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Caesarean Section (caesarean + section)
Kinds of Caesarean Section Terms modified by Caesarean Section Selected AbstractsGS26P ABDOMINAL WALL ENDOMETRIOMA FOLLOWING CAESAREAN SECTIONANZ JOURNAL OF SURGERY, Issue 2007R. J. Whitfield Purpose Endometriosis is defined as the presence of aberrant endometrial tissue outside of the uterus that responds to stimulation by ovarian hormones. A large, circumscribed mass of such tissue is commonly termed an endometrioma. Abdominal wall endometriomas in association with caesarean section scars have been reported repeatedly in the obstetrics and gynaecology literature, but rarely in general surgical journals. Methodology In this paper, six patients are reviewed who presented between 2001 and 2006 with painful, tender nodules in and around caesarean section scars. Of these, four reported exacerbation of symptoms during, or just prior to menstruation. One patient had experienced 12 years of symptoms, previously attributed to intra-abdominal adhesions. Results All patients had their scar nodules excised. Five procedures were performed electively. One patient underwent emergency exploration of her caesarean scar for possible incarcerated incisional hernia. Ectopic endometrial tissue was seen in the histological specimens of all patients. Four patients reported resolution of their symptoms following surgery. One patient had ongoing symptoms post-operatively, with an additional mass lesion seen on ultrasound consistent with a second endometrioma. One patient did not attend follow-up. Conclusion General surgeons are commonly required to assess and manage abdominal wall masses, and should have an awareness of endometrioma in the differential diagnosis when such a lesion is seen in association with a caesarean section scar. Wide excision is usually very effective at alleviating symptoms of abdominal wall endometrioma. [source] Cervical spinal cord injury following cephalic presentation and delivery by Caesarean sectionDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2001C Morgan MD MRCP MRCPCH We describe a term infant with an acute spinal cord injury following emergency Caesarean section. Foetal movements were normal on the day that the mother was admitted for postterm induction of labour. Caesarean section was performed because of foetal distress and failure to progress during labour. The initial clinical picture suggested acute birth asphyxia. The presence of a high cervical spine injury became more obvious as the clinical picture evolved over the next 7 days. A discontinuity of the cervical spinal cord at C4,5 was confirmed on MRI. Spontaneous respiration failed to develop and intensive care was withdrawn on day 15. No evidence of trauma, or a vascular, neurological, or congenital anomaly of the cervical spinal cord was found at post mortem. The absence of a similar case following cephalic presentation and Caesarean section made bereavement couselling of the parents especially difficult. [source] Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to 2003DIABETIC MEDICINE, Issue 4 2010H. E. Fadl Diabet. Med. 27, 436,441 (2010) Abstract Aims, To determine maternal and neonatal outcomes for women with gestational diabetes mellitus (GDM) in Sweden during 1991,2003, and to compare the outcomes in the two time periods. Methods, This is a population-based cohort study using the Swedish Medical Birth Register data for the period 1991,2003. There were 1 260 297 women with singleton pregnancies registered during this time, of whom 10 525 were diagnosed with GDM, based on a 75 g oral glucose tolerance test. The main diagnostic criteria were fasting capillary whole blood glucose , 6.1 mmol/l and 2 h blood glucose , 9.0 mmol/l. Results, Maternal characteristics differed significantly between the GDM and non-GDM group. Adjusted odds ratios (OR) were as follows: for pre-eclampsia, 1.81 (95% confidence interval (CI) 1.64,2.00); for shoulder dystocia, 2.74 (2.04,3.68); and for Caesarean section, 1.46 (1.38,1.54). No difference was seen in perinatal mortality, stillbirth rates, Apgar scores, fetal distress or transient tachypnoea. There was a markedly higher risk of large for gestational age, OR 3.43 (3.21,3.67), and Erb's palsy, OR 2.56 (1.96,3.32), in the GDM group, and statistically significant differences in prematurity < 37 weeks, birth weight > 4.5 kg, and major malformation, OR 1.19,1.71. No statistically significant