2.Laryngeal Mask Airway for Cesarean Delivery: A 5-Year Retrospective Cohort Study.
Chinese Medical Journal 2017;130(4):404-408
BACKGROUNDThe laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA).
METHODSWe collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital. Based on the different types of airway device, patients were divided into endotracheal intubation (ET) group and LMA group. The incidences of regurgitation and aspiration, as well as maternal and neonatal postoperative outcomes were compared between groups.
RESULTSDuring the 5-year study, GA was performed in 192 cases, which accounted for 2.0% of all CDs. The main indications for GA were contraindication to neuraxial anesthesia or a failed block. Among these, ET tube was used in 124 cases (68.9%) and LMA in 56 cases (31.1%). The percentage of critical patients above the American Society of Anesthesiologists' Grade II was 24/124 in ET group and 4/56 in LMA group (P = 0.036). The emergent delivery rate was 63.7% for ET group and 37.5% for LMA group (P = 0.001). None of the patients had regurgitation or aspiration. There were no significant differences in terms of neonatal Apgar scores, maternal and neonatal postoperative outcomes between the two groups.
CONCLUSIONSOur results suggested that GA was mainly used for contraindication to neuraxial anesthesia or a failed block, and emergent CDs accounted for most cases. The second-generation LMA could be used for obstetric anesthesia, but correct position to achieve a good seal is the key to prevent reflux and aspiration. Whether they could replace the tracheal tube in routine practice needs further large prospective studies.
Anesthesia, General ; methods ; Cesarean Section ; methods ; Female ; Humans ; Intubation, Intratracheal ; methods ; Laryngeal Masks ; Pregnancy ; Retrospective Studies
3.A case of advanced viable extrauterine pregnancy
Papua New Guinea medical journal 1997;40(1):44-47
Advanced extrauterine pregnancy with a successful outcome is a rare event. A case is presented of a 34-year-old woman at 35 weeks gestation whose abdominal pregnancy was successfully managed. The diagnostic and management problems associated with abdominal pregnancy are discussed, and especially the controversial issues of the treatment of the placenta after delivery. The reasons for the high maternal and perinatal mortality associated with the condition are analyzed.
Cesarean Section - methods
;
Female
;
Magnetic Resonance Imaging
;
Postnatal Care - methods
;
Pregnancy
;
Pregnancy Outcome
;
Pregnancy Trimester, Third
4.Clinical Observation of the Induction of General Anesthesia with Propanidid for Cesarean-Section.
Kun Wha LEE ; Dae Won PARK ; Jong Mok KIM ; Sang Hwa LEE
Korean Journal of Anesthesiology 1973;6(2):77-82
To evaluate the maternal and fetal effects of propanidid, clinical observations were carried out in 160 cases of Cesarean section out of 4, 230 deliveries made during the past three years. Upon having the obstetricians ready for incision, 10ml. of 5 per cent propanidid and 40mg. of succinylcholine chloride were administered intravenously, and surgery was begun almost simultaneously with endotracheal intubabation. Thereafter, anesthesia was maintained with N2O-O2-fluothane, N2O-O2 -ether, or ether-O2 in semiclosed circle absorption system. Umbilical cord was ligated within 3-5 minutes after the commencement of induction. This method of anesthesia did not seriously affect the maternal respiration or circulation, and Apgar scores were good or fair in the majority of cases. No undesirable side effects or complications directly attributable to propanidid were encountered.
Absorption
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Anesthesia
;
Anesthesia, General*
;
Cesarean Section
;
Female
;
Methods
;
Pregnancy
;
Propanidid*
;
Respiration
;
Succinylcholine
;
Umbilical Cord
5.Uterine artery embolization in cesarean scar pregnancy: safe and effective intervention.
Shasha CAO ; Lihong ZHU ; Long JIN ; Jian GAO ; Chen CHEN
Chinese Medical Journal 2014;127(12):2322-2326
BACKGROUNDCesarean scar pregnancy (CSP) is a very rare but life-threatening entity and there is no optimal management strategy. Here we report a successfully conservative treatment of CSP.
METHODSWe retrospectively analyzed the clinical data of 54 women with CSP, who underwent uterine artery embolization between January 2007 and September 2012 at the Peking University People's Hospital. We evaluated the clinical outcomes, the technique and the complications of uterine artery embolization.
