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At least 19 recordsLinked to original sources
PubMed1979

The "intra-abdominal version technique" for delivery of transverse lie by low-segment cesarean section.

Cesarean section is the delivery method of choice in all shoulder presentations of viable fetuses. The classic cesarean section is usually recommended when there is a transverse lie because of the potential technical difficulties associated with extraction of the fetus when a low-segment incision is used. This paper illustrates a technique that avoids the need of a classic cesarean section and permits the use of the more desirable low-segment cesarean section. The advantages of the procedure are discussed.

Cesarean Section↗
PubMed1976

Elective cesarean hysterectomy: a 5 year comparison with cesarean section.

Elective cesarean sections performed on the obstetric service at the University of Arkansas Medical Center were reviewed for the period January 1, 1970, through December 31, 1974. The purpose of the review was to compare operative and postoperative complications of cesarean section, cesarean section and tubal ligation, and cesarean section and elective hysterectomy. A total of 1,255 cesarean sections were performed of which 207 (17 per cent) were associated with tubal ligation and 242 (18 per cent) with hysterectomy. Elective cesarean hysterectomies were performed for elective sterilization (68 per cent), for medically indicated sterilizations (11 per cent), or for definitive treatment of uterine pathology(21 per cent). All cesarean sections were obstetrically indicated with the exception of 34 primary cesarean hysterectomies performed as definitive treatment of carcinoma in situ of the cervix. The operative procedures were compared in regard to the following characteristics or complications: operating time; incidence of blood transfusions, urinary tract injuries, postoperative bleeding, febrile morbidity, and other postoperative complications; and postoperative hospital days.

Adolescent↗
PubMed1979

[Can we defend a 10 per cent rate of cesarean sections? Experiences with 2000 cesarean sections (ending)].

During a period of 13 years 2000 Caesarean sections were performed in a total of 20 584 deliveries. That means a frequency of 9,7%. Maternal mortality was zero. Maternal morbidity was 72% if one includes all minor complications. Counting only the major postoperative complications the morbidity in our Caesarean sections was not higher than 1%. Perinatal mortality was 2,2%. If one excludes all premature children and not viable malformations, a perinatal mortality of 0,65% results. Conditions for good results in mother and child after Caesarean section are: prospective management of delivery, consequent prenatal care, optimal supervision in the delivery room, favourable peri-operative circumstances, elective prophylaxis with antibiotics and elective prophylaxis against thromboembolism.

Anti-Bacterial Agents↗
PubMed1979

Modern indications for cesarean section.

Total cesarean section rates and rates of various indications for primary cesarean section were reviewed for four yearly periods during the past decade. The time periods studied were chosen to follow the introduction of new obstetric practices and technologic advances in monitoring fetal condition. The total cesarean section rate increased from 6.8% to 17.1% during this time. The most common indication for primary cesarean section was cephalopelvic disproportion, which represented approximately 40% of cases during each study period. Primary cesarean section for fetal distress increased to 28.2% but has decreased over the past 2 years to a present rate of 11.7%. Primary cesarean section for breech presentation increased from 12.3% to 21%. From the perspective of this review a total cesarean section rate of 15% is predicted for the future.

Cesarean Section↗
PubMed1992

[The status of the fetus delivered vaginally after a prior cesarean section and with a second cesarean section].

The author has set himself the task of studying the state of the fetus delivered vaginally after a previous caesarean operation and the state of the fetus delivered by a second caesarean operation. He has studied the state of 304 children vaginally delivered after a previous caesarean operation and 436 children delivered by a second caesarean operation as well as early neonatal death rate over a period of ten years (1980-1989). He has come to in the conclusion that the early neonatal death rate in the former group is not greater than that in the latter group.

Apgar Score↗
PubMed1978

Neurologic activity of infants following anesthesia for cesarean section.

Elective cesarean section was performed in a consecutive series of 30 patients with full-term pregnancies who were not in labor. Epidural (lidocaine, 1.5 per cent, with epinephrine, 1:200,000) and general anesthesia (thiopental, nitrous oxide-oxygen, succinylcholine infusion) was used alternately. Neonatal acid-base values and Apgar scores showed no significant difference between the two anesthetic groups, and most infants were vigorous at birth. The neurologic recoveries of the infants showed no significant difference between the two groups. In the group receiving epidural anesthesia, there was a significant correlation between maternal hypotension and weak rooting and sucking reflexes of the infants during the first two days. All infants of high-risk obstetric patients in the series, independent of anesthetic technique used, had abnormal neurologic activity, as evidenced by either depression of muscle tone and the reflexes or all the tested variables. Neurologic assessment as followed in this series is a sensitive indicator of the effects of fetal stress factors acting during cesarean section.