improvement in outcomes was seen between the two study periods. Conclusions, Women with GDM have higher risks of pre-eclampsia, shoulder dystocia and Caesarean section. Their infants are often large for gestational age and have higher risks of prematurity, Erb's palsy and major malformations. These outcomes did not improve over time. [source] In-hospital breast feeding rates among women with gestational diabetes and pregestational Type 2 diabetes in South AucklandDIABETIC MEDICINE, Issue 2 2005D. Simmons Abstract Aim To describe the uptake of breast feeding in mothers with either Type 2 diabetes or gestational diabetes (GDM) in a hospital serving a multiethnic community in South Auckland, New Zealand. Research design and methods A retrospective study of all women attending the Diabetes in Pregnancy clinic over a 4-year period was undertaken: 30 women had Type 2 diabetes and 373 GDM. Results Compared with mothers with GDM, mothers with Type 2 diabetes were less likely to breast feed in any way as the first feed (41.4% vs. 68.0%, P = 0.011) or at discharge (69.0% vs. 84.0%, P = 0.039). In the combined group, there were no differences in uptake of breast feeding by ethnicity, age, parity, body mass index, smoking or antenatal glycaemia, use of insulin or presence of hypertension. Breast feeding on discharge was associated with a higher APGAR score, breast feeding as the first feed (78.2% vs. 19.4%, P < 0.001) and lower rates of delivery by Caesarean section (17.0% vs. 31.8%, P = 0.006). Logistic regression showed breast feeding as the first feed, the major determinant for breast feeding on discharge. Conclusions Factors delaying breast feeding as the first feed are the major determinant of breast feeding on discharge. Strategies to increase breast feeding as the first feed among women with Type 2 diabetes, and those having a Caesarean section, may be useful in increasing the uptake of breast feeding in the longer term. [source] Increased rate of prematurity associated with antenatal antiretroviral therapy in a German/Austrian cohort of HIV-1-infected womenHIV MEDICINE, Issue 1 2008I Grosch-Woerner Objective The aim of the study was to assess the risk of adverse pregnancy outcomes after antenatal antiretroviral therapy in a well-defined prospective cohort of nontransmitting HIV-infected women. Methods Prospective monitoring of 183 mother,child pairs from 13 centres in Germany and Austria, delivering between 1995 and 2001, was carried out. Following German,Austrian guidelines recommending an elective Caesarean section (CS) at 36 weeks, prematurity was defined as <36 weeks' gestation for these analyses. Results Of 183 mother,child pairs, 42% were exposed to antenatal monotherapy and 17% to dual therapy. Of the 75 women exposed to highly active antiretroviral therapy (HAART), 21 (28%) received protease inhibitor (PI)-based HAART and the remaining 54 received nonnucleoside reverse transcriptase inhibitor-based HAART. In multivariable analysis (176 pregnancies), PI-based HAART exposure during pregnancy was associated with an increased risk of premature delivery [adjusted odds ratio 3.40; 95% confidence interval (CI) 1.13,10.2; P=0.029, compared with monotherapy]. Congenital abnormalities affected 3.3% infants. Perinatally, 18.9% of children (34 of 179) had respiratory problems requiring interventions, which were associated with prematurity but not with type of treatment exposure. From adjusted regression analysis, the mean birth weight z -score for children exposed to HAART with PI (+0.46; 95% CI 0.01,0.92; P=0.047) or dual therapy (+0.43; 95% CI 0.03,0.82; P=0.034) was slightly but significantly higher than that for those exposed to monotherapy; head circumference was appropriate for gestational age and there were no significant differences between treatment groups. Conclusions Use of antenatal PI-based HAART initiated before or during pregnancy was associated with a significantly increased risk of premature delivery at <36 weeks' gestation. The overall crude prematurity rate was 34% (63 of 183; 95% CI 28,42). [source] National review of maternity care for women with HIV infectionHIV MEDICINE, Issue 5 2006C McDonald Objective To assess adherence to the British HIV Association (BHIVA) 2001 guidelines for the management of HIV-infected pregnant women. Methods A survey and a case note review were carried out using structured questionnaires sent to providers of adult HIV care in the UK and Ireland. Participants