scholarly journals Hang-up IUD, New Technique for Suturing CuT-380A IUD to Uterine Fundus in Immediate Postplacental Insertion during Cesarean Delivery: Twelve Months Follow up

2016 ◽  
Author(s):  
Hary Tjahjanto ◽  
Indah T Haryuni
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Caesarean Delivery ◽  
Obstet Gynecol ◽  
Uterine Cavity ◽  
New Technique ◽  
Pearl Index ◽  
Straight Needle ◽  
Uterine Fundus

Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at 12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. [Indones J Obstet Gynecol 2014; 2-31: 132-139] Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion

scholarly journals Predictors of success of trial of labor after cesarean section: A nested case–control study at public hospitals in Eastern Ethiopia

2021 ◽  
Vol 17 ◽  
pp. 174550652110619
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Birth ◽  
Public Hospitals ◽  
Vaginal Birth After Cesarean ◽  
Eastern Ethiopia ◽  
Trial Of Labor ◽  
History Of ◽  
Nested Case Control

Background: One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia. Methods: A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings. Results: We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial. Conclusion: Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.

scholarly journals Cesarean delivery and its social determinants in women of childbearing age: analysis of Benin’s DHS

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Kpozehouen ◽  
Y Glèlè Ahanhanzo ◽  
E Klikpo ◽  
C Azandjeme ◽  
C Metonnou ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Rural Areas ◽  
Urban Areas ◽  
Caesarean Delivery ◽  
Social Inequalities ◽  
Secondary Analysis ◽  
Well Being ◽  
Demographic Characteristics ◽  
Childbearing Age

Abstract Background Caesarean delivery, usually performed on a medical indication, is intended for maternal or fetal rescue. Accessibility issues justify setting up a so-called model of “free caesarean” in several developing countries, including Benin, in order to reduce social inequalities and contribute to the reduction of maternal and neonatal mortality. The study aimed to identify the determinants associated with caesarean delivery in women aged 15-49 in Benin. Methods This is a secondary analysis of data from Benin’s Demographic and Health Survey (DHS) 2017 - 2018. It was limited to mothers aged 15 to 49 who gave birth to at least one child in the 5 years preceding the survey. The socio-demographic characteristics of the mother and the variables related to pregnancy were the independent variables. Association between cesarean delivery and its determinants was assessed by odds ratios and their 95% confidence interval using a logistic regression. Results The percentage of mothers who gave birth by caesarean was 6.84%, 95% CI = [6.07; 7.59]. The average age was 29.37 years, 95% CI = [29.20; 29.55]. The probability of cesarean delivery was higher with women aged 45 years and older (OR = 3.33, 95% CI = [1.85, 6.01]), living in urban areas (OR = 1.41, 95% CI = [1.08 1.84]), from rich or very rich households (OR = 1.98, 95% CI = [1.29, 3.05], OR = 1.87, 95% CI = [1.19, 2.96] respectively) and educated (OR = 1.63 95% CI = [1.19, 2.24] and OR = 1.81, 95% CI = [0.97, 3.39] for the secondary and upper levels respectively). Conclusions This analysis shows that cesarean delivery remains associated with the socio-demographic characteristics of the mother, including the level of economic well-being. The current financing model of cesarean should be evaluated for effectiveness and further interventions need to be implemented to account for other factors of disparity. Key messages Benin health authorities should improve the geographical accessibility of Cesarean section, especially in rural areas. The strategies proposed to improve the financial accessibility of cesarean section do not seem effective, so the Beninese authorities should think about revising them.

scholarly journals The Risk of Expulsion is Higher in IUD-Endometrium Distance of More than 10 mm

2016 ◽  
Author(s):  
Teguh Senjaya
Keyword(s):  
Vaginal Delivery ◽  
Obstet Gynecol ◽  
Index Finger ◽  
Average Distance ◽  
Uterine Cavity ◽  
Gestation Age ◽  
Post Placental ◽  
Uterine Fundus

Objective: To acknowledge the rate of expulsion in post placental IUD CuT-380A insertion after vaginal delivery. Method: Postplacental IUD Cu T-380A insertion was performed at least 10 minutes after the placenta has been delivered by inserting IUD Cu T-380A in uterine cavity using index finger, and positioned the IUD in uterine cavity and pushed as high as possible directly to the uterine fundus. Then the IUD-endometrium distances were checked using transvaginal USG on the seventh and forty second day after IUD insertion. Result: From May and August 2012 has been done post placental IUD Cu T-380A set in 38 women, found that average of women age was ≥ 30 years old (34.21%), multi parities (63.16%), and gestation age for 37-42 weeks (100%). In this study found that three expulsion cases. Totally expulsion found in 2 cases, each found in days of 16 with averages distances of IUD and endometrium for 16.8 mm and in days of 19 with average distances of IUD-ED for 13.5 mm after IUD set. While partially expulsion found in 1 case, occurred in days of 11 after IUD set with average distance IUD-ED for 13.2 mm. Conclusion: IUD Cu T-380A set after vaginal delivery that observed for 42 days found that 3 (7.89%) peoples have expulsion. There is significant correlation the distance between IUD and ED in expulsion occurrences. [Indones J Obstet Gynecol 2013; 37-1: 26-31] Keywords: expulsion, post placental IUD Cu T-380A