RESULTSOf the 54 patients, 2 patients with hemorrhage after induced abortion received bilateral uterine artery embolization treatment alone, and 52 patients underwent suction curettage after bilateral uterine artery embolization. All 54 women were successfully cured, without any severe complications, and uterine function was restored. During the follow-up, one patient had accidental normal interuterine pregnancy and received induced abortion during the first trimester.
CONCLUSION[corrected] Uterine artery embolization combined with suction curettage is an effective and safe conservative treatment for cesarean scar pregnancy.
Adult ; Cesarean Section ; Cicatrix ; Female ; Humans ; Retrospective Studies ; Uterine Artery Embolization ; methods
6.Measurement of retropubic tissue thickness using intrapartum transperineal ultrasound to assess cephalopelvic disproportion.
Chung Ming CHOR ; Wai Yin Winnie CHAN ; Wing Ting Ada TSE ; Daljit Singh SAHOTA
Ultrasonography 2018;37(3):211-216
PURPOSE: First, to describe a new method of assessing cephalopelvic disproportion by measuring the retropubic tissue thickness (RTT), and second, to determine whether RTT was associated with an eventual delivery by cesarean section. METHODS: Three-dimensional transperineal ultrasound scans were performed on 129 laboring nulliparous women to obtain 3-dimensional volume datasets for assessing RTT. RTT was measured off-line by three operators (A, B, and C) as the shortest distance between the capsule of the pubic symphysis and the outer border of the fetal skull. The intraoperator repeatability of operator A and the interoperator reproducibility among A, B, and C were determined. The RTT in women who were delivered by cesarean section due to failure to progress was compared to that of women who had a vaginal delivery. RESULTS: The intraoperator repeatability for RTT was 1.2 mm. The overall RTT interoperator interclass correlation was 0.97 (0.95-0.98). The RTT in women who had a spontaneous, instrumental, or cesarean delivery was 1.16±0.32 cm, 1.12±0.25 cm, and 0.94±0.25 cm, respectively. Women who were delivered by cesarean section had a significantly smaller RTT than women who had a spontaneous delivery (P=0.008). There was no statistically significant difference in RTT between patients who had a normal vaginal delivery and patients who had an instrumental delivery (P=0.990), or between those who had an instrumental delivery and those who had a cesarean delivery after the Bonferroni correction (P=0.120). CONCLUSION: RTT can be measured with satisfactory intraoperator repeatability and interoperator reproducibility. RTT was significantly smaller in women who eventually had a cesarean delivery than in those who had a vaginal delivery.
Cephalopelvic Disproportion*
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Cesarean Section
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Dataset
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Female
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Humans
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Methods
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Pregnancy
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Pubic Symphysis
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Skull
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Ultrasonography*
7.Effects of Pregnancy and Delivery Methods on Change in Ankylosing Spondylitis Treatment Using the Korean Health Insurance Review and Assessment Service Claims Database
Jung Sun LEE ; Ji Seon OH ; Ye Jee KIM ; Seokchan HONG ; Chang Keun LEE ; Bin YOO ; Yong Gil KIM
Journal of Korean Medical Science 2019;34(37):e238-
BACKGROUND: Women with ankylosing spondylitis (AS) show a higher rate of cesarean section (CS) compared with healthy women. In this study, we determined the effects of pregnancy and delivery methods on AS worsening by analyzing prescription patterns. METHODS: The subjects were women with AS aged 20–49 years listed in the Korean Health Insurance Review and Assessment Service claims database. Change in treatment was defined as change in prescriptions 1–2 years before delivery or 1 year after delivery. We compared change in prescriptions between AS women with delivery or without delivery (1:1 matched). Moreover, we evaluated change in prescriptions according to delivery method among AS women with delivery. RESULTS: A total of 6,821 women with AS were included. Women in the delivery group (n = 996) were younger and showed less drug use and lower comorbidity rates than those in the no delivery group. Change in prescriptions did not differ between the delivery and no delivery groups (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.56–1.05). Furthermore, the overall change in prescriptions did not significantly differ between vaginal delivery (VD) and CS (OR, 0.72; 95% CI, 0.45–1.14). CONCLUSION: The rate of change in prescriptions was comparable between AS patients with and without delivery. There was no association between the method of delivery and change in prescription. Therefore, pregnancy and VD may not be the factors associated with AS worsening.
Cesarean Section
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Comorbidity
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Female
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Humans
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Insurance, Health
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Methods
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Pregnancy
;
Prescriptions
;
Spondylitis, Ankylosing
8.Modified cesarean hysterectomy for placenta previa percreta in the third trimester via peritoneum lateral approach.