were women with HIV infection who delivered a live or stillborn infant between October 2002 and September 2003. The main outcome measures were the appropriate use of antiretroviral therapy, the use and timing of elective Caesarean section, and support for the avoidance of breast-feeding. Results Of 186 centres, 100 (54%) responded with data on 501 eligible pregnancies. Conclusions In general, practice was in accordance with the BHIVA 2001 guidelines. However, in a number of cases Caesarean sections were planned later than the recommended 38 weeks. [source] Regional anaesthesia for a Caesarean section in women with cardiac disease: a prospective studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2010E. LANGESÆTER Background We conducted a prospective observational survey of pregnant women with cardiac disease. The aim was to analyse and present the mode of delivery, outcome, and haemodynamic changes during a caesarean section under regional anaesthesia in women with cardiac disease. Methods All pregnant women with a cardiovascular diagnosis, except hypertension, were included in the registry. Based on the cardiac diagnoses, and on the New York Heart Association classification, a multidisciplinary group made recommendations for each patient and decided on the mode of delivery. The data from continuous, invasive haemodynamic monitoring in intermediate- and high-risk patients under regional anaesthesia for a caesarean section were analysed and presented. Results The hospital had approximately 9000 deliveries in the period from November 2003 to April 2008. A total of 113 pregnancies in 107 women were included. Thirty-two (28.3%) pregnancies were classified into the high-risk category. Of 103 deliveries, caesarean sections were performed in 59 (52.2%) cases, with regional anaesthesia in 51 patients (18 emergencies), general anaesthesia in eight patients (five emergencies), and a planned vaginal delivery in 44 patients. There was no mortality among the mothers or the babies during the hospital stay or 6 months postpartum. Pre-operative cardiovascular stability during the caesarean section was maintained by volume and phenylephrine infusion guided by invasive monitoring of haemodynamic variables. Conclusion Our study suggests that pregnant women with cardiac disease may safely deliver the baby by a caesarean section under regional anaesthesia. According to our findings, haemodynamic stability can be obtained by titrated regional anaesthesia, intravenous (i.v.) volume, phenylephrine infusion, and small repeated doses of i.v. oxytocin guided by invasive monitoring. [source] Ethylene glycol intoxication misdiagnosed as eclampsiaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2006I. Kralova Ethylene glycol intoxication is one of the most serious acute poisonings with very uncertain prognosis with regard to both recovery and survival. A case report is presented in which a woman who was admitted for the termination of pregnancy by Caesarean section with a diagnosis of eclampsia turned out to be severely intoxicated by ethylene glycol. [source] Risk factors for low birthweight in north-east Brazil: the role of caesarean sectionPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2001Antônio A.M. Silva Summary Caesarean section (CS) delivery is associated with low birthweight (LBW) in south-east Brazil. A hospital-based study was conducted on singleton infants from mothers residing in São Luís, to assess if an association between CS and LBW was found in the northern part of the country, where the CS rate is lower than in the south-east. A standardised questionnaire was administered to a sample of 2541 mothers in 10 hospitals, representing 94% of all deliveries, from March 1997 to February 1998. In a logistic model, type of delivery was the independent variable, the other variables were treated as confounders, and interaction terms were added between type of delivery and all other factors. LBW was associated with low maternal height, maternal smoking, primiparity, previous LBW, public insurance, preterm birth and CS. The CS rate was 33.7%. The risk of CS was higher for primiparous and married mothers, those with high level of schooling and attended by the same physician during prenatal and delivery care, deliveries held in private hospitals, daylight hours or evenings, and for those mothers who had adequate prenatal care. Because it appears unlikely that only medical reasons are operative, it