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Elective Cesarean Section (elective + cesarean_section)
Selected AbstractsOnset of Vocal Interaction Between Parents and Newborns in Skin-to-Skin Contact Immediately After Elective Cesarean SectionBIRTH, Issue 3 2010Marianne Velandia RNM Abstract:, Background:, Cesarean section is associated with delayed mother-infant interaction because neither the mother nor the father routinely maintains skin-to-skin contact with the infant after birth. The aim of the study was to explore and compare parent-newborn vocal interaction when the infant is placed in skin-to-skin contact either with the mother or the father immediately after a planned cesarean section. Methods:, A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin-to-skin contact either with fathers or mothers after an initial 5 minutes of skin-to-skin contact with the mothers after birth. The newborns' and parents' vocal interaction were recorded on a videotape and audiotape. The following variables were explored: newborns' and parents' soliciting, newborns' crying and whining, and parental speech directed to the other parent and to the newborn. Results:, Newborns' soliciting increased over time (p = 0.032). Both fathers and mothers in skin-to-skin contact communicated more vocally with the newborn than did fathers (p = 0.003) and mothers (p = 0.009) without skin-to-skin contact. Fathers in skin-to-skin contact also communicated more with the mother (p = 0.046) and performed more soliciting responses than the control fathers (p = 0.010). Infants in skin-to-skin contact with their fathers cried significantly less than those in skin-to-skin contact with their mothers (p = 0.002) and shifted to a relaxed state earlier than in skin-to-skin contact with mothers (p = 0.029). Conclusions:, Skin-to-skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin-to-skin contact and exposed to the parents' speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin-to-skin contact after cesarean section, to support the early onset of the first vocal communication. (BIRTH 37:3 September 2010) [source] Maternal-infant transmission of hepatitis C virus infectionHEPATOLOGY, Issue 5B 2002Eve A. Roberts 555 University Ave. Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 106 copies per mL). The rate of mother-to-infant transmission is 4% to 7% per pregnancy in women with HCV viremia. Co-infection with human immunodeficiency virus (HIV) increases the rate of transmission 4 to 5 fold. The actual time and mode of transmission are not known. Elective Cesarean section is not recommended for women with chronic HCV infection alone. The role of treatment to prevent transmission is limited by the fetal toxicity of currently available medications for hepatitis C. Breast feeding poses no important risk of HCV transmission if nipples are not traumatized and maternal hepatitis C is quiescent. Pregnant women at high risk for HCV infection should be screened for anti-HCV, and HCV RNA testing should be performed if anti-HCV is positive. Infants of women with hepatitis C should be tested for HCV RNA on two occasions, between the ages of 2 and 6 months and again at 18 to 24 months, along with serum anti-HCV. The natural history of mother-to-infant hepatitis C remains uncertain, especially the course in the first year of life when some infants appear to have spontaneous resolution. [source] Maternal-infant transmission of hepatitis C virus infectionHEPATOLOGY, Issue S1 2002Eve A. Roberts M.D., FRCPC Mother-to-infant transmission of hepatitis C virus (HCV) is comparatively uncommon. The prevalence of antibody to HCV (anti-HCV) in pregnant women is 0.1% to 2.4%, although in some endemic areas it is much higher. The proportion of women with anti-HCV who have active infection with viremia is 60% to 70%. Transmission of HCV occurs only when serum HCV RNA is detectable and may be related to higher levels (above 106 copies per mL). The rate of mother-to-infant transmission is 4% to 7% per pregnancy in women with HCV viremia. Co-infection with human immunodeficiency virus (HIV) increases the rate of transmission 4 to 5 fold. The actual time and mode of transmission are not known. Elective Cesarean section is not recommended for women with chronic HCV infection alone. The role of treatment to prevent transmission is limited by the fetal toxicity of currently available medications for hepatitis C. Breast feeding poses no important risk of HCV transmission if nipples are not traumatized and maternal hepatitis C is quiescent. Pregnant women at high risk for HCV infection should be screened for anti-HCV, and HCV RNA testing should be performed if anti-HCV is positive. Infants of women with hepatitis C should be tested for HCV RNA on two occasions, between the ages of 2 and 6 months and again at 18 to 24 months, along with serum anti-HCV. The natural history of mother-to-infant hepatitis C remains uncertain, especially the course in the first year of life when some infants appear to have spontaneous resolution. (HEPATOLOGY 2002;36:S106,S113). [source] Mode of delivery and risk of fecal incontinence in women with or without inflammatory bowel disease: Questionnaire survey,INFLAMMATORY BOWEL DISEASES, Issue 11 2007J.P.L. Ong MRCP Abstract Background: Elective cesarean section (CS) may be recommended for patients with Crohn's disease and perineal involvement. Little is known about CS rates in parous women with inflammatory bowel disease (IBD), nor