Academic literature on the topic 'Cesarean section Victoria'

Objective: It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Design: Cross-sectional comparative study. Place and Duration of Study: Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. Patients and Method: The study was carried out on all Primigravida with breech presentation reported through emergency in labour deliveredvaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. Results: It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 incesarean group. Respiratory distress syndrome is more in cesarean (4.4%) than vaginal group (2.2%). Observed neonatal trauma is more in vaginal group (6.7%) than cesarean section (2.2%). Conclusion: Neonatal morbidity appears to be more in vaginal breech delivery than cesarean section for Primigravida with breech presentation at term.

Objective: To compare the fetal outcome of elective cesarean section with elective vaginal birth for Term Breechpresentation in terms of APGAR Score, Respiratory Distress Syndrome, Admission in Neonatology Unit and Neonatal mortality. Design:Quasi experimental study. Setting: Department of Obstetrics & Gynaecololgy Bahawal Victoria Hospital, Bahawalpur. Methods: Total 120cases were included in the study divided into two groups, each having 60 fulfilling the inclusion criteria. Group 'A' had those who deliveredby planned cesarean and Group 'B' comprised those having planned vaginal delivery. Results: It was found that neonatal mortality was3.33 in vaginal and 0 in cesarean group. Mean APGAR Score at 1 and 5 minute was 8.47 and 9.53 in vaginal and 8.58 and 9.62 incesarean group. RDS was more in cesarean (5) than vaginal group (1.6). Admission in Neonatalogy Unit was more in vaginally deliveredgroup (8.33) as compared to the cesarean section group (5). Conclusion: Planned cesarean delivery in breech presentation at term isassociated with a reduction in neonatal mortality and morbidity as compared to the planned vaginal birth.

Objectives: To compare the frequency of wound infection between subcuticular stitches versus interrupted mattress sutures after cesarean section. Setting: Obstetrics & Gynecology Department, Bahawal Victoria Hospital, Bahawalpur. Study duration: 21st July 2019 to 20th December 2020 Study design: Randomized controlled Clinical trial Materials & Methods: In this clinical trial study, A sum-total of 60 women, 18-40 yrs of age, scheduled for planned elective cesarean section through Pfannenstiel incision were enrolled. In Group I women, subcuticular sutures were placed while in group II women, interrupted mattress sutures were placed. All women were discharged on tablet Augmentin 1gram x twice a day for 7 days at which wound infection was noted. Results: The mean age of women in group I was 27.60 ± 5.16 years and was 27.40 ± 3.99 years in group II. My study has shown the wound infection in group I (sub-cuticular stitches) as 01 (3.33%) and in group II (interrupted mattress sutures) as 08 (26.67%) respectively with p-value of 0.011. Conclusion: The inference from my study shows that the wound infection after cesarean section is less after sub cuticular stitches as compared to interrupted mattress sutures. Keywords: cesarean section, sub cuticular stitches, wound infectio

Background.The Victorian Hospital Acquired Infection Surveillance System (VICNISS) hospital-acquired infection surveillance system was established in 2002 in Victoria, Australia, and collates surgical site infection (SSI) surveillance data from public hospitals in Australia.Objective.To evaluate the association between the US National Nosocomial Infections Surveillance (NNIS) system's risk index and SSI rates for 7 surgical procedures.Methods.SSI surveillance was performed with NNIS definitions and methods for surgical procedures performed between November 2002 and September 2004. Correlations were assessed using the Goodman-Kruskal γ statistic.Results.Data were submitted for the following numbers of procedures: appendectomy, 545; coronary artery bypass graft (CABG), 4,632; cholecystectomy, 1,001; colon surgery, 623; cesarean section, 4,857; hip arthroplasty, 3,825; and knee arthroplasty, 2,416. NNIS risk index and increasing SSI rate were moderately well correlated for appendectomy (γ = 0.55), colon surgery (γ = 0.48), and cesarean section (γ = 0.42). A fairly positive correlation was found for cholecystectomy (γ = 0.17), hip arthroplasty (γ = 0.2), and knee arthroplasty (γ = 0.16). However, for CABG surgery, a poor association was found (γ = 0.02).Conclusions.The NNIS risk index was positively correlated with an increasing SSI rate for all 7 procedures; the strongest correlation was found for appendectomy, cesarean section, and colon surgery, and the poorest correlation was found for CABG surgery. We believe that risk stratification with the NNIS risk index is appropriate for comparison of data for most procedures and superior to use of no risk adjustment. However, for some procedures, particularly CABG, further studies of alternative risk indexes are needed to better stratify patients.

