scholarly journals A Case of Torsion of Gravid Uterus Caused by Leiomyoma

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Gururaj Deshpande ◽  
Rajesh Kaul ◽  
Manjuladevi P.
Keyword(s):  
Abdominal Pain ◽  
Cesarean Section ◽  
Posterior Wall ◽  
Fetal Outcome ◽  
Gravid Uterus ◽  
Lower Segment ◽  
Fetal Bradycardia ◽  
Lower Segment Cesarean Section ◽  
Uterine Torsion ◽  
In Pregnancy

Uterine torsion during pregnancy is only sporadically reported in the literature. Here we present a case of leiomyoma causing uterine torsion in pregnancy and review the literature on etiology, diagnosis, and management. A 25-years-old primigravida with leiomyoma complicating pregnancy was admitted in our hospital with abdominal pain and uterine tenderness. She underwent emergency LSCS (lower segment cesarean section) for fetal bradycardia. Intraoperatively, the uterus was rotated 180 degrees left to right. Inadvertent incision on the posterior wall was avoided by proper delineation of anatomy. Torsion was corrected by exteriorization of leiomyoma and uterus, and lower segment cesarean was carried out safely. Prompt recognition and management of this condition is necessary for better maternal and fetal outcome.

scholarly journals Anesthetic Management of a Parturient with Congenital Complete Heart Block posted for Emergency Lower Segment Cesarean Section

2015 ◽  
Vol 1 (4) ◽  
pp. 74-76
Author(s):  
GS Karthik ◽  
R Mamatha ◽  
MJ Sowmya ◽  
KT Venkateshmurthy ◽  
H Sahajananda
Keyword(s):  
Cesarean Section ◽  
Heart Block ◽  
Complete Heart Block ◽  
Anesthetic Management ◽  
Cardiac Pacing ◽  
Pregnant Patient ◽  
Fetal Outcome ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Congenital Complete Heart Block

ABSTRACT Pregnancy complicated with complete heart block is rare and usually required termination of pregnancy in the past. Improvement in medical technology in the form of cardiac pacing has allowed taking these women to term. Overall, maternal and fetal outcome is not affected in asymptomatic cases. We report here an unbooked, pregnant patient presented at 38+ weeks with complete heart block and pregnancy-induced hypertension for emergency lower segment cesarean section (LSCS). Emergency LSCS was performed under general anesthesia. Maternal and fetal outcome was good. How to cite this article Mamatha R, Sowmya MJ, Venkateshmurthy, Sahajananda H, Karthik GS. Anesthetic Management of a Parturient with Congenital Complete Heart Block posted for Emergency Lower Segment Cesarean Section. J Med Sci 2015;1(4):74-76.

A COMPARISON OF LEFT UTERINE DISPLACEMENT USING CLINOMETER GUIDED TABLE TILT VS CONVENTIONAL CRAWFORD WEDGE DURING SPINAL ANAESTHESIA IN CESAREAN SECTION- A PROSPECTIVE RANDOMIZED STUDY

2021 ◽  
pp. 7-9
Author(s):  
Jeya Pratheef Muthiah ◽  
Senthil Kumar. N
Keyword(s):  
Cesarean Section ◽  
Spinal Anaesthesia ◽  
Vena Cava ◽  
Gravid Uterus ◽  
Lower Segment ◽  
Subarachnoid Block ◽  
Lower Segment Cesarean Section ◽  
The Impact ◽  
Surgeon Satisfaction ◽  
Aortocaval Compression

