Cesarean Section

This Randomized Controlled Trial sought to determine whether mothers who underwent Cesarean delivery had better postoperative outcomes when subjected to the Enhanced Recovery After Surgery (ERAS) protocol compared to mothers who also underwent Cesarean section as a mode of delivery but were under the Standard operative protocol. The research concentrated on evaluating the postoperative outcomes of the patients in the study through the following factors: length of hospitalization, efficiency and cost-effectiveness of hospital expenses, early resumption of diet and early ambulation, breastfeeding initiation and continuation. A total of 72 subjects were included in the study. Two were not included due to conversion to general anesthesia. Thirty two (44.4%) were randomized to the ERAS protocol while 40 (55.6%) patients were randomized to Standard postoperative procedure. Demographic characteristics were recorded and comparable between the two groups. Mothers randomized to the ERAS protocol had significantly shorter length of stay compared to mothers in the standard operative procedure with a mean of 53.01 hours (2.21 days) and 78.86 hours (3.29 days) respectively. Mothers randomized to the ERAS protocol spent significantly lower hospitalization cost compared to mothers in the standard operative procedure. There was no significant difference noted in the proportion of mothers with fever between the two groups (p=0.25). Mothers randomized to the ERAS protocol had significantly lower post-operative pain compared to mothers in the standard operative procedure. The time from end of OR until general liquids was also significantly shorter among mothers randomized to the ERAS protocol compared to mothers in the standard operative procedure. Similarly, the time from end of OR to flatus and bowel movement was also significantly shorter among mothers randomized to the ERAS protocol compared to mothers in the standard operative procedure. The time from end of OR to removal of foley catheter and time to void after foley catheter removal was also significantly shorter among mothers randomized to the ERAS protocol compared to mothers in the standard operative procedure. Finally, there was a significant difference noted in the length of time from end of OR to breastfeeding as proven by all p value of 0.02. Mothers randomized to the ERAS protocol had significantly shorter length of time from end of OR to breastfeeding compared to mothers in the standard operative procedure with a mean of 30.67 hours and 43.09 hours respectively. Ultimately, the study concentrated on Emergency or Elective Cesarean deliveries of Low risk patients as well as patients with controlled gestational or overt diabetes mellitus, thyroid disorders in euthyroid state, and hypertensive disorders not complicated with eclampsia. This study did not seek to generalize the benefit of ERAS protocol on all Cesarean deliveries. ERAS protocol showed better postoperative outcomes compared to the Standard operative protocol in terms of shorter length of hospital confinement, lower cost of hospitalization, no occurrence of post-operative infections and complications, shorter length of time from operation to diet progression tolerance, passage of flatus, bowel movement, shorter length of time from end of OR to removal of foley catheter and time to void and finally shorter time from operation to initiation of breastfeeding and continuation.
Cesarean Section

No abstract available.
Cesarean Section* ; Female ; Pregnancy

No abstract available.
Cesarean Section* ; Female ; Pregnancy

A randomize, controlled trial was conducted at the Department of Obstetrics and Gynecology, Da Nang Hospital between February 2004 and October 2004. 180 cesarean section cases, who met selection criteria (first cesarean section, gestational age ≥37 weeks, single pregnancy, same surgeon), were randomly assigned into 2 groups: modification group with modified Misgav Ladach method and Pfannelstiel group with Pfannelstiel incision. Results: Mean time of extraction of the newborn was 2.6±0.8 minutes in the modification group and 5.7±0.9 minutes in the Pfannelstiel group (p = 0). Mean duration of operation was 33.4±2.1 minutes in the modification group compared with 43.5±3.2 minutes in the Pfannelstiel group (p = 0). One hematoma (1.1%) was seen with the modification group versus 9 (10%) in the control group (p<0.05). The number of analgestic doses required during postoperative period was significantly lower in the modification group (1.3±0.6 versus 1.9±0.7 vials of pethidin; p<0.000001). There were no significant differences between the two groups in maternal age, gestational age, and indication of operation, Apgar scores and duration of hospitalization
Cesarean Section ; Epidemiology

Study on 1260 women aged from 19 to 45 years old: 180 cases of elective cesarean section (CS), 360 cases of emergency CS, and 720 cases of vaginal delivery (the control group) at Hung Vuong Hospital in order to evaluate the effects of medical and socioeconomic factors on the decision of CS. Results: economic status didn’t affect on the indication of emergency CS, but the rate of elective CS in women with favorable economic level increased by 3.64 times. Seeking examinations at an obstetric hospital itself may have potential risk of pregnancies, the risk of emergency CS increased 16.99 times and the risk of elective CS raised 5.67 times. In addition, some factors can affect on the decision of CS such as 1st born child, having expected for pregnancy, having request for CS, fetal sex, etc
Cesarean Section ; Epidemiology

The author analyzed 102 cases of Cesarean section at Hµ T©y Hospital. 4 main indications have been identified: 1) dystocia; 2) breech presentation; 3) previous Cesarean section; and 4) failure of augmentation of labor. Partograph is a useful tool to detect when a Cesarean is needed. If the patient has arrest of dilatation, arrest of descent or a fetal distress
Cesarean Section ; Parturition

In diagnosis of obstructed labor, beside the line of cervical dilation comes to the right of the alert line and crosses the action line, the line of descent of fetal presentation should be noted. After 4 hours, if the contractions occur with frequency of 3 and last for 20 to 40 seconds and the fetal head has not descended further, it should be considered as a sign of obstructed labor. The partograph that was designed according to national standard is proper and useful in decision of cesarean section.
Cesarean section ; Parturition

The percentage of first-time cesarean section at Hanoi Obstetric and Gynecology Hospital in 2000 was 28.94%. Among the patients with a history of cesarean section, 88.25% have undergone cesarean section and 8.30% had a forceps delivery. The most common reason for repeated cesarean section is premature rupture of the membranes, non-progressive cervix (36%), and interval between this cesarean section and previous cesarean section was less than 2 years (5%). There were 3 uterine ruptures (0.5%), and subtotal hysterectomy rate was 1.7%.
Cesarean section ; Parturition

The study included 71 pregnant women underwent cesarean section in the National Hospital of Gynecology and Obstetrics between January and May 2004. Results: average duration of a cesarean section is 31 minutes and 1 second, the mean time of transversal laparotomy is 28 minutes and 15 seconds. In cases of transversall incision, the duration is 37 minutes and 9 seconds. The mean time required for newborn extraction is 5 minutes and 10 seconds. In cases of transversal incision, this duration is 4 minutes and 36 seconds. If the incision was made in white line below navel, the duration is 6 minutes and 29 seconds
Cesarean Section ; Pregnant Women