the possible long-term impact of vaginal delivery and episiotomy on continence in women with IBD. Methods: Questionnaires were sent to all 777 regional members of a Colitis and Crohn's Disease patient association. Male members were asked to request their unaffected female spouse/partner to complete the forms in order to give a "control" group for comparison. Results: Forms were returned by 491 members (response rate 63%). CS had been undertaken for 37 of the 229 parous women with IBD (16%) versus 15 of the 116 without IBD (13%) (,2 = 0.62, P = NS). Only 2 women had undergone CS due to IBD. Of the parous women with IBD, 75 (33%) had persisting problems with fecal incontinence, of whom 21 (28%) dated this back to the time of vaginal delivery. By contrast, only 2 (2%) of the parous control group had suffered persisting fecal incontinence following vaginal delivery (,2 = 8.27, P < 0.01). Conclusions: Persisting fecal incontinence is reported by a significant minority of parous women with IBD, of whom over one-quarter date this back to vaginal delivery. CS is rarely recommended due to IBD alone. If our findings are confirmed in prospective studies, the threshold for recommending CS may need to be lowered for patients with IBD. (Inflamm Bowel Dis 2007) [source] Increased Apoptosis in Human Amnion is Associated with Labor at TermAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 5 2000CHAUR-DONG HSU PROBLEM: To characterize whether increased apoptosis in human amnion was associated with labor at term. METHOD OF STUDY: Human amnion were obtained from term patients with vaginal delivery (n=5) or who underwent elective Cesarean section (C/S) without labor (n=5). Apoptosis was performed by the TUNEL (Terminal dUTP Nuclear End Labeling) assay. All nucleated cells stained with propidium iodide in the amnion epithelial cells were identified in red fluorescence. TUNEL positive apoptotic nuclei were identified in green fluorescence. Five random fields of each specimen were blindly counted by investigators. The percentage of apoptotic nuclei of total nuclei (apoptotic index) was calculated and compared between the two groups (25 microscopic fields for each group, respectively). RESULTS: Patients with term labor had a significantly higher mean apoptotic index in amnion epithelial cells than that with elective C/S without labor (27.3±4.1% versus 3.6±1.6%, P<0.001). CONCLUSIONS: Our data indicate that apoptosis in human amnion is significantly increased and associated with labor at term. [source] Effect of Labour and Delivery on Plasma Hepatic Enzymes in the NewbornJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2000Dr. Max Mongelli Abstract Objective: To study the relationship between cord blood hepatic enzymes and obstetric and neonatal outcome in a Chinese population. Materials and Methods: The study group consisted of 288 low-risk Chinese women with singleton term pregnancies. The following enzymes were assayed in cord blood: lactate dehydrogenase (LDH), glutamyl transferase (GGT), aspartate aminotransferase (AST) and alanine transferase (ALT). These were correlated to maternal and neonatal characteristics. Results: A strong correlation was noted between cord blood AST and LDH (R = 0.582, p < 0.01), which was absent amongst those infants delivered by elective cesarean section. LDH, AST and ALT were negatively correlated with cord arterial pH and base excess (BE). GGT was inversely related only to gestational age (R = - 0.18, p < 0.01). Both LDH and AST were weakly correlated with the duration of the first and second stages of labour. LDH was most closely linked to arterial pH, whereas AST was related to both arterial BE and duration of the second stage. Conclusions: The reference values are comparable to those published for Caucasian populations. There are moderate elevations in LDH and AST associated with the onset of labour and changes in acid-base status. [source] Impact of delivery mode on electromyographic activity of pelvic floor: Comparative prospective study,NEUROUROLOGY AND URODYNAMICS, Issue 7 2010Simone Botelho Abstract Aims Several studies evidenced the association between pregnancy, mode of delivery and genitourinary symptoms. However, there are still controversies about the role of mode of delivery in the prevention or aggravation of these symptoms. This study aimed to compare the impact of three distinct modes of delivery on pelvic floor muscle contractility. Methods Seventy-five primiparous women were divided into three groups: (1) vaginal delivery with mediolateral episiotomy (n,=,28); (2) elective cesarean section (n,=,26); (3) emergency cesarean section (n,=,21). All patients underwent vaginal digital examination, grading the muscle contractility from 0 to 5 and surface electromyography (EMG) of the pelvic floor during the last trimester of pregnancy and 45 days after delivery. Results There was a significant increase in pelvic floor contractility in the elective cesarean section group, from 2.35 to 2.92 (P,=,0.03), when compared to the vaginal delivery and emergency cesarean section groups. Analysis of electromyography data showed a significant reduction in maximum contraction of the pelvic floor after vaginal delivery, from 39.17 to 31.14,µV (P,=,0.001), which was not observed in both cesarean section groups. Conclusion Vaginal delivery was associated with a decrease in pelvic floor muscle strength and endurance 45 days after delivery when compared to elective cesarean section as well as emergency cesarean section. Neurourol. Urodynam. 