Objectives: Determination of the relationship among the peritoneal adhesions, cesarean scar and striae gravidarum. Study Design: Cross sectional Study. Settings: Gynecology and Obstetrics Department of Bahawal Victoria Hospital, Bahawalpur. Period: June 2018 to May 2018. Material & Methods: A total of 150 cases of cesarean section which presented at gynecology and obstetrics department of Bahawal Victoria Hospital, Bahawalpur were involved in this study. Davey scoring system was applied in order to determine the severity of striae gravidarum. Intraperitoneal adhesions were classified into five subcategories on the basis of Modified Blauer classification. Grouping was done on the random basis. Three groups were made. Group 1 consisted of the women with no striae gravidarum, group 2 had women with number of striae gravidarum from mild to moderate and group 3 had women of severe number of striae gravidarum. Comparison between different groups was done using the Mann-Whitney and student T test. Mean and standard deviation were calculated for quantitative variables while qualitative variables were assessed by their frequency and percentage. Statistically significant P value was 0.05 or less. Results: Intraperitoneal adhesions of grade 2-4, pigmentations and keliods were frequent in group 2 and 3 but the difference between these groups was not statistically significant (p-value 0.517, 0.427 and 0.372, respectively). There was no difference present among the group regarding the appearance of scar as well (p=0.541). As far as the length and width of the scar was concerned, the length was relatively more in patients of group 3 while width was relatively more in patients of group 1 but there were no statistically significant differences (Table-II) (p=0.289 and p=0.248 respectively). Conclusion: It can be concluded that there is no association between intraperitoneal adhesions and striae gravidarum but correlation between scar characteristics and striae gravidarum are evident.

Objective: The objective of this study is to evaluate diagnostic performance of total bile acids and transaminases in intrahepatic cholestasis of pregnancy (ICP). Material and Methods: This observational cross-sectional study was conducted at Gynecology & Obstetrics ward, Bahawal Victoria Hospital and Pathology Laboratory of Quaid-e-Azam Medical College, Bahawalpur. Thirty pregnant females with intrahepatic cholestasis of pregnancy were included in the study. Thirty age, parity and gestational age matched controls were selected. Total bile acids and alanine transaminases (ALT) were measured in each study subject. Results: The sensitivity and specificity for both total bile acids and ALT were calculated. Our study results showed a comparable sensitivity and specificity for both tests in patients with ICP. The rise in bile acids and ALT was statistically significant in ICP. The level of transaminases increased in proportion to total bile acids. Also, our study found an increased risk of preterm delivery, low birth weight and delivery by cesarean section in patients with ICP. Conclusion: It is concluded that ALT can be used alternatively to total bile acids for the diagnosis of intrahepatic cholestasis of jaundice. Total bile acids are expensive and only a few laboratories in Pakistan are offering this service, making its access limited to general population. Whereas ALT is a cost effective and common test, its results are readily available with an additional benefit that no fasting sample is required. Hence, it is a more appropriate diagnostic test for ICP in our resource constraint setup. Key Words: Bile acids, Liver enzymes, Cholestasis, Pregnancy, Aminotransaminase

Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches.The objective: to identify antenatal factors that correlate with perinatal losses, by conducting a retrospective cohort study of women at high perinatal risk, to build a multifactorial prognostic model of adverse pregnancy outcomes.Materials and methods. A retrospective cohort study was conducted from 2014 to 2016 on the basis of the medical center LLC «Uniclinic», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 2154 medical cards of pregnant women from the group of high perinatal risk were selected and analyzed. Of these, 782 pregnant women were included in the final protocol after verification of compliance with the criteria.Results. Cesarean delivery occurred in 115 cases (14.7%). In 50 cases (6.4%) the caesarean section was performed in a planned manner, in 65 (8.3%) – in an emergency. In 39 (5%) cases, the indication for surgical delivery was acute fetal distress. Antenatal fetal death occurred in 11 (1.4%) cases: one case in terms of <34 weeks and <37 weeks of gestation, the remaining 9 cases – in terms of> 37 weeks. Intranatal death of two fetuses (0.3%) was due to acute asphyxia on the background of placental insufficiency. In the early neonatal period, 14 (1.8%) newborns died. Hospitalization of the newborn to the intensive care unit for the first 7 days was registered in 64 (8.2%) cases.The need for mechanical ventilation was stated in 3.96% (31/782) of newborns. The method of construction and analysis of multifactor models of logistic regression was used in the analysis of the relationship between the risk of perinatal losses (antenatal death, intranatal death, early neonatal death) and factor characteristics.Conclusion. Signs associated with the risk of perinatal loss: the presence of chronic hypertension, preeclampsia in previous pregnancies, type of fertilization (natural or artificial), the concentration of PAPP-A (MoM), the concentration of free β-HCG (MoM) in the second trimester, average PI in the uterine arteries in 28–30 weeks of pregnancy, PI in the middle cerebral arteries in 28–30 weeks of pregnancy, episodes of low fetal heart rate variability in the third trimester of pregnancy, episodes of high fetal heart rate variability in the third trimester of pregnancy. The model, built on selected features, allows with a sensitivity of 73.1% (95% CI: 52.2% – 88.4%) and a specificity of 72.7% (95% CI: 69.3% – 75.9%) to predict risk perinatal loss.

Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches. The objective: сomparison of pregnancy results in the high perinatal risk group using the proposed monitoring algorithms and the traditional method of management in a prospective cohort study. Materials and methods. The prospective cohort study was conducted from 2016 to 2018 on the basis of the medical center LLC «Uniclinica», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 580 women were included in the final analysis. Exclusion criteria were: low risk (0–2) according to the adapted antenatal risk scale (Alberta perinatal health program), multiple pregnancy, critical malformations and chromosomal abnormalities of the fetus, lack of complete information about the outcome of pregnancy, lack of results of all intermediate clinical and laboratory surveys. Results. The introduction of a comprehensive differentiated approach has improved the diagnosis of late forms of growth retardation (OR 4,14 [1.42–12.09]; p=0,009), reduced the frequency of urgent cesarean sections (OR 1,61 [1,03–2,49]; p=0,046) and reduced perinatal mortality [1,09–21,3]; р=0,041) due to reduction of antenatal losses (OR 2,2 [1,06–4,378]; р=0,045). There was a significant increase in the frequency of planned cesarean sections (p<0,0001, without affecting the total number of operative deliveries) and statistically insignificant, but tendentiously clear shifts to the increase in the frequency of preterm birth between 34–37 weeks of pregnancy and intensive care unit. The latter observation can be explained by better diagnosis of threatening fetal conditions and an increase in the frequency of active obstetric tactics, which in turn affects the number of premature infants, the involvement of the neonatal service, and thus the intensification of the load on intensive. Conclusions. Adequate enhanced monitoring should combine ultrasound, cardiotocography, actography and laboratory techniques, each of which will have a clearly defined purpose in a combined approach to fetal assessment.

Cesarean section is the most commonly performed abdominal operations on women worldwide. Its rate has increased markedly in recent years in most developed countries. Due to insufficient available data regarding the best suture materials for cesarean skin closure, we conducted a study “to compare the efficacy of 2 suture materials non absorbable prolene 2-0 and absorbable suture vicryl (2-0), brand Ethicon as subcuticular skin stitches in women undergoing elective cesarean section. Study Design: Prospective, observational study. Setting: Department of Obstetrics and Gynecology, Bahawal Victoria Hospital Bahawalpur. Period: 6 months. Materials and Methods: A total of 200 women fulfilling inclusion and exclusion criteria as above were enrolled for the present study. They were divided into 2 groups of 100 each by systematic sampling technique. Results: There is statistically significant difference related to post-operative wound complication parameters between non absorbable vs absorbable suture material on day 8, 15, 30 and 45. More number of patients having absorbable suture had pain, tenderness swelling and indurations. Maximum number of participants, that is, 86 (86%) and 93 (93%) from Group 1 showed excellent wound healing at day 30 and day 45 of caesarean section as compared to 63 (63%) and 66 (68%) from Group 2. Conclusion: The non-absorbable suture (prolene) was better in terms of wound healing and cosmesis as compared to absorbable suture used in our study (vicryl).