INTRODUCTION: Enlarged gravid uterus causing aortocaval compression may decrease the venous return and cause maternal hypotension. Maternal position after neuraxial blockade may exacerbate the impact of aortocaval compression and consequences on cardiovascular instability. Left uterine displacement (LUD) after spinal anaesthesia in lower segment cesarean section is essential in preventing supine hypotension syndrome. Decreased cardiac output secondary to vena cava obstruction by the gravid uterus can be prevented by lateral tilt position. AIM OF THE STUDY: This study is therefore designed to evaluate the role of leftward uterine displacement by table tilt using clinometer software or by using crawford wedge tilt and compare the effects on hemodynamics in parturient undergoing lower segment cesarean section (LSCS) under subarachnoid block MATERIALS AND METHODS: The study was carried out in the Department of Anaesthesiology involving Department of Obstetrics and gynecology in Kanyakumari Government Medical College from January 2018 to June 2019. Patients were allocated into two groups by randomization. After spinal anaesthesia parturient in Group T: Lateral Table Tilt by using clinometer -15 degree- (40 parturient). Parturient in Group W: Crawford wedge Tilt- (40 parturient). Patients, age, body weight, BMI and baseline vital parameters were recorded. Incidence of hypotension after spinal anaesthesia in a cesarean section, Total dose Vasopressor required, Level of blockade, APGAR Score, Surgeon satisfaction grading. RESULTS: The demographic parameters like age, height, weight, BMI and the indication for surgery were similar in both groups. There were no difference in mean height level of block between both groups. In comparison of hypotensive incidence in both groups, the high incidence noted in the GROUP W (wedge group) (35%) is higher than the incidence in GROUP T (table tilt) nd th th (7.5%). The incidence of hypotension is signicantly noted at 2 , 4 , 5 minute after the subarachnoid block in wedge group compared to the table tilt group. The dose of vasopressor requirements and average ephedrine dose used is less in GROUP T (table tilt) (0.6±2.3mg) compared to GROUP W (wedge) (3.9±5.7 mg). In comparison of surgeon satisfaction between both groups, surgeons are much satised with the wedge group patient and found difcult, disturbing and sometimes unbearable st th while perform the surgery for the patient in table tilt. The APGAR Scores in GROUP W at 1 minute and 5 minute is (7.3±0.5 and st th 8.7 ±0.5) respectively which are relatively satisfactory compared to the GROUP T (6.8±0.6 and 8.3±0.6) at 1 and 5 minute. CONCLUSION: Table tilt provide a good relief from inferior vena cava and aortocaval compression when compared to the wedge placed under the right hip during cesarean section done under subarachnoid block. Using the wedge is easier and 0 surgeons at our institute found it more comfortable than the table tilt to 15 but anesthetists feel better with table tilt because there is little incidence of hemodynamic variation. We conclude that all the parturient posted for caesarean section should be 0 given a table tilt of 15 placed with angle measured exactly by clinometer to decrease incidence of hypotension occurring due to aortocaval compression

scholarly journals Fetomaternal outcome in patients with previous one lower segment cesarean section, complications with repeat scar and trial of scar.

2019 ◽  
Vol 26 (10) ◽  
pp. 1600-1605
Author(s):  
Asma Batool ◽  
Mussarat Sultana ◽  
Saima Perveen
Keyword(s):  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Number Of Patients ◽  
Nicu Admission ◽  
Study Setting ◽  
Selection Of

Objectives: The aim of our study is to see the maternal and fetal outcome of pregnancies with previous one lower segment cesarean section. Study Design: Prospective study. Setting: Department of obstetrics and gynecology at DHQ Teaching Hospital Rawalpindi. Period:  1st July 2018 to 31st June 2018. Material and Methods: All pregnant women with previous one LSCS and at the gestation of more than 34 week are included after taking consent. Results: 258 patients were included. 132(51.2%) had elective LSCS, 106(41%) had emergency LSCS. 77(29.8%) patients actually took trial of scar, 20(25.9%) patients delivered vaginally. 179 (69.8%) patients had no maternal morbidity. 3(1.2%) patients had peripartum hysterectomy secondary to PPH due to placenta previa. The most common indication for emergency LSCS was fetal distress. The second commonest indication was failure to progress in first stage of labour. 248 (96.1%) of our neonates had good APGAR score(>7 at one minute).We had very low rate for NICU admission, only 10(3.9%) neonates were admitted to NICU. 4 neonates were premature, 5 neonates were admitted due to low birth weight and one with fetal hypoxia. Conclusion: Rate of repeat LSCS is increasing on maternal demand and fetal distress, by careful selection of the patients for VBAC, proper counseling and advanced facilities for monitoring of fetus, repeat LSCS rate can be decreased with associated decrease in maternal and perinatal morbidity and mortality. Comfortable environment and tender loving care during first delivery can decrease the number of patients with refused trial of labour.