is a possibility that CS could cause LBW, reflecting abusive indications for elective CS. [source] Antenatal detection of a single umbilical artery: does it matter?PRENATAL DIAGNOSIS, Issue 2 2003A. S. Gornall Abstract The presence of a single umbilical artery is recognised as a soft marker for congenital anomalies, aneuploidy, earlier delivery and low birthweight. Most of the available data are derived from case series or highly selected populations and are therefore likely to be unrepresentative. In this retrospective case-comparison study, we firstly aimed to determine the incidence of a single umbilical artery in an unselected population and secondly to examine the clinical significance of this soft marker. Over a 40-month period, 107 cases were identified from a cohort of 35 066 births giving an incidence of 3.1 per 1000 total births and late pregnancy losses. The antenatal detection rate was only 30%. Compared to fetuses with normal cord vasculature, fetuses with a single umbilical artery were more likely to be delivered at an earlier gestation and to weigh less, were 1.7 times more likely to be delivered by a Caesarean section and 19% of the cases had a congenital anomaly. The perinatal mortality was 49.0 per 1000 total births, which was 6 times higher than the background hospital rate. The presence of a single umbilical artery is associated with a poorer perinatal outcome compared to that in fetuses with three vessels in the cord. Unfortunately, the antenatal detection rate is poor. Recognising the importance of this soft marker in counselling and management of pregnancies should provide the stimulus to improve detection rates. Copyright © 2003 John Wiley & Sons, Ltd. [source] Factors affecting outcomes of prenatally-diagnosed tumoursPRENATAL DIAGNOSIS, Issue 5 2002K. L. Chan Abstract Objective The outcomes of prenatally-diagnosed tumours affect obstetrical management and parental decisions. The present study reviews the factors affecting outcomes for fetuses with prenatally-diagnosed tumours. Methods Medical records of all fetuses referred to our institutions with antenatally-diagnosed tumours were reviewed for the type and location of the tumours, results of treatment and/or causes of death. Results From January 1994 to May 2001, there were 15 fetuses with antenatally- diagnosed tumours: mesoblastic nephroma (MN) (n=2); neuroblastoma (NB) (n=2); cystic hygroma (CH) (n=3); intracranial germ cell tumour (IGCT) (n=2); sacrococcygeal teratoma (SCT) (n=3) and haemangioma (liver, n=2; limb, n=1). One mother had termination of pregnancy for her fetal SCT. Three mothers had Caesarean section for large fetal heads (CH, n=2; IGCT, n=1). Three fetuses died; two with IGCT and one with SCT, who died of heart failure. Two newborns with CH needed emergency intubation and, later, one of them had tracheostomy. One baby had cardiac failure resulting from a lower limb haemangioma and needed drug therapy. All solid tumours (MN, NB, SCT) of the live births had no recurrence after surgery with or without adjuvant chemotherapy. Conclusion Prenatally-diagnosed tumours without any other associated abnormality cause morbidity and mortality because of their location and vascularity. Solid tumours are relatively benign. Copyright © 2002 John Wiley & Sons, Ltd. [source] A Caesarean section under spinal anaesthesia for a patient with pustular psoriasisANAESTHESIA, Issue 7 2009O. Pemberton No abstract is available for this article. [source] Pre-oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulationANAESTHESIA, Issue 4 2009S. H. McClelland Summary Using the Nottingham Physiology Simulator, we investigated the effects on pre-oxygenation and apnoea during rapid sequence induction of labour, obesity, sepsis, pre-eclampsia, maternal haemorrhage and multiple pregnancy in term pregnancy. Pre-oxygenation with 100% oxygen was followed by simulated rapid sequence induction when end-tidal nitrogen tension was less than 1 kPa, and apnoea. Labour, morbid obesity and sepsis accelerated pre-oxygenation and de-oxygenation during apnoea. Fastest pre-oxygenation was in labour, with 95% of the maximum change in expired oxygen tension occurring in 47 s, compared to 97 s in a standard pregnant subject. The labouring subject with a body mass index of 50 kg.m,2 demonstrated the fastest desaturation, the time taken to fall to an arterial saturation < 90% being 98 s, compared to 292 s in a standard pregnant subject. Pre-eclampsia