scholarly journals Uterine Fundectomy in Patients With Benign Etiology Undergoing Hysterectomy: New Surgical Technique (Preprint)

2017 ◽  
Author(s):  
AboTaleb Saremi ◽  
Homa Bahrami ◽  
Fariba Feizy
Keyword(s):  
Surgical Procedure ◽  
Positive Impact ◽  
Uterine Cavity ◽  
New Technique ◽  
Surgical Approaches ◽  
Patient Recruitment ◽  
Fallopian Tubes ◽  
Uterine Preservation ◽  
Uterine Fundus ◽  
New Surgical Technique

BACKGROUND Hysterectomy is the most common surgical procedure in gynecology, not only in cases of malignancies but also in many benign cases. Many uterine preservation techniques have been introduced as alternatives to hysterectomy. OBJECTIVE We aimed to propose a new uterine surgical procedure. In this paper, we compare the utility of this new technique to the limitations of current procedures. METHODS Uterine fundectomy may be considered as a subtotal hysterectomy. In this new technique, the uterine fundus including all pathologic tissue is cut as a reverse trapezoid by monopolar cautery. The upper side of the trapezoid, which includes the whole uterine fundus, is removed, but the fallopian tubes and cornual segment are preserved. A small uterine cavity remains, as well as the endometrial tissue lining it. RESULTS Patient recruitment for this study began in April 2017 and is expected to end approximately 12 months later. Assessment of the primary outcomes is expected to take place in April 2018. CONCLUSIONS Uterine preservation is particularly critical in developing new surgical approaches that can lead to a positive impact on patient satisfaction. This protocol outlines the first attempt to prospectively test surgical fundectomy in candidates for hysterectomy for benign indications.

scholarly journals Endometriosis in cesarean section surgical scar

2007 ◽  
Vol 54 (2) ◽  
pp. 79-81 ◽  
Author(s):  
D. Stefanovic ◽  
M. Kerkez ◽  
Z. Djordjevic ◽  
S. Knezevic ◽  
Lj. Markovic ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Abdominal Wall ◽  
Uterine Cavity ◽  
Surgical Excision ◽  
Histopathologic Examination ◽  
Surgical Scar ◽  
Decidual Tissue ◽  
History Of ◽  
One Year

Introduction: Endometriosis is the presence of endometrial glands and stroma outside of uterine cavity. It may occur in the abdominal wall scar after the operation in which uterus was opened. In cesarean section scar it occurs in 0.4%. It is in 2/3 patients characterized with triad of: tumor, periodic pain associated with menses and history of cesarean section. The mechanism of endometriosis occurring in the cesarean scar is felt to be secondary to iatrogenic transplantation of endometrium or extrauterine decidual tissue into the incision during the cesarean section. Case outline. Forty years old patient with tumor 4,5x4 cm that appeared in abdominal wall scar one year after second cesarean section, followed by periodic pain and macroscopic changes associated with menses. First diagnosis was granuloma in the surgical scar, but as she had periodic symptoms, diferential diagnosis was endometriosis. Hormonal therapy with contraceptive drugs was ordered. As it was no improvement she was operated. The surgical excision of the tumor including fascia and muscle tissue was done. Sample revealed endometrium after histopathologic examination. Patient was completely recovered and without relapse of symptoms during follow up to date. Conclusion. When there is a tumor in the cesarean section scar or scar after the operation in which uterus or ovarial tube was opened, followed with periodical pain and macroscopic changes associated with menses, endometriosis should be considered. Surgical excision of the tumor is sufficient and patohistological examination confirms diagnosis. .

scholarly journals Postplacental IUD Insertion Using Ring Forceps versus Push and Push Technique

2016 ◽  
pp. 78
Author(s):  
Hary Tjahjanto ◽  
Rahmad Rizal
Keyword(s):  
Randomized Control Trial ◽  
Obstet Gynecol ◽  
Normal Position ◽  
Insertion Technique ◽  
Double Blind ◽  
The Mean ◽  
Randomized Control ◽  
Uterine Fundus