Qiaoshu LIU ; Jing ZHANG ; Weishe ZHANG ; Meilian DONG ; Xinhua WU
Journal of Central South University(Medical Sciences) 2013;38(6):617-622
OBJECTIVE:
To investigate the application of modified cesarean hysterectomy for placenta previa percreta in the third trimester via peritoneum lateral approach.
METHODS:
Data of 8 patients at 34 weeks or more gestation, who underwent cesarean hysterectomy for placenta previa percreta in Xiangya Hospital, Central South University, between January 2008 and December 2011, were analyzed retrospectively. The patients were divided into a modified cesarean hysterectomy by peritoneum lateral approach group (modified group, n=4) and a conventional cesarean hysterectomy group (conventional group, n=4), according to the principles of the case-control and the operation performed by the same doctor. The incidence of blood loss, the number of transfusions of RBC, and the ocurrnce of complications were compared between the 2 groups.
RESULTS:
The blood loss in the modified group and the conventional group was (2280±687) mL and (6150±2023) mL, and the number of transfusions of RBC was (4.5±2.1) U and (11.7±8.9) U, respectively. There was no coagulation disorder and ureteral injury in the modified group whereas there were 2 disorders and 1 injury in the conventional group. Two patients with bladder laceration were observed in the 2 groups.
CONCLUSION
Large amounts of bleeding will be onset in the placenta previa percreta. Modified cesarean hysterectomy for placenta previa percreta can reduce the blood loss and the incidence of related complications in the operation.
Adult
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Cesarean Section
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methods
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Female
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Humans
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Hysterectomy
;
methods
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Peritoneum
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surgery
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Placenta Accreta
;
surgery
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Placenta Previa
;
surgery
;
Pregnancy
;
Pregnancy Trimester, Third
9.Low-intensity ultrasound promotes uterine involution following cesarean section.
Dan WANG ; Yi ZHANG ; Li JING ; Wei HE ; Xiaoxu TANG ; Jiangchuan SUN ; Liaoqiong FANG ; Zhibiao WANG ; Hongbo QI
Journal of Southern Medical University 2013;33(2):276-278
OBJECTIVETo observe the clinical effect of low-intensity ultrasound in promoting uterine involution following cesarean section.
METHODSA total of 122 women undergoing cesarean section were randomly selected and divided into low-intensity ultrasound treatment group (67 cases) and control group (55 cases). The women in the treatment group received daily low-intensity ultrasound treatment for 30 min 24 h after the delivery for 3 consecutive days, and the control group had no particular treatments. The descent of the uterine fundus and cessation of lochia was observed in the two groups.
RESULTSThe treatment group showed obviously greater descent of the uterine fundus with a higher rate of cessation of vaginal bleeding than the control group at 30 days postpartum. The ratio of incomplete uterine involution was significantly lower in the treatment group than in the control group.
CONCLUSIONLow-intensity ultrasound is effective in promoting uterine contraction and uterine involution following cesarean section.
Adult ; Cesarean Section ; rehabilitation ; Female ; Humans ; Postpartum Period ; Pregnancy ; Ultrasonic Therapy ; methods ; Ultrasonography ; Uterus ; diagnostic imaging ; Young Adult
10.Foetal salvage by Caesarean section in a case of maternal burn injury.
Tibar BANERJEE ; Anirvan KARMAKAR ; Souvik ADHIKARI
Singapore medical journal 2012;53(11):e247-8
Burn injury sustained during pregnancy is a serious clinical complication that requires individualisation of management. We describe the case of a 30-week pregnant woman who presented to the hospital in a state of shock with approximately 90% burn injuries. Resuscitation was carried out, and the patient's family consented to an emergency Caesarean section in view of the grave prognosis of such burn injuries. A live male infant was delivered via emergency Caesarean section. However, the mother succumbed to her injuries two days after the operation, while the baby was successfully resuscitated and discharged after ten days. This case highlights the importance of timely decision-making and coordination, which are required to salvage a near-term foetus. It also underscores that emergent resuscitation and timely operative procedures might be able to salvage a living foetus, particularly in patients with burns covering more than 60% of total body surface area.
Burns
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complications
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surgery
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Cesarean Section
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methods
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Female
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Humans
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Infant, Newborn
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Male
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Maternal Exposure
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Pregnancy
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Pregnancy Complications
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Shock
;
complications
;
Young Adult