China
Africa
Explore chapters and articles related to this topic
Cesarean Delivery
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Meike Schuster
A meta-analysis of 4694 women showed that manual removal of the placenta is associated with greater morbidity than spontaneous expulsion with gentle cord traction: Increased endometritis (RR 1.64, 95% CI 1.42, 1.90) and PPH (RR 1.81, 95% CI 1.44, 2.28), greater blood loss (by 94 mL), and decreased hematocrit after delivery (by 1.6%) [211]; these findings were confirmed by a more recent RCT [212]. Therefore, gentle cord traction resulting in spontaneous expulsion should be utilized for delivery of the placenta, given the significant decrease in blood loss and endometritis as compared to manual placental removal. Less intraabdominal hemorrhagic fluid was noted with extraabdominal placental removal as compared to intraabdominal removal, though intraoperative blood loss, infectious morbidity, and pain did not differ [213]. In summary, gentle cord traction resulting in spontaneous placental expulsion is recommended.
Cesarean Section in the Setting of Fibroid Uterus and Cesarean Myomectomy
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Andrea Tinelli, Marina Vinciguerra, Antonio Malvasi, Michael Stark
Unlike Hatırnaz Ş. et al., the transendometrial CM technique, described by Huang SY et al., principally differs in extraction of the myoma without its pseudocapsule, which is therefore preserved according to the reasons mentioned above. In addition the use of an infusion of 30 IU of oxytocin in 500 ml of dextrose at a rate of 60 mL/h in combination with uterine compression is mentioned and bi-manual massage after placental expulsion is done in order to promote uterine contraction and hemostasis, while the lower uterine segment incision is sutured only after the EM [97].
Miscellaneous
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The most probable reasons are noted below. Classic reason is a high spinal block – sensory block higher than T4 due to the blocking of the sympathetic cardio accelerator fibres to the heart (T1–T4). This can cause severe bradycardia which if not treated can lead to asystole.Reflex bradycardia due to the use of vasopressors (phenylephrine) to maintain the feto-placental circulationReflex cardiovascular depression due to decrease in venous return, known as Bezold–Jarisch reflex or neurocardiogenic syncopeSevere reflex bradycardia has been supported in case studies during the time of placental expulsion and tractionManipulation of the abdominal viscera, peritoneum or traction of the visceral ligaments, uterine exteriorisation and inversionPatient with pre-existing cardiac disease such as sick-sinus syndrome can also have bradycardia
Comparative evaluation of normal saline, 1/3-2/3, and ringer's lactate infusion on labour outcome, PH, bilirubin, and glucose level of the umbilical cord blood in nulliparous women with labour induction: a randomised clinical trial
Published in Journal of Obstetrics and Gynaecology, 2022
Ladan Haghighi, Fatemeh Jahanshahi, Mojgan Mokhtari, Zahra Rampisheh, Mina Momeni
Childbirth is one of the prominent health indicators in any country, with profound psychological, social and emotional consequences for the mother and her family (Marshall and Raynor 2014). Childbirth consists of four stages. The first stage of labour can also be divided into two phases of latent and active. The first stage begins with the onset of uterine contractions, which are sufficient in number, intensity, and duration and ends with the completion of cervical dilatation (10 cm). Upon completion of the cervical dilatation, the foetus is delivered as the next stage. The third stage begins immediately after foetal delivery and ends with placental expulsion. Finally, the fourth stage of labour refers to the first two hours after placental expulsion. In the process of childbirth, the four factors of uterine contractile force, pelvic position, foetal situation, and mental condition of the mother are actively participating. Several factors, including maternal anxiety, fatigue, therapeutic interventions, obesity, abnormal foetal presentation, and epidural analgesia, cause prolongation of labour (Hutchison et al. 2020). Prolonged labour is the most common reason for a planned shift to caesarean section and the cause of 8% of maternal mortality in developing countries (Kubli et al. 2002). Therefore, detecting abnormal labour progress and controlling the potential complications can effectively prevent neonatal and maternal mortality and morbidity. To this end, proper methods and approaches with the least side effects are required to avoid prolonged labour (Tranmer et al. 2005).
Epidemiology of Oxytocin Administration in Out-of-Hospital Births Attended by Paramedics
Published in Prehospital Emergency Care, 2021
Brendan V. Schultz, Shonel Hall, Lachlan Parker, Stephen Rashford, Emma Bosley
There were no documented adverse events or side effects following oxytocin administration during the study period. Following oxytocin administration patients were observed for a median period of 35 minutes while being conveyed to hospital for definitive care. The median interval from time of birth to the administration of oxytocin across all OOH births was 14 minutes (interquartile range 9-25). Births that occurred in the presence of a paramedic were found to have a significantly shorter time to administration than births that occurred prior to ambulance arrival (9 vs 14 minutes; p < 0.001) (Table 3). In patients administered oxytocin for the MAMTSL, placental expulsion occurred prehospitally in 72 patients (37.5%), with a median time from oxytocin administration to placenta delivery of 10 minutes (interquartile range 5–22).