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At least 1,261 records · Page 70Linked to original sources
PubMed2006

Induction of labour with previous caesarean delivery: where do we stand?

PURPOSE OF REVIEW: This paper reviews the literature to elucidate the international stance on induction of labour in women with previous caesarean section. RECENT FINDINGS: There is no evidence to suggest that current induction methods are less effective in women with previous caesarean section. It would, therefore, seem logical to use the same regimens as for women with intact uteri, including prostaglandins, particularly in women with unfavourable cervices. The clinical decision making and counselling, however, will always focus on safety, not effectiveness. There is no question that induction of labour is associated with higher risk of uterine rupture, but quantifying this risk remains elusive. SUMMARY: For the present, we will continue our practice, based on the sources of the best evidence available. Improvements in obstetric care have not only reduced the risks associated with uterine rupture but also risks associated with caesarean section. Therefore, both elective caesarean section and induction of labour, with or without prostaglandins, are reasonable choices for women who need induction with previous caesarean section. The efforts to better quantify the benefits/risks of various policies and regimens should continue, but should be complemented with qualitative studies to obtain crucial insight into the demands and challenges confronting women and clinicians to identify factors influencing their decision-making or their preferences.

Cesarean Section↗
PubMed1983

Hypotension during epidural analgesia for Caesarean section. Arterial and central venous pressure changes after acute intravenous loading with two litres of Hartmann's solution.

The incidence of hypotension occurring in women undergoing Caesarean section with epidural analgesia was investigated in 60 patients receiving an intravenous preload of two litres Hartmann's solution. Hypotension occurred in only 6.7% of patients. Central venous pressure measurements in 20 patients confirmed the safety of the technique. A comparison is made with other preloading techniques.

Anesthesia, Epidural↗
PubMed1988

Vaginal delivery after caesarean section: is it safe in a developing country?

Many studies from developed countries have shown that a trial of vaginal delivery after a Caesarean section can be a safe alternative to repeated Caesarean section when certain criteria are fulfilled. However, few data are available from developing countries where, in most cases, there is no electronic fetal heart rate monitoring, no information about the prior section and no X-ray pelvimetry. At Gweru Hospital, 401 patients with a scarred uterus have been managed according to a standard protocol and 288 were allowed to have a trial of scar. The results show that the trial was successful in 235 mothers (82%) and there were only 2 uterine ruptures (0.7%). Postpartum morbidity was higher after Caesarean section than after vaginal delivery.

Adult↗
PubMed1997

Trial of scar.

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Cesarean Section, Repeat↗
PubMed1999

[Ureteral iatrogenic disease of obstetric-gynecologic origin].

OBJECTIVE: To review our experience in the diagnosis and management of ureteral injuries secondary to obstetric and gynecologic procedures. METHODS: During the last 25 years, 42 patients were treated at our center for iatrogenic ureteral injuries (45 renal units) associated with obstetric and gynecologic procedures, principally hysterectomy via the abdominal approach (29 cases). The injury was diagnosed in the immediate postoperative period in 21 of the 42 cases. Surgical management was frequently by ureteroneocystostomy. Patient follow-up ranged from 3 months to 11 years. RESULTS: Good results were obtained in 83.3% of the cases. CONCLUSIONS: Ureteral injuries detected intraoperatively should be immediately repaired. For those diagnosed postoperatively, management by retrograde or antegrade catheterization and/or US or CT-guided percutaneous nephrostomy should be attempted before performing surgery.

Adult↗
PubMed1951

Obstetric shock.

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Female↗
PubMed1989

Vaginal birth after cesarean section: is suspected fetal macrosomia a contraindication?

The American College of Obstetricians and Gynecologists' "Guidelines for vaginal delivery after a previous cesarean birth" include a precautionary statement regarding estimated fetal weight of more than 4000 g. To evaluate the validity of this restriction, we conducted an analysis of the outcomes of 301 trials of labor with birth weights equal to or greater than 4000 g. In the birth-weight range of 4000-4499 g, 139 of 240 patients (58%) delivered vaginally. In the group with birth weights exceeding 4500 g, 26 of 61 patients (43%) delivered vaginally. When compared with 1475 trials of labor with birth weights under 4000 g, no significant differences in perinatal or maternal morbidity were found. Comparison with a control group of 301 women with no previous uterine surgery who delivered macrosomic infants also demonstrated no significant differences in perinatal or maternal morbidity. The medical literature does not support elective cesarean section for suspected fetal macrosomia in nondiabetic women, and based on our experience, there appears to be no reason for treating previous-cesarean mothers differently.

Birth Weight↗