aRR) were used to estimate the association between obesity and second stage characteristics, composite neonatal morbidity, and composite maternal morbidity. Effect modification of prolonged second stage on the association between obesity and morbidity was assessed by including an interaction term in the regression model. Results Compared with nonobese, obese women were more likely to have a prolonged second stage (aRR: 1.48, 95% CI: 1.18–1.85 for ≥3 hours; aRR: 1.65, 95% CI: 1.18–2.30 for ≥4 hours). Obesity was associated with a higher rate of second stage cesarean (aRR: 1.78, 95% CI: 1.34–2.34) and cesarean delivery for fetal distress (aRR: 2.67, 95% CI: 1.18–3.58). Obesity was also associated with increased rates of neonatal (aRR: 1.38, 95% CI: 1.05–1.80), but not maternal morbidity (aRR: 1.06, 95% CI: 0.90–1.25). Neonatal morbidity risk was not modified by prolonged second stage. Conclusion Obesity is associated with increased risk of neonatal morbidity, which is not modified by prolonged second stage of labor.

scholarly journals Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Cost Of Care ◽  
Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

scholarly journals Prospectively Validated Dosing Nomograms for Maximizing the Pharmacodynamics of Vancomycin Administered by Continuous Infusion in Critically Ill Patients

2009 ◽  
Vol 53 (5) ◽  
pp. 1863-1867 ◽  
Author(s):  
Federico Pea ◽  
Mario Furlanut ◽  
Camilla Negri ◽  
Federica Pavan ◽  
Massimo Crapis ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Dosage Calculation ◽  
Cohort Group ◽  
Increased Risk ◽  
Dependent Activity ◽  
Group 2 ◽  
Vancomycin Treatment ◽  
Group 1

ABSTRACT The efficacy of vancomycin against methicillin-resistant Staphylococcus aureus (MRSA)-related infections has been called into question by recent findings of higher rates of failure of vancomycin treatment of infections caused by strains with high MICs. Continuous infusion may be the best way to maximize the time-dependent activity of vancomycin. The aim of this study was to create dosing nomograms in relation to different creatinine clearance (CLCr) estimates for use in daily clinical practice to target the steady-state concentrations (C sss) of vancomycin during continuous infusion at 15 to 20 mg/liter (after the administration of an initial loading dose of 15 mg/kg of body weight over 2 h). The correlation between vancomycin clearance (CLv) and CLCr was retrospectively assessed in a cohort of critically ill patients (group 1, n = 70) to create a formula for dosage calculation to target C ss at 15 mg/liter. The performance of this formula was prospectively validated in a similar cohort (group 2, n = 63) by comparison of the observed and the predicted C sss. A significant relationship between CLv and CLCr was observed in group 1 (P < 0.001). The application of the calculated formula to vancomycin dosing in group 2 {infusion rate (g/24 h) = [0.029 × CLCr (ml/min) + 0.94] × target Css × (24/1,000)} led to a significant correlation between the observed and the predicted C sss (r = 0.80, P < 0.001). Two dosing nomograms based on CLCr were created to target the vancomycin C ss at 15 and 20 mg/liter in critically ill patients. These nomograms could be helpful in improving the vancomycin treatment of MRSA infections, especially in the presence of borderline-susceptible pathogens and/or of pathophysiological conditions which may enhance the clearance of vancomycin, while potentially avoiding the increased risk of nephrotoxicity observed with the use of high intermittent doses of vancomycin.

scholarly journals Study of the Differential Consequences of Neglect and Poverty on Adaptive and Maladaptive Behavior in Children

2020 ◽  
Vol 17 (3) ◽  
pp. 739
Author(s):  
Carlos Herruzo ◽  
Antonio Raya Trenas ◽  
María J. Pino ◽  
Javier Herruzo
Keyword(s):  
Assessment System ◽  
Maladaptive Behavior ◽  
Adaptive Skills ◽  
School Problems ◽  
Increased Risk ◽  
Externalizing And Internalizing Problems ◽  
Group 3 ◽  
Physical Neglect ◽  
Group 2 ◽  
Group 1

The consequences of physical neglect on retardation in the development of adaptive behaviors and the increased risk of poor physical and mental health are well documented. As physical neglect is a phenomenon found almost exclusively among socially deprived people, it is important to distinguish the health effects caused by neglect from those caused by poverty. The objective of this study was to compare the effects of poverty and physical neglect on the development of problematic externalizing and internalizing behaviors, adaptive skills, and school problems among school children between the ages of 3 and 12. A group of 157 children were chosen from 28 Andalusian schools and classified in three homogeneous groups. Children in group 1 (n = 53) had two target conditions: living in slums (poverty) and suffering from neglect. Children in group 2 (n = 52) had one target condition: living in the same slums as the children in group 1, but not suffering from neglect. Group 3 (n = 52) consisted of children from other (non-slum) neighborhoods who did not suffer from neglect. Adaptive and maladaptive behaviors were evaluated with the Behavior Assessment System for Children (BASC). Significant differences were found between group 1 and group 2, but there were no important differences between group 2 and group 3. The conclusion was that externalizing and internalizing problems, school problems, and low adaptive skills found in neglected children were associated with neglect rather than with poverty or socially deprived environments.

Sign in / Sign up

Export Citation Format

Share Document