prolonged pre-oxygenation and tolerance to apnoea. Maternal haemorrhage and multiple pregnancy had minor effects. Our results inform the risk-benefit comparison of the anaesthetic options for Caesarean section. [source] Open vs specific questioning during anaesthetic follow-up after Caesarean sectionANAESTHESIA, Issue 2 2009T. Nguyen Summary Words with negative emotional content such as pain or itch may enhance perception of these symptoms. We assessed open and direct questioning for symptoms in 100 women following Caesarean section. Of the 65 women reporting pain, 25 (39%) did so only when questioned specifically. Similarly, three women with bothersome pain (5%), and two requesting analgesia (3%), failed to disclose pain until questioned specifically. None of the 46 women with pain scores < 6 on a verbal numerical rating scale requested additional analgesia. Of 31 women with pruritus, two (6%) stated it bothered them and requested treatment and one (3%) failed to disclose pruritus on open questioning. Most women with bothersome pain or who request analgesia reveal this with open questioning. However, specific questioning is required to elicit pain in all patients. Most patients are bothered by pain at pain scores , 6, while those with scores < 6 are unlikely to request additional analgesia. [source] Warming of patients during Caesarean section: a telephone survey,ANAESTHESIA, Issue 1 2009M. J. Woolnough Summary We contacted the duty obstetric anaesthetist in 219 of the 220 consultant-led maternity units in the UK (99.5%) and asked about departmental and individual practice regarding temperature management during Caesarean section. Warming during elective Caesarean section was routine in 35 units (16%). Intravenous fluid warmers were available in 213 units (97%), forced air warmers were available in 211 (96%) and warming mattresses were available in 42 (19%). Only 18 (8%) departments had specific guidelines for temperature management during Caesarean section. Personal intra-operative practice was variable, although all of those contacted would initiate some form of active temperature management after a mean (SD) volume of blood loss of 1282 (404) ml, length of surgery of 78 (24) min, or core body temperature (if measured) of median (IQR [range]), 36 (35.5,36 [34,37.2]) °C. [source] Variation in rapid sequence induction techniques: current practice in WalesANAESTHESIA, Issue 1 2009J. P. Koerber Summary A questionnaire survey examining rapid sequence induction techniques was sent to all anaesthetists in Wales. The questionnaire presented five common clinical scenarios: emergency appendicectomy; elective knee arthroscopy with a symptomatic hiatus hernia; elective knee arthroscopy with an asymptomatic hiatus hernia; elective Caesarean section; and emergency laparotomy for bowel obstruction. Completed surveys were received from 421 anaesthetists, a 68% response rate. Rapid sequence induction was chosen by 398/400 respondents (100%) for bowel obstruction, 392/399 (98%) for Caesarean section, 388/408 (95%) for appendicectomy, 328/395 (83%) for symptomatic hiatus hernia but only 98/399 (25%) for asymptomatic hiatus hernia (p < 0.001). Trainees were more likely to use a rapid sequence induction technique than consultants and staff grades for the appendicectomy (p = 0.025), symptomatic hiatus hernia (p = 0.004) and asymptomatic hiatus hernia (p = 0.001) scenarios and were also more likely to use a thiopental,suxamethonium combination for rapid sequence induction (p < 0.001). [source] Caesarean section in a complicated case of central core diseaseANAESTHESIA, Issue 5 2008R. N. Foster Summary We describe the anaesthetic management of a 21-year-old lady with central core disease for elective Caesarean section. Central core disease is characterised by muscle weakness, skeletal deformities and susceptibility to malignant hyperthermia. Total intravenous anaesthesia was used because of the combination of potential malignant hyperthermia, severe kyphoscoliosis and extensive spinal scarring. The authors believe there is no previous report of propofol and remifentanil being used in these circumstances. A short review of central core disease and its anaesthetic implications is provided. [source] Local anaesthetic-opioid mixture for emergency Caesarean sectionANAESTHESIA, Issue 12 2007D. Benhamou No abstract is available for this article. [source] Ultra-low dose combined spinal-epidural anaesthesia for Caesarean