Adult↗
PubMed1976

Anesthesia for cesarean section III: effects of epidural analgesia on the respiratory adaptation of the newborn in elective cesarean section.

A rise in fetal Paco2 was observed after elective cesarean section in patients anesthetized both with a barbiturate and with nitrous oxide/oxygen. Epidural analgesia seemed to be a good alternative in order to attain better blood gas values in the newborn infant. Fourteen healthy mothers and their infants were studied in connection with elective cesarean section. Epidural analgesia with plain bupivacaine 0.75% was used. Doses varied between 90 and 120 mg. The time between the epidural injection and delivery was around 50 min. In six cases the fetal heart rate was registered continuously. Most of the mothers were sedated with diazepam intravenously or fully anesthetized, after delivery. The mothers were interviewed later. The respiratory adaptation of the infants was studied by blood gas and acid-base measurements in repeated arterial samples during the first 3 hours of life. A comparison was made with a group previously studied, where general anesthesia with a barbiturate, nitrous oxide/oxygen was the method used. The present material showed no differences concerning Pao2 and Paco2 but clearly indicated a tendency towards an earlier normalization of the initial metabolic acidosis. Mothers showed a respiratory alkalosis which was overcompensated by the metabolic component. Maternal blood pressure falls were observed in four cases, and fetal effects could be detected. Although epidural analgesia has a more favorable effect upon the newborn's metabolic component, both the compared methods allow good respiratory adaptation provided they are used correctly. Mothers can be given the opportunity to choose between being conscious or asleep when their child is delivered.

Adaptation, Physiological↗
PubMed1975

Anesthesia for cesarean section II: effects of the induction-delivery interval on the respiratory adaptation of the newborn in elective cesarean section.

Ten healthy mothers and their infants were studied in connection with elective cesarean section. Anesthesia was induced with 250-300 mg hexobarbitone followed by 100 mg succinylcholine for endotracheal intubation. The surgeon started the operation when the eyelid reflex disappeared, and delivered the baby as quickly as possible. Mean induction-delivery (I-D) interval was 2 min 45 s. Anesthesia was then deepened with further barbiturate, diazepam and methoxyflurane, and alcuronium used as muscle relaxant. The respiratory adaptation of the infant was studied by blood gas and acid-base measurements in repeated arterial samples during the first three hours of life. The mothers were interviewed after 3-12 months. A comparison was made with another barbiturate group with a longer I-D interval (x = 9 min 10 s). The present material showed initially higher PaO2 lower PaCO2, higher pH and less base deficit (BD), which relfected the maternal state at delivery. After 10-30 min, the results approached equivalence, though the babies in the short I-D group showed a tendency toward normalization of metabolic acidosis earlier. At the interviews, two mothers complained of pain during skin incision, and two of nightmares. Anesthesia with barbiturate for cesarean section with the I-D intervals studied in both groups allowed good respiratory adaptation in the infants. There is, neverless, the need for an adequate period of time between induction and the start of the operation in order to minimize the risk for maternal awareness.

Adolescent↗
PubMed1976

Anesthesia for cesarean section IV: placental transfer and neonatal elimination of bupivacaine following epidural analgesia for elective cesarean section.

Epidural analgesia with bupivacaine was used for elective cesarean section, and repeated maternal and neonatal blood samples were collected over 24 h for calculation of drug concentration. A gas-chromatogrphic micro-method was used for the analysis. The aim of this investigation was to evaluate the placental transfer and the elimination rate of the drug. No signs of systemic toxicity were observed in any mother or child, despite relatively high blood concentrations. The fetal-maternal ratio of concentrations at delivery was higher than in previous studies, most probably due to the protein-binding characteristics of bupivacaine and the dosage used. The biological half-life of the rapid phase of elimination (alpha-phase) in the newborn was shorter than in the mother (P less than 0.002), indicating a more rapid distribution process. The half-life of the slow phase of elimination (beta-phase) in the newborn was of the same magnitude as in the mother, indicating that neonatal elimination processes of bupivacaine may be well developed at birth.

Adult↗
PubMed1992

[Cesarean section: descriptive epidemiology. Increase in frequency of indications for cesarean section].

