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Caesarean Section
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Caesarean section is the delivery of the fetus after incising the uterus through an abdominal incision. The rate of caesarean section is variable. It depends on the proportion of high-risk pregnancies in the concerned facility.
Management Of The Uncomplicated Term Pregnancy
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Compared with no sweeping, sweeping of the membranes, performed weekly as a general policy in women at term (e.g. weekly starting at 37–38 weeks), is associated with reduced duration of pregnancy and reduced frequency of pregnancy continuing beyond 41 and 42 weeks [14, 15]. To avoid one formal induction of labor, sweeping of membranes must be performed in eight women. Risk of cesarean section, maternal, or neonatal infection is similar. Serial sweeping of membranes starting at 41 weeks every 48 hours also decreases the risk of postterm pregnancy from 41% to 23%, with efficacy both in nulliparous and multiparous women [16]. Discomfort during vaginal examination and other adverse effects (bleeding and irregular contractions) are more frequently reported by women allocated to sweeping, but its safety has been confirmed in multiple studies [14–17] (see also Chap. 23).
Fetal Death
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
For women with a previous low transverse incision, after 28 weeks of gestation, oxytocin protocols may be utilized and cervical ripening with Foley bulb may be considered [31, 69]. Given the absence of fetal benefit, cesarean section should in general be avoided. Therefore, on the basis of limited data in patients with a prior low transverse CD, trial of labor remains the preferable option [31, 69]. There are limited data for patients with a prior classical uterine incision or prior myomectomy, therefore the delivery plan should be individualized [31, 69].
Efficacy and safety of broad spectrum penicillin with or without beta-lactamase inhibitors vs first and second generation cephalosporins as prophylactic antibiotics during cesarean section: a systematic review and meta-analysis
Published in Journal of Obstetrics and Gynaecology, 2023
Qianqian Song, Jingjing Yan, Na Bu, Ying Qian
Cesarean section is a routine surgery in critical obstetric cases. With the development of cesarean section, the rate of cesarean delivery continues to increase worldwide (Abdel Jalil et al.2017). However, cesarean section is considered to be a clean-contaminated procedure and one of the most important risk factors for postpartum infection, with a global infection range of 2.5%–20.5% (Conroy et al.2012), the risk of infections is 5–20-fold higher for women who have a cesarean delivery than for vaginal births (Van Schalkwyk and Van Eyk 2017). Good surgical technique is important for reducing infections. Additionally, guidelines of the American College of Obstetricians and Gynecologists (Committee on Practice Bulletins-Obstetrics 2018) recommend that the use of prophylactic antibiotics before cesarean section to reduce postoperative endometritis, wound infection, fever and severe infectious complications including pelvic abscess, bacteremia and sepsis, these more serious complications can lead to maternal deaths. Prophylactic antibiotics can decrease the risk of postoperative infections by >50% (Lamont et al.2011). However, antibiotics can have adverse effects on the mother and infant. Antibiotics administered to women during delivery may have a direct impact on the offspring’s microbiota and interfere with the development of the infant’s immune system (Mutic et al.2017, Stinson et al.2018). Therefore, the selection of effective and safe prophylactic antibiotics is particularly important.
The effect of pregnant women’s health-seeking behavior and preference for mode of birth on pregnancy distress during the COVID-19 pandemic
Published in Health Care for Women International, 2023
Songül Aktaş, Ruveyde Aydın, Dilek Kaloğlu Binici
In this study, more than half of the pregnant women (54.99%) emphasized that giving birth during the pandemic would create difficulties for them, and they would like to be informed about which mode of birth (vaginal/cesarean section) is beneficial for the health of the “fetus/newborn” (%24.7) and “pregnant women” (33%) (Table 2). Aydın and Aktaş (2021) and Chivers et al. (2020) explained that some pregnant women wanted to be informed about birth by health professionals, and they preferred home birthing due to fear of virus transmission. In this study, 11.3% of the pregnant women changed their preference of a mode of birth due to the pandemic (from vaginal to cesarean or from cesarean to vaginal), and 12% of them did not decide. Yassa et al. (2020) examined the birth mode preferences during the COVID-19 pandemic and noted that 55.2% did not change their decisions, 18% of them thought to change, 26.7% “did not decide”. In Yassa’s (2020) study, the reason for changing the birth mode and the indecisive percentage of pregnant women is different from our study may be because the study was conducted when the pandemic was first declared in the world, and there were more uncertainties and concerns about the virus in pregnant women in that period.
Visual estimation of blood loss versus quantitative blood loss for maternal outcomes related to obstetrical hemorrhage
Published in Baylor University Medical Center Proceedings, 2023
Michael Ayala, Vikas Nookala, Joshua Fogel, Mary Fatehi
EBL is a visual estimated measurement of intrapartum blood loss recorded by the physician after delivery. QBL is a quantitative measurement of intrapartum blood loss performed after delivery and recorded by labor and delivery nurses. QBL is calculated by adding all sources of collected blood including (1) all wet lap pads, towels, and canisters that were used during a delivery, weighed and subtracted from their dry weight with the assumption that 1 g is equivalent to 1 mL; (2) a gravimetric buttocks drape that is placed under every delivering patient including the amount of blood in the drape prior to delivery of the placenta subtracted from the total volume after delivery of the placenta. During cesarean section delivery, the same process is performed. However, in lieu of a buttock drape, the volume of blood in suction canisters is recorded prior to amniotomy and subtracted from the volume at the end of the delivery. Postpartum blood loss is collected in similar fashion from the time of delivery through hospital discharge and added for a cumulative EBL and QBL.