section in severe pre-eclampsiaANAESTHESIA, Issue 5 2006W. H. L. Teoh No abstract is available for this article. [source] Extending low-dose epidural analgesia for emergency Caesarean section using ropivacaine 0.75%ANAESTHESIA, Issue 10 2004R. D. Sanders Summary We compared ropivacaine 0.75% and bupivacaine 0.5% for extending low-dose epidural analgesia for emergency Caesarean section, using a prospective double-blind randomised controlled trial design. The trial was halted after 45 patients were studied (23 ropivacaine; 22 bupivacaine) because bupivacaine was replaced by levobupivacaine in our unit. Time to reach T4 for loss of cold sensation was similar in both groups, although analgesic supplementation was required less often in the ropivacaine group than in the bupivacaine group (2/23 vs. 9/21; p = 0.01). [source] Anaesthetic considerations in a parturient with varicella presenting for Caesarean sectionANAESTHESIA, Issue 11 2003N. W. Brown Summary A parturient with varicella (chickenpox) presented for an elective Caesarean section and spinal anaesthesia was employed for surgery. A review of the literature is presented and the anaesthetic issues are discussed. [source] A simple device as a guide to 15° tilt during Caesarean sectionANAESTHESIA, Issue 9 2003C. Siegmueller No abstract is available for this article. [source] Probable dystonic reaction after a single dose of cyclizine in a patient with a history of encephalitisANAESTHESIA, Issue 3 2003H. King Summary A patient underwent an emergency Caesarean section under general anaesthesia for an antepartum haemorrhage. Following delivery of a live infant, cyclizine was administered in accordance with departmental anti-emetic protocol. On awakening she was confused, slow to articulate and had slurred speech. A computed tomography (CT) scan, which was performed to exclude an intracranial event, was normal. Her symptoms were suggestive of a lingual,facial,buccal dyskinesia as seen with dopamine antagonists. A presumptive diagnosis of a dystonic reaction to cyclizine was made. She received two doses of procyclidine before her symptoms completely resolved. Cyclizine has had a resurgence in popularity owing to the recent withdrawal of droperidol and anaesthetists should be aware that, although extremely rare, dystonic reactions may occur with this agent. [source] Seizures on emergence from sevoflurane anaesthesia for Caesarean section in a healthy parturientANAESTHESIA, Issue 12 2002Article first published online: 18 NOV 200 No abstract is available for this article. [source] Oxygen administration for elective Caesarean section under spinal anaesthesiaANAESTHESIA, Issue 12 2002Article first published online: 18 NOV 200 No abstract is available for this article. [source] Oxytocin during Caesarean sectionANAESTHESIA, Issue 7 2002A. Spence No abstract is available for this article. [source] Dose of oxytocin after Caesarean sectionANAESTHESIA, Issue 7 2002M. M. Khan No abstract is available for this article. [source] Maternal self-administration of oral analgesia after Caesarean sectionANAESTHESIA, Issue 9 2001S. Scott First page of article [source] Prevention and management of hypotension during spinal anaesthesia for elective Caesarean section: a survey of practiceANAESTHESIA, Issue 8 2001S. M. Burns Hypotension during obstetric spinal anaesthesia has traditionally been managed by such measures as fluid preloading, positioning of the patient and the use of vasoconstrictors. However, studies and reports have regularly appeared in the literature disputing the value of conventional management, in particular, the fluid preload. With this in mind, we surveyed UK consultant obstetric anaesthetists to determine current practice in this area. Of the 558 respondents, 486 (87.1%) stated that they routinely give a fluid preload. The fluid chosen by 405 (83.3%) of the preloaders was Hartmann's solution and the usual volume, chosen by 194 (39.9%), was 1000 ml. A simple left lateral position was preferred by 221 respondents (39.6%) overall and in the treatment of hypotension, ephedrine was the sole vasoconstrictor selected by 531 (95.2%). Heavy bupivacaine 0.5% was the local anaesthetic chosen by 545 (97.7%) and 407 (72.9%) respondents indicated the use of additional spinal drugs. [source] Caesarean section in a patient with Engelmann's diseaseANAESTHESIA, Issue 4 2000A reply No abstract is available for this article. [source] | |||||||||||||||||||||||||||||||