Objective: To compare IUD-endometrium (ED) distance and the incident of malposition postplacental CuT-380A IUD insertion in vaginal delivery between ring forceps technique and push and push technique. Method: This study was a double-blind randomized control trial, performed in September 2014 until March 2015 at Dr. Kariadi Hospital. Ring forceps and push and push insertion technique groups consisted of 25 subjects in each group. Follow-up was performed at 1-2 weeks, 6-8 weeks and >12 weeks after insertion. Result: The mean of IUD-ED distance in push and push group was shorter (but not statistically significant) than ring forceps group. The IUD-ED distance was at 1-2-week follow-up 4.1 (2.2) vs. 4.9 (3.4) mm; p=0.208, at 6-8-week follow-up: 2.6 (1.8) vs. 3.2 (3.7) mm; p=0.452, and at > 12-week follow-up: 0.9 (0.8) vs. 1.0 (0.9) mm; p=0.427, respectively. Malposition was found in 1-2-week follow-up, but the IUD was changed to the normal position (sagital position in uterine fundus) at 6-8-week and >12-week follow-up. Up to 3 months of follow-up, there was no occurrence of perforation, expulsion or pregnancy in both groups. Most of subjects (56% in the ring forceps, 68% in push and push groups) did not feel painful during IUD insertion. Conclusion: Push and push insertion technique clinically tends to produce IUD-ED distance shorter than ring forceps technique. Both techniques are comfortable, safe and effective. [Indones J Obstet Gynecol 2016; 4-2: 78-87] Keywords: immediate postplacental IUD insertion technique, IUDendometrium distance, IUD malposition, push and push technique, ring forceps technique

Neurological manifestation in severe hypothyroidism in pregnancy

2020 ◽  
Vol 13 (12) ◽  
pp. e238069
Author(s):  
Aparna Sharma ◽  
Nilofar Noor ◽  
Vatsla Dadhwal
Keyword(s):  
Peripheral Neuropathy ◽  
Facial Palsy ◽  
Caesarean Delivery ◽  
Thyroid Stimulating Hormone ◽  
Neurological Manifestations ◽  
Second Trimester ◽  
Pituitary Hyperplasia ◽  
Very High ◽  
In Pregnancy

Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5 months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.

scholarly journals Cesarean delivery on maternal request and its influencing factors in Chongqing, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruibin Deng ◽  
Xian Tang ◽  
Jiaxiu Liu ◽  
Yuwen Gao ◽  
Xiaoni Zhong
Keyword(s):  
Logistic Regression ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
High Rate ◽  
Primiparous Woman ◽  
Personal Factors ◽  
Maternal Request ◽  
Primary Indication ◽  
Vaginal Deliveries

Abstract Background A high rate of cesarean delivery has become a cause of global concern. Although the rate of cesarean delivery has declined over recent years, it remains at a high level largely because of cesarean delivery on maternal request (CDMR). Unnecessary cesarean delivery has limited significance in benefiting maternal and infant physical health; in some ways, it might pose potential risks instead. With the implementation of the “Two-child Policy” in China, an increasing number of women plan to have a second child. Accordingly, how to handle the CDMR rate in China remains an important issue. Methods Data were collected from a longitudinal follow-up study conducted in Chongqing, China, from 2018 to 2019. A structured questionnaire was administered to subjects for data collection. Basic information, including demographic characteristics, living habits, medical history, and follow-up data of pregnant women, as well as their families and society, was collected. Additionally, delivery outcomes were recorded. Logistic regression was performed to analyze the factors influencing CDMR. Results The rate of cesarean delivery in Chongqing, China was 36.01 %, and the CDMR rate was 8.42 %. Maternal request (23.38 %), fetal distress (22.73 %), and pregnancy complications (9.96 %) were the top three indications for cesarean delivery. Logistic regression analysis showed that older age (OR = 4.292, 95 % CI: 1.984–9.283) and being a primiparous woman (OR = 6.792, 95 % CI: 3.230-14.281) were risk factors for CDMR. In addition, CDMR was also associated with factors such as the tendency to choose cesarean delivery during late pregnancy (OR = 5.525, 95 % CI: 2.116–14.431), frequent contact with mothers who had undergone vaginal deliveries (OR = 0.547, 95 % CI: 0.311–0.961), and the recommendation of cesarean delivery by doctors (OR = 4.071, 95 % CI: 1.007–16.455). Conclusions “Maternal request” has become the primary indication for cesarean delivery. The occurrence of CDMR is related to both the personal factors of women during pregnancy and others. Medical institutions and obstetricians should continue popularizing delivery knowledge among pregnant women, enhancing their own professional knowledge about delivery, adhering to the standard indications for cesarean delivery, and providing pregnant women with adequate opportunities for attempting vaginal delivery.

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