scholarly journals UTERINE TORSION IN TWIN PREGNANCY

2006 ◽  
Vol 13 (02) ◽  
pp. 327-329
Author(s):  
MUHAMMAD SAJJAD MASOOD ◽  
HUMA QUDDUSI ◽  
MUHAMMAD SAMEE AKHTAR ◽  
NASEER-UD- DIN
Keyword(s):  
Cesarean Section ◽  
Twin Pregnancy ◽  
Posterior Wall ◽  
Married Women ◽  
Gravid Uterus ◽  
Ongoing Pregnancy ◽  
Incision Site ◽  
Uterine Torsion ◽  
The Right ◽  
Labour Pains

A young married women in her 3rd ongoing pregnancy, having no alive issuepresented at 37+ weeks with labour pains. Cesarean section was planned because of twin pregnancy and past badobstetrical history. During operation, the uterus was found to have rotated to 180 degree to the right. A transverseincision was made on posterior wall of uterus to deliver babies. After suturing the incision site, the uterus wasrepositioned in right place. This paper presents a case of torsion of gravid uterus in which the delivery and repositioningof the uterus was successful.

scholarly journals Placental Teratoma Presenting as a Lobulated Mass behind the Neck of Fetus: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Adiga Prashanth ◽  
Rai Lavanya ◽  
K. M. Girisha ◽  
Anjali Mundkur
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
Germ Cells ◽  
Histopathological Examination ◽  
Breech Presentation ◽  
Fetal Outcome ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Cell Layers ◽  
Gross Examination

Placental teratoma is a rare nontrophoblastic benign tumour, which is thought to arise from germ cells. These tumours contain elements derived from multiple germ cell layers. We report a case of teratoma, where on ultrasound; there were two echogenic masses of 4 cm × 5 cm and 3 cm × 4 cm, arising from the placenta. Elective lower segment cesarean section was done in view of breech presentation at 38 weeks of gestation. Gross examination of the placenta showed two lobulated masses of 5 cm × 5 cm and 4 cm × 4.5 cm, respectively. Histopathological examination of the placenta was suggestive of teratoma of the placenta. The fetus was normal.The maternal and fetal outcome was good.

scholarly journals Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique

2020 ◽  
Vol 24 (1) ◽  
pp. 50-53
Author(s):  
Ali Kashif ◽  
Rizwana Bashir Kiani ◽  
Syed Muhammad Asad Shabbir ◽  
Tariq Mahmood ◽  
Ghulam Sabir ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cesarean Section ◽  
Epigastric Pain ◽  
Intravenous Bolus ◽  
Lower Segment ◽  
Lower Segment Cesarean Section ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Infusion Technique

Aim: To compare the frequency of epigastric pain and uterotonic effect of an equivalent dose of oxytocin administered as an intravenous bolus versus intravenous infusion during elective LSCS under spinal anesthesia. Methodology: We recruited 98 parturients undergoing elective LSCS under spinal anesthesia for this prospective quasi experimental study and divided them into two groups. Group-A received 5 IU of oxytocin as bolus intravenous (IV) injection in 5 sec (bolus group, n= 48), and Group-B (infusion group, n= 50) received 5 IU of oxytocin as an infusion over 5 min. Any complaint of epigastric pain by the patients was noted and its frequency was compared between the two groups. The uterine tone was assessed as adequate or inadequate by an obstetrician. The data were entered into SPSS version 22. Patient demographic data were analyzed with independent samples T-test and the study data were analyzed with Chi‑square test and presented as n (%). p < 0.05 was considered statistically significant. Results: Epigastric pain was noted in 25 (52.03%) out of 48 parturients in Group-A and 15 (30%) out of 50 in Group-B (p = 0.026). There was no significant difference in the uterotonic effect of oxytocin between the two groups (p = 0.736). Conclusion:  We conclude that oxytocin infusion is associated with lower frequency of epigastric pain in elective LSCS when compared to intravenous bolus of an equivalent dose of oxytocin, However, the effect on uterine contractions was adequate with both methods. Citation: Kashif A, Kiani RB, Shabbir SMA, Mahmood T, Sabir G, Fatima NE, Khan WA. Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique. Anaesth pain intensive care 2020;24(1):_ DOI: https://doi.org/10.35975/apic.v2i1. Received – 20 February 2019; Reviewed – 4, 16 March, 25 June, 9 September, 2, 25 November, 10 December 2019, 7 January 2020; Revised – 19 June, 10 August, 29 September, 1 November 2019, 6 January 2020; Accepted – 10 January 2020;

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