29:1258,1261, 2010. © 2010 Wiley-Liss, Inc. [source] Cesarean section: Does it really prevent the development of postpartum stress urinary incontinence? a prospective study of 363 women one year after their first deliveryNEUROUROLOGY AND URODYNAMICS, Issue 1 2004Asnat Groutz Abstract Aims Stress urinary incontinence (SUI) in young women is usually the result of pelvic floor injury during vaginal delivery. Whether cesarean section delivery may prevent such injury is questionable. We undertook a prospective study to compare the prevalence of SUI among primiparae 1 year after spontaneous vaginal delivery versus elective cesarean section, or cesarean section performed for obstructed labor. Methods Three hundred and sixty-three consecutive primiparae were recruited immediately after delivery and were followed for 1 year. Women were asked upon recruitment whether they had ever experienced SUI before pregnancy. Those who had SUI before pregnancy were excluded. Thus, only cases of de novo childbirth-associated SUI were analyzed. Patients were divided into three subgroups according to the mode of delivery: spontaneous vaginal delivery (n,=,145), elective cesarean section (n,=,118), and cesarean section performed for obstructed labor (n,=,100). Patients who underwent elective cesarean section were not given a trial of labor. Cesarean sections for obstructed labor were performed at a mean cervical dilatation of 8.7,±,1.6 cm and arrest of 184,±,24 min. Prevalence, frequency, and severity of postpartum SUI, as well as demographic and obstetric parameters, were analyzed in each subgroup. Results The three subgroups were comparable with respect to maternal age, weight, and height. Prevalence of postpartum SUI was similar after spontaneous vaginal delivery (10.3%) and cesarean section performed for obstructed labor (12%). However, SUI was significantly less common following elective cesarean section with no trial of labor (3.4%, P,<,0.05). Approximately half of the symptomatic patients in each subgroup reported either moderate or severe symptoms, however, only 15,18% expressed their desire for further evaluation. Conclusions Prevalence of postpartum SUI is similar following spontaneous vaginal delivery and cesarean section performed for obstructed labor. It is quite possible that pelvic floor injury in such cases is already too extensive to be prevented by surgical intervention. Conversely, elective cesarean section, with no trial of labor, was found to be associated with a significantly lower prevalence of postpartum SUI. Whether the prevention of pelvic floor injury should be an indication for elective cesarean section is yet to be established. Neurourol. Urodynam. 23:2,6, 2004. © 2003 Wiley-Liss, Inc. [source] Neonatal clinical outcome after electivecesarean section before the onset of labor at the 37th and 38thweek of gestationPEDIATRICS INTERNATIONAL, Issue 4 2003Hajime Yamazaki Abstract Background:,Although elective cesareansections are often performed after the 37th week of gestation withoutany complicating factor that may influence the timing of delivery,there is a possibility that infants born in the 37th week of gestation,especially early in the 37th week of gestation, do not obtain asatisfactory clinical outcome due to premature birth. Methods:,The authors analyzed the clinicalcourse during the neonatal period in 96 infants born in the 37th (n = 81)and 38th (n = 15) week of gestationby an elective cesarean section. Subjects were retrospectively dividedinto two groups: infants born in the first half of the 37th weekof gestation (37+0,37+3)(n = 48), and infants born fromthe latter half of the 37th week of gestation (37+4,37+6)through the 38th week of gestation (n = 48).Twin pregnancies, pregnancy with placenta previa, and pregnancyof women who had a diversity of medical complications were excludedfrom the present study, because of the possibility that these conditions mayhave affected the infants' status. The incidence of infantswho showed clinical symptoms during the neonatal period and whoneeded medical care was compared between the two groups. Results:,Of the 96 subjects, 25 infants(26.0%) had significant clinical symptoms. The incidenceof breathing difficulty was significantly higher in the infant groupborn in the first half of the 37th week of gestation than in thelatter group. Conclusions:,An elective cesarean sectionbefore the onset of labor early in the 37th week of gestation should notbe routinely undertaken. [source] Laparoscopic management of recurrent rupture of an adnexal mass in the second trimester of pregnancy: A case reportASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2010S Hayasaka Abstract We present the case of a patient who developed an acute abdomen after recurrent rupture of an ovarian cyst in the first trimester of pregnancy. After the third rupture and recurrence of the cyst, we performed laparoscopic ovarian cystectomy at 13 weeks of gestation. She went on to deliver a healthy neonate via elective cesarean section at 38 weeks of gestation. To our knowledge, this is the first report of a recurrent rupturing ovarian cyst during pregnancy. Our patient's case suggests that idiopathic recurrent rupture of an ovarian cyst can occur during early pregnancy. Careful follow-up and timely surgical intervention for recurrent rupture of an ovarian cyst are needed in order to reduce the risk of pregnancy loss. [source] | ||||||||||