The use of caesarean section is constantly increasing in all countries of the western world. This article considers various aspects of the phenomenon, from the most frequent justifications for the increase in caesarean sections, to the consequences of this practise on the health of the mother and of the fetus/newborn infant. The often-suggested link between the increase in the number of caesarean births and the decrease of the perinatal mortality rate is also discussed. The caesarean section is potentially capable of offering large benefits, but at the same time is not without risk for the mother and the child. In order to reduce this risk meticulous attention must be paid to the anesthesiological and surgical techniques employed and surgery must be used only when absolutely necessary.

Adolescent↗
PubMed1976

Anesthesia for cesarean section V: effects of enflurane anesthesia on the respiratory adaptation of the newborn in elective cesarean section.

The new anesthetic inhalation agent, enflurane, is supposed to allow rapid induction and recovery. Experinece with this agent in obstetrics is limited. Enflurane was therefore studied in 14 pregnant women undergoing elective cesarean section. Its effects upon the respiratory adaptation of the newborn infants were followed during the first 3 hours, as judged by oxygen tensions and acid-base balance measurements in serial neonatal arterial samples. Results were compared with those from a previously studied group of women anesthetized with a barbiturate and nitrous oxide-oxygen. There were no differences with respect to oxygen tension. Carbon dioxide values in the enflurane group were higher than those in the barbiturate group. In comparison with the barbiturate group the enflurane group of babies had lower BD values, which is a sign of a better metabolic state post-partum. Mothers anesthetized with enflurane were satisfied with the method, especially for the post-operative period.

Adaptation, Physiological↗
PubMedDate not supplied

[Comparison of the rate of complications after primary, secondary and emergency Cesarean section].

3799 women delivered by cesarean section at the Department of Obstetrics and Gynaecology of the University of Ulm between 1978 and 1988 were retrospectively divided into three groups, according to the urgency of cesarean section: group [1]: elective cesarean section (n = 1333), group [2]: urgent cesarean section (n = 2295), group [3]: emergency cesarean section (n = 171). Group [1] comprised the greatest risk in terms of maternal diseases, pregnancy complications and previous cesarean sections, group [2] the least. Intraoperative complications were seen more often in group [3] than in groups [1] and [2] and included a greater number of operations lasting more than 2 hours (group [3]: 2.3%, group [1] and [2]: < or = 0.5%), a higher incidence of severe blood loss and consequent need for blood transfusions, and of serious complications such as damage to adjacent organs and need for hysterectomy (group [3] 4.7%, groups [1] and [2]: 1.6%). In group [3] the rate of postoperative complications, especially of infections, was unexpectedly low (e.g. fever > 38 degrees C in group [1]: 8.6%, group [2]: 11.5%, and in group [3]: 9.9%). This was not only explainable by more frequent prophylactic use, in group [3], of antibiotics whose efficacy in reducing infections was demonstrated. Altogether five patients died, two deaths, both in group [2], were directly related to cesarean section. Between 1978 and 1988 an increasing incidence of low birth weight infants was found in all groups, with the highest rate in group [3].(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Bladder injuries associated with cesarean section.

Bladder injury during cesarean section is unusual and may occur by failure to empty the bladder preoperatively, inadequate bladder flap reflection or incision into the vagina rather than the lower uterine segment. Three bladder injuries during cesarean section are reported. Although 2 women recovered normally 1 has persistent vesicoureteral reflux. With liberalization of indications for cesarean section bladder injuries may be seen more frequently.

Adult↗
PubMed1992

[Vaginal delivery after previous cesarean section].

Data concerning frequency of cesarean section as well as frequency of vaginal delivery after cesarean section in Poznań region in years 1990-1991 were presented. During last years we observed significant increase of spontaneous deliveries after cesarean section. The indications for the previous cesarean section and the outcome of the present pregnancy are discussed.

Cesarean Section↗
PubMed1979

Cesarean section in California--1960 through 1975.

The cesarean section rate has been rising in California since 1965. In this article, we describe the trend in cesarean section rates in California from 1960 to 1975 in relation to maternal and infant variables. Approximately proportionate increases in cesarean section rates by infant birth weight and maternal race were found. Cesarean section rates for women under 20 years of age and for those of first parity have risen proportionately more than rates for other age and parity groups. We also found that cesarean section rates for births at gestational age's exceeding 42 weeks have risen proportionately more than rates for births at other gestational ages. Maternal mortality ratios associated with cesarean section were twice those associated with noncesarean births for the years 1973, 1974, and 1975. Possible explanations of the current cesarean section rate include an increase in indications for the procedure, use of the fetal monitor, and the current medical-legal climate. The potential problems that cesarean section may create for the mother and infant are higher rates of iatrogenic prematurity and respiratory distress and of maternal morbidity and mortality.

Adult↗